Institution-based Case-control Study Research Articles

Determinants of macrosomia among newborns delivered in Jigjiga City, Eastern Ethiopia: a case-control study

BackgroundMacrosomia is a forgotten health problem that directly or indirectly affects maternal and neonatal health outcomes. There is a lack of evidence on the factors that affect macrosomia in eastern Ethiopia. This study aimed to assess the determinants of macrosomia among newborns delivered in Jigjiga City, Eastern Ethiopia.MethodsAn institutional-based case-control study was conducted among 82 cases and 164 controls in Jigjiga City from June 25 to August 24, 2023. Bivariable and multivariable logistic regression were used to identify the determinants of macrosomia. An adjusted odds ratio (AOR) with a 95% confidence interval was used to report the strength of the association, and the statistical significance was declared at a p-value < 0.05.ResultsThis study found that lack of preconception care (AOR = 2.48, 95% CI: 1.29, 4.76); post-term pregnancy (AOR = 2.90, 95% CI: 1.16, 7.28); inadequate physical activity (AOR = 3.52, 95% CI: 1.55, 7.98), having previous macrosomia (AOR = 4.52, 95% CI: 2.18, 9.36), and gestational diabetic mellitus (AOR = 2.58, 95% CI: 1.10, 6.28) were the main risk factors of macrosomia.ConclusionThis study indicated that failed utilization of preconception care, inadequate physical activity during pregnancy, post-term pregnancy, gestational diabetic mellitus, and having previous macrosomia were the risk factors for fetal macrosomia. Encouraging women to utilize reproductive health services and providing special care for high-risk mothers are essential to reducing and preventing the level of fetal macrosomia and its consequences.

Determinants of feto-maternal outcomes of antepartum hemorrhage among women who gave birth in Awi zone public hospitals, Ethiopia. A case-control study.

Antepartum hemorrhage continues to be a major cause of maternal and perinatal morbidity and mortality in developing countries including Ethiopia and it complicates 2-5% of all pregnancies with an increased rate of maternal and perinatal morbidity and even mortality. Despite many activities, still, poor fetomaternal outcomes of antepartum hemorrhage are still there. Moreover, studies around the current study area emphasize the magnitude and associated factors for antepartum hemorrhage rather than its feto-maternal outcomes. Thus, there is a need to identify the determinants associated with the fetomaternal outcomes of antepartum hemorrhage to guide midwives and obstetricians in the early diagnosis and treatment. An institution-based case-control study was conducted in four-year delivery charts diagnosed with antepartum hemorrhage from April 2, 2022, to May 12, 2022, at Awi Zone public hospitals. To see the association between dependent and independent variables logistic regression model along with a 95% confidence interval (CI) and a p-value of <0.05 were used. No antenatal care follow-up (AOR: 2.5, 95% CI 1.49-4.2), rural residence (AOR: 1.706, 95%CI 1.09-2.66), delay to seek care >12 hours (AOR: 2.57, 95% CI: 1.57-4.23) and advanced maternal age (AOR: 3.43, 95% CI 1.784-6.59) were significant factors associated with feto-maternal outcomes of antepartum Hemorrhage. This study revealed that rural residence, delay in seeking the care of more than 12 hours, not having antenatal care follow up and advanced maternal age were significant factors associated with feto-maternal outcomes of Antepartum hemorrhage. The findings of our study suggest the need for health education about the importance of antenatal care follow-up which is the ideal entry point for health promotion and early detection of complications, especially for rural residents.

Determinants of low Apgar score among newborns delivered by Cesarean section in Nigist Eleni Mohammed memorial specialized hospital, Southern Ethiopia

