Unmatched Case-control Study Research Articles

Association between fine particulate matter (PM2.5) and infant mortality in a North Carolina birth cohort (2003-2015).

While the association between fine particulate matter (PM2.5) and adult mortality is well established, few studies have examined the association between long-term PM2.5 exposure and infant mortality. We conducted an unmatched case-control study of 5992 infant mortality cases and 60,000 randomly selected controls from a North Carolina birth cohort (2003-2015). PM2.5 during critical exposure periods (trimesters, pregnancy, first month alive) was estimated using residential address and a national spatiotemporal model at census block centroid. We fit adjusted logistic regression models and calculated odds ratios (ORs) and 95% confidence intervals (CIs). Due to differences in PM2 .5 over time, we stratified analyses into two periods: 2003-2009 (mean = 12.1 µg/m3, interquartile range [IQR]: 10.8-13.5) and 2011-2015 (mean = 8.4 µg/m3, IQR: 7.7-9.0). We assessed effect measure modification by birthing parent race/ethnicity, full-term birth, and PM2.5 concentrations. For births 2003-2015, the odds of infant mortality increased by 12% (95% CI: 1.06, 1.17) per 4.0 µg/m3 increase in PM2.5 exposure averaged over the pregnancy. After stratifying, we observed an increase of 4% (95% CI: 0.95, 1.14) for births in 2003-2009 and a decrease of 15% (95% CI: 0.72, 1.01) for births in 2011-2015. Among infants with higher PM2.5 exposure (≥12 µg/m3) during pregnancy, the odds of infant mortality increased (OR: 2.69; 95% CI: 2.17, 3.34) whereas the lower exposure (<8 µg/m3) group reported decreased odds (OR: 0.50; 95% CI: 0.28, 0.89). We observed differing associations of PM2.5 exposure with infant mortality across higher versus lower PM2.5 concentrations. Research findings suggest the importance of accounting for long-term trends of decreasing PM2.5 concentrations in future research.

Determinants of underweight among returnee lactating mothers in Gedeb District, Southern Ethiopia: a case–control study

ObjectiveThis study aimed to assess the determinants of underweight among returnees lactating mothers in governmental health facilities of Gedeo zone, Southern Ethiopia.DesignCase–control study.SettingGedeb District governmental health facilities.ParticipantsA total of 264...

Burden and determinants of scabies in a pastoralist community: a case–control study from Southwest Ethiopia

BackgroundScabies is a skin infestation caused by the human itch mite, affecting people globally across all demographics. However, it is more prevalent among children, individuals with poor hygiene, those in...

Determinants of suboptimal birth spacing among reproductive-age women in Adama district, Ethiopia: a community-based unmatched case-control study

BackgroundBirth spacing is crucial for ensuring the health of mothers and their children, as well as determining population growth. Short birth intervals represent a universal public health problem associated with adverse maternal, fetal, neonatal, and child outcomes. However, there is limited information in the study area regarding the determinants of suboptimal birth spacing. Thus, this study aimed to identify the determinants of suboptimal spacing among women of reproductive age in the Adama district, Ethiopia.MethodsA community-based unmatched case-control study was conducted among 568 randomly selected reproductive-age women using the multi-stage sampling technique. Data were collected using an interviewer-administered, structured questionnaire. The collected data were entered into Epi Info version 7.2 and analyzed using SPSS version 26. Binary logistic regression analysis was used to model the association between suboptimal birth spacing and independent variables. Adjusted odds ratios with their 95% confidence intervals were calculated to determine the strength of the association. A p-value < 0.05 was considered to declare statistical significance.ResultEducational status (no formal education) (AOR = 2.40; 95% CI: 1.23–1.75), inadequate knowledge of optimal birth space (AOR = 2.60; 95% CI; 1.80–3.90), non-use of modern contraceptives (AOR = 3.00; CI: 1.90–4.20), short breastfeeding duration (AOR = 2.30; 95% CI: 1.50–3.40), and having female index child (AOR = 1.60; 95% CI: 1.13–2.50) were independent determinants of suboptimal birth spacing practice.ConclusionEncouraging women’s education, contraceptive use, and breastfeeding is crucial for birth spacing. Community health initiatives should also focus on preventing sex-based birth intervals.

Maternal factors associated with early-onset neonatal sepsis among caesarean-delivered babies at Mbarara Regional Referral Hospital, Uganda: a case-control study