A variety of factors can predispose newborns to have a low Apgar score after delivery. Identification of the determinants of low Apgar scores is an important first step to take to apply the necessary precautions. This study aimed to identify the determinants of low fifth-minute Apgar score after a Cesarean section. An institutional-based case–control study was conducted among mothers who deliver their newborns by Cesarean section in Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital, Ethiopia, from July 1, 2022, to September 30, 2022. Data were collected from 70 cases and 140 controls using a semi-structured checklist. A systematic random sampling technique was used to select both charts of mothers with cases and controls. Charts of mothers with newborns Apgar score less than 7 were considered as cases; whereas a similar group of charts of mothers with newborns with fifth-minute Apgar score greater than or equal to 7 were categorized as control. Descriptive statistics and bivariable and multivariable binary logistic regression analyses were conducted to describe the mothers and newborns and identify determinants of the fifth-minute low Apgar score, respectively. Adjusted odds ratios (AOR) with their respective 95% confidence interval (CI) were used to declare the determinant factors, and the statistical significance was set at P < 0.05. In total, 140 controls and 70 cases of mothers charts were enrolled in this study. The Mean ± SD age of mothers of cases and controls were 26.9 ± 4.9 and 27.06 ± 4.1 years, respectively. General anaesthesia (AOR = 4.2; 95% CI: 1.9 ‒ 9.3), rural residence (AOR = 3.7, 95% CI, 1.7‒8.1), low birth weight (AOR = 3.2, 95% CI, 1.3‒7.8), and emergency Cesarean section (AOR = 2.6; 95% CI: 1.2 ‒ 5.8) were identified determinant factors of low fifth minute Apgar score. A fifth-minute low Apgar score was significantly associated with newborns delivered through emergency Cesarean section, low birth weight, rural residence, and delivered from mothers who had undergone Cesarean section under general anaesthesia.

Determinants of Disability Among Individuals Living with Schizophrenia Attending Psychiatric Follow-Up Clinic in Jimma, Southwest Ethiopia: An Institution-Based Case-Control Study.

Disability due to schizophrenia ends up with a higher degree of impairment in occupational, social and interpersonal functioning than other chronic illnesses. Despite severe and long-lasting schizophrenia associated disability, little has been explored so far to identify determinants of disability among individuals living with schizophrenia in Ethiopia. To identify the determinants of disability among individuals living with schizophrenia attending the psychiatric follow-up clinic at Jimma Medical Center (JMC). An institution-based unmatched case-control study was conducted among 98 Cases and 98 controls of individuals living with schizophrenia attending the JMC psychiatric clinic from September 1 to October 30, 2022. Consecutive sampling technique was used to recruit the required sample size of both groups. The cases group were participants who scored >12 total on the WHO Disability Assessment Scale version 2-0 (WHODAS 2-0) whereas the control group were those who scored 12 total on the WHODAS 2-0. Being jobless (AOR = 2.29; 95% CI: 1.10-4.77), longer than 5-year duration of illness without treatment (AOR = 3.13; 95% CI: 1.23-7.98), poor social support (AOR = 2.54; 95% CI: 1.04-6.22), negative symptoms (AOR = 2.45; 95% CI: 1.14-5.29), known family history of mental illness (AOR = 3.59; 95%: 1.67-7.73) and risky khat use (AOR = 4.37; 95% CI: 1.86-10.29) were found to be determinants of disability among schizophrenia patients. Joblessness, longer than 5-year duration of illness without treatment, poor social support, negative symptoms, known family history of mental illness and risky khat use were found to be determinants of disability in schizophrenia patients. Interventions targeting reducing of disability and improving quality of life of schizophrenia patients should consider the aforementioned determinants.

Factors associated with low fifth minute Apgar score among newborns delivered at public health facilities of Dilla town, Southern Ethiopia, 2022

ObjectiveThe aim of this study is to identify the associated factors of low fifth minute Apgar scores among newborns in Dilla town public health facilities, southern Ethiopia. MethodsAn institution-based case-control study was conducted in Dilla town public health facilities, Southern Ethiopia. The case and control groups were newborns with fifth minute Apgar score of < 7 and ≥ 7, respectively. The study included 534 participants (178 cases and 356 controls). Data were collected through face-to-face interviews and record reviews. Consecutive and systematic random sampling was used to recruit cases and controls, respectively. Bivariate and multivariate analyses were performed. The degree of association between independent and dependent variables was assessed using adjusted odds ratios (ORs) with 95 % confidence intervals (CIs). Finally, variables with a p-value of < 0.05, were consider that had statistically significant. ResultsIn this study, No antenatal care follow-up [AOR = 1.74, 95 % CI: (1.12, 2.69)], instrumental mode of delivery [AOR = 2.11, 95 % CI: (1.25, 3.56)], non-vertex presentation [AOR = 6.54, 95 % CI: (2.92, 14.65)], prolonged second stage of labor [AOR = 5.63, 95 % CI: (2.45, 12.95)], and gestational hypertension [AOR = 0.45, 95 % CI: (0.22, 0.86)] were significantly associated with a low fifth minute Apgar score. ConclusionsThis study found that no antenatal care follow-up, instrumental mode of delivery, pregnancy-induced hypertension, prolonged second stage of labor, and non-vertex presentation were all independently associated with low fifth-minute Apgar scores. These findings suggest the need for improved maternal and neonatal care during pregnancy, delivery, and the postpartum period to reduce the risk of low Apgar scores and to improve newborn outcomes.

Determinants of pre-eclampsia among pregnant women attending antenatal care and delivery services at Bahir Dar public hospitals, northwest Ethiopia: A case-control study.

Pre-eclampsia (PE) is a pregnancy-related syndrome that occurs after 20 weeks of pregnancy. The current study was designed to evaluate the determinants of PE in pregnant women following antenatal and delivery services. An institution-based case-control study was performed in governmental hospitals of Bahir Dar city. The data were collected using an interview-administered questionnaire and analyzed by SPSS version 20 software. Bivariate and multivariable logistic regression models were utilized for the analysis of variables. A p < 0.05 was used to declare the level of significance. In this study, the mean ages (in years) of cases and controls were 28.20 ± 5.66 and 27.52 ± 4.70, respectively. Factors such as: being primiparous (adjusted odds ratio [AOR]: 3.19 at 95% confidence interval [CI]: 1.71, 5.97), family history of hypertension (HTN) (AOR: 4.14 at 95% CI: 1.71, 10.05), previous history of PE (AOR: 7.97 at 95% CI: 2.42, 26.63), number of antenatal care (ANC) visits (AOR: 5.43 at 95% CI: 2.86, 10.33), not taking iron and folic acid supplement (AOR: 4.46 at 95% CI: 1.59, 12.48), body mass index ≥25 kg/m2 (AOR: 3.47 at 95% CI: 1.78, 6.77), not consuming vegetables (AOR: 1.99 at 95% CI: 1.07, 3.69) and not consuming egg, milk and milk products (AOR: 3.00 at 95% CI: 1.47, 6.11) were the determinants of PE. In this study, different determinants of PE were identified. Hence, special attention should be given for primiparous women, women having previous history of PE and family history of HTN. Moreover, nutritional counseling should be given for pregnant women during ANC visits. Besides, higher officials should design an appropriate strategy to increase the number of mothers to complete their ANC visits and to take iron and folic acid supplements. Furthermore, to verify the determinants of PE, community-based cohort studies are warranted.

Association between iron-folic acid supplementation and pregnancy-induced hypertension among pregnant women in public hospitals, Wolaita Sodo, Ethiopia 2021: a case- control study

BackgroundPregnancy-induced hypertension is the new onset of high blood pressure after 20 weeks of gestation in women with previously normal blood pressure. To the best of our knowledge, no study has been conducted in our country to investigate the association between this pregnancy problem and iron-folic acid supplementation. The aim of this study was to determine the association between iron-folic acid supplementation and pregnancy-induced hypertension (PIH) in pregnant women at public hospitals in the Wolaita Sodo zone.MethodsAn institution-based case–control study was conducted among pregnant women who visited public hospitals in the Wolaita Sodo zone from March 3, 2022, to August 30, 2022. A consecutive sampling method was used to select the study participants. The total sample size was 492, of which 164 were cases and 328 were controls. The data were collected by conducting face-to-face interviews and measurements. The data were entered into EpiData version 4.6 and exported to STATA 14 for analysis. Those variables with a p-value less than 0.05 were considered statistically significant. Descriptive statistics and odds ratios were presented using texts, tables, and figures.ResultsA total of 471 women participated in this study, yielding a response rate of 96%. The cases had a mean age of 25 ± 4.43, while the controls had a mean age of 25 ± 3.99. The mean age at first pregnancy among cases was 20 ± 2.82 and among controls was 20 ± 2.97. The average number of deliveries for cases and controls was 1.97 ± 1.41 and 1.95 ± 1.38, respectively. There is no significant association between iron-folic acid supplementation and PIH. Pregnant women with high hemoglobin levels had higher odds of PIH as compared to those without it (AOR = 3.65; 95% CI: 1.0–12.9). Eating kocho (AOR = 14.4; 95% CI: 1.2–16.7) was positively associated with PIH.ConclusionsThere is no association between iron-folic acid supplementation during pregnancy and pregnancy-induced hypertension. Pregnant women with high hemoglobin levels had higher odds of PIH as compared to those without it. There is an association between kocho consumption and PIH. More research should be done using stronger designs.

Determinants of Child Nutritional Status in Debre Berhan Town, North Shewa Zone, Amhara Region, Ethiopia

The study examined the main Determinants of Child nutritional status in Debre Berhan Town, North Shewa Zone, Amhara Region, Ethiopia. It employed institution-based case control study design that used both descriptive and inferential approaches. A total of 603 randomly selected children under the age of five participated in the study. Among them 201 were malnourished (cases) and 402 were normal (controls). Data was collected using interviewer administered questionnaire, infant-meter, weight-scale and checklist. OLS regression model was used for the analyses the relation between child malnutrition statuses with its main determinants. From the given explanatory variables, Breast feeding, status of the child, residence, marital and educational status of mother, family size, mothers average working hours per day outside home, age of mother, age difference with husband, satisfaction of women on others supports and access to media showed statistically significant contributions to child nutritional status. Based on those finding our study recommends that to improve the nutritional status and alleviate the problem of malnutrition, there should be a lot to be done on improving the status of women through various empowering programs including education. Keywords: Child nutritional status, anthropometrics, Infant meter, OLS DOI: 10.7176/JESD/13-21-04 Publication date: November 30 th 2022

A Cross Sectional Study of Psychiatric Morbidity and Quality of Life in Vitiligo Patients

Introduction: Vitiligo is a chronic disorder of skin pigmentation caused by the selective destruction of melanocytes. It causes psychological distress and affects quality of life. Materials and method: An institution based case control study with 55 cases and 55 controls with vitiligo and without vitiligo was undertaken. They were assessed using the Vitiligo area severity index (VASI), Vitiligo Disease Activity Scoring (VDAS), Hamilton Depression Scale (HAMD) and Dermatology life quality index (DLQI). Results: In our study sample 29.1 % had vulgaris, 27.3 % had focal type of vitiligo, and 32.7 % had acro-facial vitiligo, 5.5 % mixed and 5.5 % segmental type of vitiligo was respectively seen. 76.4 % of the cases scored for mild depression and 16.4 % of the cases scored for moderate degree of depression. 23 (41.8 %) of the cases had mild degree of anxiety and 2 (3.6 %) had moderate degree of anxiety. Acro- facial and vulgaris group scored more for anxiety. Significant difference between two groups on WHO Quality of Life scale BREF and DLQI scores. Discussion: Psychiatric morbidity and Quality of Life was found to be significant in patient group with vitiligo than normal controls. There was a higher positive correlation between QOL and VASI scores, denoting the poor quality of life in patients attributable to the severity of the lesions. Conclusion: Psycho-dermatological services will help to mitigate the sufferings and improve the quality of life of patients with vitiligo.

DETERMINANTS OF PELVIC ORGAN PROLAPSE AMONG WOMEN VISITING ARBA MINCH, SAWLA AND JINKA GENERAL HOSPITALS, SOUTHERN ETHIOPIA

Background: Pelvic organ prolapse is one of the most common gynecological health problems; it can severely limit a woman's psychological, social, physical, and sexual function. The factors causing pelvic organ prolapse have been poorly understood. Therefore this study aimed to investigate the determinants of pelvic organ prolapse among women visiting Arba Minch, Sawla, and Jinka General Hospitals, Southern Ethiopia. Method: Institution-based case-control study was conducted from July 10 to August 31, 2020, in Arba Minch, Sawla, and Jinka general hospital. A total of 348 participants were included in the study. Cases and controls were identified by health professionals using the pelvic organ prolapse symptom score (POP-SS). Data was collected by using a pre-tested interviewer-administered questionnaire. Bivariate logistic regression was done to identify variables candidate for Multivariable logistic regression at p-value &lt;0.25. Multivariable logistic regression analysis was done and p-value &lt;0.05 and 95%CI of AOR were used to declare the level significance. Result: Age of the mother at first delivery (AOR=4, 95% CI: 1.48-11.53), carrying heavy object (AOR=2.8, 95% CI: 1.9-7.62), place of previous delivery (AOR=3.6, 95% CI: 1.37-9.47), mode of previous delivery (AOR=3, 95% CI: 1.73-8.44), family history of pelvic organ prolapse. (AOR=4, 95% CI: 1.63-11.2), body mass index (AOR=4, 95% CI: 1.82-12.9) and household food insecurity (AOR=3, 95% CI: 1.51-7.75) were identified as the determinants of pelvic organ prolapse. Conclusion: In this study age of the mother at first delivery, carrying a heavy object, place of previous delivery, mode of previous delivery, body mass index, family history of pelvic organ prolapse, and household food insecurity were factors found to be significantly associated with pelvic organ prolapse. Therefore, to prevent pelvic organ prolapse health care providers should counsel mothers for maintaining normal weight and skilled delivery. Also, women in the community should be screened for food insecurity and linked with the agriculture sector.

Women’s sexual autonomy as a determinant of cervical cancer screening uptake in Addis Ababa, Ethiopia: a case–control study

Cervical cancer (CC) is the fourth most common cancer in women worldwide and the leading cause of cancer deaths in developing countries. CC can be prevented through available preventive interventions. However, most patients in developing countries, such as Ethiopia, present late with advanced stage disease due to low participation in CC screening and require treatment involving multiple modalities. Women’s social, economic and cultural backgrounds have been associated with the level of participation in CC screening programmes. Therefore, this study aimed to assess women’s sexual autonomy as a determinant of lifetime CC screening among women in Addis Ababa, Ethiopia. An institutional-based case–control study was conducted in which controls were women who had received screening services during the last 5 years, and cases were randomly selected from women coming for other services but never screened or aware of the screening service. Accordingly, 294 women were enrolled. Data were collected by using a pre-tested standard questionnaire through interviewing. Bivariate and multivariable logistic regression analyses were performed to assess the women’s sexual autonomy as a determinant of lifetime CC screening. The study revealed higher sexual autonomy led to higher odds for having been screened (adjusted odds ratio (AOR) = 3.128, 95% CI (1.730, 5.658)). Moreover, direct referral to the screening service (AOR = 3.173, 95% CI (1.57, 6.45)) and parity had positively affected the lifetime uptake of CC screening (AOR = 2.844, 95% CI (1.344, 6.014)). We found that women’s own sexual autonomy was associated with the improvement of CC screening uptake. Empowering women could alleviate barriers to CC screening in the community.

Congenital Hydrocephalus and Associated Risk Factors: An Institution-Based Case-Control Study, Dessie Town, North East Ethiopia.

IntroductionCongenital hydrocephalus is one of the commonest congenital anomalies of the central nervous system. It is characterized by extensive accumulation of cerebrospinal fluid within the ventricles of the brain due to an imbalance between synthesis and absorption of cerebrospinal fluid. This study was planned to investigate the incidence and associated risk factors of congenital hydrocephalus.MethodsUnmatched case–control study was conducted in 34 (cases) and 104 (controls) pregnant women. Maternal data were collected from a structured questionnaire, and fetal-related data were recorded from obstetric ultrasound. Epi-info 7 and SPSS version 24 were used for data entry and analysis, respectively. The association between congenital hydrocephalus and risk factors was evaluated using binary logistic regression.ResultsThe incidence of congenital hydrocephalus was 2.67 per 1000 pregnancies. The result of multivariate logistic regression indicated that alcohol use and iron with folic acid supplementation during pregnancy were significantly associated with the development of congenital hydrocephalus (OR: 7.64, 95% CI: 1.97–29.66 and p-value: 0.003 and OR: 0.186, 95% CI: 0.07–0.49 and p-value: 0.001, respectively). Maternal exposure to typhus and typhoid and use of antibiotics during early pregnancy were also significantly associated with congenital hydrocephalus. Moreover, significant association was also observed between the simultaneous development of spina bifida and congenital hydrocephalus (p-value 0.03).ConclusionIn conclusion, alcohol consumption, unprescribed use of antibiotics and infection during pregnancy as well as absence of folic acid supplementation may predispose to congenital hydrocephalus.

Determinants of non-disclosure to sexual partner among human immune virus infected adults on anti-retroviral therapy follow-up care at North Shewa zone public hospitals in Oromia Region, Ethiopia

BackgroundHIV positive status non-disclosure to sexual partner remains a challenge for HIV prevention and control. It leads to poor adherence to antiretroviral treatment and a high risk of transmission. The purpose of this study was to assess the determinants of HIV-positive status non-disclosure to sexual partner. MethodsAn institutional based case control study was conducted among 378 (94 cases and 284 controls) HIV-infected adults on Follow-Up Care. For data entry and analysis, Epi data version 3.1 and SPSS version 25 was used. To identify factors associated with non-disclosure to sexual partner, bivariable and multivariable logistic regression analyses were performed. ResultA total of 369 study participants were interviewed (92 cases and 277 controls), yielding a response rate of 97.5 %. Male sex (AOR: 0.25, 95 % CI: 0.13–0.47), ART duration < 36 months (AOR: 2.13, 95 % CI: 1.14–4.01), WHO clinical staging one (AOR: 3.00, 95 % CI: 1.26–7.12), having more than one lifetime sexual partners (AOR: 0.46, 95 % CI: 0.22–0.95) and not seeing person publicly disclosed HIV status (AOR: 3.12, 95 % CI: 1.47–6.65) were determinants of non-disclosure to sexual partner. ConclusionMale sex, ART duration of < 36 months, WHO clinical staging one, having more than one lifetime sexual partner, and not seeing person publicly disclosed HIV status were determinantal to sexual partner disclosure. As a result, continuous HIV disclosure counseling is required for females, those in WHO clinical staging one, ART duration < 36 months, and those with only one lifetime sexual partner.

Diabetic Foot Ulcer Among Adults Attending Follow-Up Diabetes Clinics in Wolaita Zone, Southern Ethiopia: An Unmatched, Case-Control Study

BackgroundDiabetic foot ulcer is a major public health problem, and among the leading causes of this complication in Ethiopian patients with diabetes. Despite the magnitude of this problem, data regarding the determinants of diabetic foot ulcers are limited.ObjectiveThis study aimed to assess the determinants of diabetic foot ulcers among adults attending follow-up visits in diabetes clinics in the Wolaita Zone, southern Ethiopia.MethodsAn institution-based case-control study was done from September 10 to December 28, 2020, in southern Ethiopia. We recruited 137 patients with diabetic foot ulcers and 408 patients without any diabetic foot ulcers using a consecutive sampling method. EpiData version 3.1.1 (EpiData Association, Odense, Denmark) and SPSS version 25 (IBM-SPSS Inc, Armonk, New York) were used for data entry and analysis. Descriptive statistics were calculated followed by a multivariate logistic regression analysis.ResultsHaving a low wealth index (adjusted odds ratio [AOR] = 2.6; 95% CI, 1.177–5.662); being obese (AOR = 3.6; 95% CI, 1.380–9.547; P = 0.003), being overweight (AOR = 3.1; 95% CI, 1.480–6.436; P = 0.009), having peripheral neuropathy (AOR = 3.9; 95% CI, 1.641–9.430; P = 0.002), living with diabetes for >10 years (AOR = 2.3; 95% CI, 1.191–4.475; P = 0.013), and practicing poor diabetic foot self-care (AOR = 6.0; 95% CI, 3.156–11.312; P = 0.000) were significantly associated with having a diabetic foot ulcer.ConclusionsThis study suggests there is a need for education and counseling of patients on decreasing weight and improving foot-care practice, especially in those who are economically disadvantaged, have peripheral neuropathy, and have lived with diabetes for more than 10 years. (Curr Ther Res Clin Exp. 2022; 83:XXX–XXX)

Comparative Plasma Levels of Vitamin D in Women with or without Uterine Fibriods in Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

Background: Fibroids are commonest benign tumour of the uterus in reproductive age women. Surgical treatment has been the mainstay of treatment for symptomatic fibroids. Recently, hypovitamin D has been associated with fibroid. The aim of the study was to compare the level of vitamin D in women with fibroids and women without fibroids. Aim: To determine and compare plasma levels of Vitamin D in women with uterine fibroids and those without uterine fibroids Method: An institution based case control study comprising of 274 women. It compared the serum levels of 25 hydroxy vitamin D in 137 women with uterine fibroids and 137 women without uterine fibroids as controls. Result: The level of vitamin D in the women with and without uterine fibroids were {13.5ng /ml, (IQR 3.8 – 22.1)} and {52.1 ng/ml, (IQR 30.6 – 75.0)} (P = &lt; 0.001) respectively. Conclusion: The plasma level of 25-Hydoxy vitamin D was significantly lower in women with uterine fibroids and higher in women without fibroids. Subsequently, prompt detection of vitamin D deficiency by screening with effective treatment may reduce the incidence of fibroids and its sequelae in these group of women.

Determinants of uncontrolled asthma among adult asthmatic patients on follow-up at chest clinic of Jimma medical center: unmatched case-control study

Objective To identify the determinants of uncontrolled asthma among asthmatic patients on follow-up at Jimma Medical Center. Methods Institution-based case-control study was conducted on asthmatic patients who were on follow-up at the chest clinic of Jimma University Medical (JMC) from March to May 2020. A total of 59 cases and 118 controls (1: 2 ratio) were included in the study. Cases and controls were defined based on asthma control test (ACT) scores where those who had scores of ≤19 and above 19 were defined to be cases and controls, respectively. Results Age of the patients [AOR: 2.78; 95% CI: 1.14, 6.81], age of the cases’ residential houses [AOR: 3.65; 95% CI: 1.30, 10.28], presence of pets within the houses [AOR: 2.78; 95% CI: 1.29, 5.96], having rhinitis [AOR: 3.34; 95% CI: 1.17, 9.52], past asthma exacerbation [AOR: 2.38, 95% CI: 1.05, 5.40], non-adherence to treatment [AOR: 2.81; 95% CI: 1.30, 6.08] and smoking [AOR: 7.09; 95% CI: 1.84, 27.33] were found to be determinants of uncontrolled asthma. Conclusions Uncontrolled asthma results from multiple sociodemographic, environmental, clinical, and behavioral factors. Therefore, patients should be counseled on avoiding pets, maintenance of houses, adherence to treatment, quitting smoking, and early treatment-seeking for rhinitis and asthma exacerbation to improve asthma control comprehensively.

Risk Factors of Antepartum Hemorrhage Among Mothers Who Gave Birth at Suhul General Hospital, 2016: A Case-Control Study.

BackgroundAntepartum hemorrhage is a very serious problem and contributes significantly to maternal and neonatal morbidity and mortality in developing countries including Ethiopia. Identification of risk factors of antepartum hemorrhage will help for prevention and control programs.MethodsAn institutional-based case–control study was conducted from July 2013 to June 2016. A simple random sampling technique was employed, and 420 mothers’ medical cards were reviewed using a pretested checklist. The data were entered in to EPI-info version 7 and then exported to SPSS version 20 for analysis, and all variables with a P-value<0.2 at bivariate logistic regression analysis were considered as a candidate for multivariate logistic regression analysis, and those variables with a P-value<0.05 in multiple logistic regression analysis were considered as significantly associated at 95% confidence interval.ResultsResults of the multiple logistic regression showed that those mothers whose age was in the range of 35–44 years were significantly 4-times more likely to present with antepartum hemorrhage as compared to mothers in the age range of 15–24 years. Moreover, mothers who presented with a previous history of cesarean section were 4.7-times more likely to present with antepartum hemorrhage than those who had no previous history of cesarean section. Furthermore, women with a previous history of abortion were 2-times more likely to develop antepartum hemorrhage as compared to women who had no previous history of abortion.Conclusion and RecommendationIn this study, the factors found to be risk factors of antepartum hemorrhage were maternal age, previous history of cesarean section, and previous history of abortion. Strategies towards reduction of unwanted pregnancy to prevent abortion, pregnancy at advanced age, and to reduce the cesarean section rate should be emphasized.

Determinants of long acting reversible contraception utilization in Northwest Ethiopia: An institution-based case control study.

BackgroundThough long-acting reversible contraceptives (LARCs) are highly effective, have minimal side effects, require minimal follow-up, and are low cost, only 10% of contraceptives used in Ethiopia are LARCs. The reason for this low uptake is not understood at the country or regional level. Therefore, this study identified determinants of LARC utilization in Northwest Ethiopia.MethodsA facility-based unmatched case control study, using LARC users as cases and short- acting reversible contraception (SARC) users as controls, had been conducted at fourteen public health institutions in Northwest Ethiopia. A systematic random sampling technique was used to select participants with a 1:2 case to control ratio (n = 1167). Binary logistic regression analysis was used to identify determinants of LARC utilization among family planning service users.ResultsWealth status [AOR:1.87, 95%CI (1.08, 3.24)], history of abortion [AOR:2.69, 95%CI (1.41, 5.12)], limiting family size [AOR: 2.38, 95%CI (1.01, 5.62)], good knowledge about LARCs [AOR: 2.52, 95%CI (1.17, 5.41)], method convenience [AOR: 0.23, 95%CI (0.16, 0.34)], good availability of method [AOR:0.10 (0.05, 0.19)], less frequent visits to health facility [AOR:2.95, 95% CI(1.89, 4.62)], health care providers advice [AOR:10.69, 95%CI (3.27, 34.87)], partner approval [AOR:0.66, 95%CI (0.45, 0.97)], and favorable attitude towards LARCs [AOR:13.0, 95%CI (8.60, 19.72)] were significantly associated with LARC utilization.ConclusionProfessional support, favorable attitude towards LARC use, high economic status, history of abortion, advantage of less frequent visits, having good knowledge towards LARC and interest of limiting births were significantly associated with LARC Utilization. On the other hand, perceived method convenience, and contraception availability were inversely associated with it. Family planning education about the benefits of LARC should be done by health providers and media. Male involvement in the counselling and decision making about the advantage of using LARC may improve the negative influence of partners on LARC utilization. It is also recommended that, future qualitative research further explore perceptions of LARC use.

Determinants of long acting contraceptive utilization among HIV positive reproductive age women attending care at ART clinics of public health facilities in Arba Minch town, Southern Ethiopia, 2019: a case control study

BackgroundLong acting and permanent contraceptive methods by far are the most effective, very safe and convenient methods than short acting contraceptive methods. But in less developed countries, use of long acting reversible contraceptive or permanent methods (LARCs/PMs) is very low. Therefore the aim of this study was to identify determinants of long acting contraceptive method utilization among HIV positive reproductive age women.MethodsAn institutional based case control study was conducted among random sample of 354 HIV positive reproductive age women (total of 97.8% response rate) at Anti-Retroviral Therapy clinics from February 20 to March 20, 2019. Case to control ratio was 1:2. A structured questionnaire and information recorded from ART card review were used to collect the data. Each variable was entered in Bivariate analysis with dependent variables and those variables with P-value of ≤ 0.25 were included in the Multivariate analysis. Significance was determined at the level of P-value < 0.05 with 95% CI of AOR.ResultsA total of 354 (33.3% cases and 66.7% controls) HIV positive reproductive age women were interviewed with response rate of 97.8%. The study revealed being in age group of 39 and above [AOR = 0.17, 95% CI (0.06, 0.48)], being divorced/separated and widowed [AOR = 0.05, 95% CI (0.003, 0.61)], having supportive opinion and strongly supportive opinion regarding family planning service availability in ART clinic [AOR = 5.01, 95% CI (1.79, 14.07)], [AOR = 7.81, 95% CI (2.54, 24.01)] and having no future fertility intention [AOR = 7.03, 95% CI (2.73, 18.06)] were statistically significant determinants for long acting contraceptive method utilization.ConclusionWoman in age group of 39 and above, having no future fertility intention and being divorced/separated and widowed was found to be determinants of long acting contraceptive method utilization among HIV positive reproductive age women. In addition our study support the WHO Strategic Considerations for Strengthening the Linkages between Family Planning and HIV/AIDS Policies, Programs, and Services.

Determinants of Low Birth Weight among Newborns Delivered at Public Hospitals in Sidama Zone, South Ethiopia: Unmatched Case-Control Study.

Low birth weight is a global public health problem having various severe and life-threatening health effects. The World Health Organization is working to reduce the prevalence of low birth weight to 30% by the year 2025. Pinpointing the determinants of low birth weight at different scenarios is crucial to reduce the rate of low birth weight in low-income countries which consist of 96.5% of global low birth weight newborns. Thus, the aim of this study was to assess determinants of low birth weight in Sidama Zone public hospitals of South Ethiopia. An institution-based case-control study was conducted from March 1 to May 5, 2019, in Sidama Zone public hospitals. Data were collected from 354 mother-neonate samples with 118 of them having newborns with birth weight < 2500 g (cases) and 236 of them having birth weight ≥ 2500 g (controls) using a pretested, interviewer-administered structured questionnaire and medical record review. The odds of being rural dweller women was 3.51 times higher among cases (low birth weight babies) than among controls (normal birth weight babies) as compared to being urban dweller women (AOR = 3.51, 95% CI (1.91-6.45)). The likelihood of initiating antenatal care late was 3.22 times more among cases than among controls when compared with timely initiation of antenatal care (AOR = 3.22, 95% CI (1.47-7.14)). The probability of having pregnancy-induced hypertension was 4.49 times higher among mothers of the cases than among mothers of the controls as compared to not having pregnancy-induced hypertension (AOR = 4.49, 95% CI (1.94-10.38)). The odds of not taking iron and folic acid during pregnancy was 3.92 times higher among mothers of the cases than mothers of the controls when compared with taking iron and folic acid (AOR = 3.92, 95% CI (1.80-8.50)). The likelihood of having Mid-Upper Arm Circumference (MUAC) < 23 cm was 4.27 times higher among mothers of the cases than among mothers of the controls as compared to having MUAC ≥ 23 cm (AOR = 4.27, 95% CI (2.24-8.12)). The probability of having inadequate dietary diversity was 3.75 times higher among cases than among controls as compared to having adequate dietary diversity (AOR = 3.75, 95% CI (1.64-8.57)). Interventions targeting the aversion of low birth weight should focus on promotion of iron-folic acid supplementation and dietary diversification through timely initiation of antenatal care.