BackgroundBabies born via caesarean section in low-income settings face a higher risk of early-onset neonatal sepsis (EONS), which has greater mortality than late-onset sepsis. However, maternal factors contributing to EONS among caesarean-delivered babies in these settings, including Uganda, are not well documented. We determined maternal factors associated with EONS among term babies delivered by caesarian section at Mbarara Regional Referral Hospital (MRRH), southwestern Uganda.MethodsWe conducted an unmatched case-control study at MRRH from December 2019 to March 2020. Cases were caesarean section-delivered term babies with EONS (within 72 h). Controls were caesarean section-delivered term babies without EONS. We enrolled mother-baby pairs for both groups, obtaining maternal data via structured questionnaires The diagnosis of EONS was made using the WHO Young Infant Integrated Management of Childhood Illnesses algorithm. Cases were consecutively recruited while controls were recruited by simple random sampling in a ratio of 1:2. We excluded newborns whose mothers were too ill to consent. We used multivariable logistic regression analysis to identify maternal factors associated with EONS.ResultsWe enrolled 52 cases and 104 controls. The mean age for the mothers was 27 (± 5.5) years. Neonates born to referred mothers had higher odds of EONS than those born to non-referred mothers (AOR = 6.2, 95% CI: 1.8–21). Additionally, decision-to-delivery time > 1 h for emergency caesarean section (AOR = 16, 95% CI: 4.2–65), antepartum hemorrhage (AOR = 8.0, 95% CI: 1.6–40), primiparity (AOR = 4.8, 95% CI: 1.1–21), and > 3 vaginal examinations after membrane rupture (AOR = 4.3, 95% CI: 1.5–12) were associated with EONS.ConclusionsPrime gravidity, antepartum hemorrhage, multiple vaginal examinations after membrane rupture, long decision-to-delivery time, and referral status were associated with EONS among term babies delivered by caesarean section at MRRH. To reduce EONS risk, clinicians should limit post-membrane rupture vaginal exams or consider prophylactic antibiotics if multiple exams are needed. Screening babies born to primiparous women, those referred, those with antepartum hemorrhage, multiple vaginal exams after membranes rupture, and long decision-to-delivery times, could aid prompt recognition of EONS and timely interventions. Implementing standard procedures to reduce caesarean decision-to-delivery time could reduce risk for EONS in this setting.

Determinants of uncontrolled blood pressure among adult hypertensive patients on follow-up at Negelle and Adola General Hospital, Guji Zone, Southern Ethiopia: facility-based case control study

BackgroundUncontrolled blood pressure is a significant public health problem associated with a high rate of mortality and morbidity worldwide. In Ethiopia, 48% of hypertensive patients have Uncontrolled blood pressure. Therefore, this study aimed to identify the determinants of uncontrolled blood pressure among adult hypertensive patients on follow-up at the Negele and Adola General Hospitals in the Guji Zone, Oromia, Ethiopia.MethodsA facility-based, unmatched case–control study was conducted in Negelle and Adola General Hospitals, Guji Zone, from January-01–30, 2023, on 384 samples. Study participants were selected consecutively as they came for treatment until the required sample size was obtained. The data were collected using an interview-administered structured questionnaire and medical chart review. The data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. Binary logistic regression analysis was used to model the association between the dependent and independent variables. The candidate variables with p < 0.25 in the bivariate analysis were entered into the multivariable logistic regression. An Adjusted Odds ratio (AOR) and 95% CI were used to measure the strength of the association. Finally, at p < 0.05, statistical significance was declared.ResultsA sample of 384 respondents (128 cases and 256 controls) were included, for a response rate of 100%. No adherence to medication (AOR = 2.01, 95% CI = 1.16–3.44), no adherence to smoking abstinence (AOR = 1.84, 95% CI = 1.05–3.22), no adherence to weight management (AOR = 2.02, 95% CI = 1.04–3.92), poor hypertension knowledge (AOR = 2.18, 95% CI = 1.26–3.76), use of traditional medicine (AOR = 9.13, 95% CI = 5.31–15.69), and overweight (AOR = 3.35, 95% CI = 1.79–6.26) were significantly associated with uncontrolled blood pressure.ConclusionThis study revealed that no adherence to medication, smoking, weight management, poor hypertension knowledge, traditional medicine use, and being overweight were determinants of uncontrolled blood pressure. Since these are modifiable and preventable factors, there is a need to implement interventions that will enhance self-care practices in this population to improve treatment outcomes.

Associated Factors of Low Birth Weight among Newborns at Hospitals in Kisangani, Democratic Republic of Congo

Background: Low birth weight remains a major public health problem in every country in the world. It is a predictor of early neonatal mortality, morbidity and long-term health. The aim of this study was to determine the prevalence of low birth weight and to identify the associated factors in a hospital setting in Kisangani. Material and Methods: An unmatched case-control study was used including all live and full-term births was conducted from 1 December 2023 to 31 May 2024 in the maternity wards of Makiso-Kisangani General Referral Hospital, Mangobo General Referral Hospital, Tshopo General Referral Hospital and Alwaleed Health Centre. A sample of 646 newborns was selected: 86 cases (newborns weighing less than 2500 grams) and 560 controls (newborns weighing 2500 grams or more). Factors associated with prehypertension were identified using logistic regression. Results: The prevalence of low birth weight was 13.4%. Factors associated with low birth weight were maternal age less than 18 years, intergenital interval less than 2 years, maternal infection during pregnancy, high blood pressure, level of primary education and urban residential environment. Conclusion: This study shows that low birth weight remains a public health problem in Kisangani. In addition to shedding light on the other contributing variables and the connections between them, prospective national research would enable the development of preventative measures.

Determinants of unsuccessful tuberculosis treatment outcome in Southwest Ethiopia regional state public hospitals, 2022: a multi-center case control study.

Tuberculosis is the major cause of morbidity, and it is one of the top ten causes of death globally. In Africa, the overall pooled estimate of unsuccessful tuberculosis treatment outcome was reported to be 21.1%, which is above the World Health Organization defined threshold of 15%. Unsuccessful treatment outcomes result in drug resistance, prolonged periods of infection, and increased morbidity and mortality. Therefore, this study aimed to assess determinants of unsuccessful treatment outcomes among tuberculosis patients in Southwest Ethiopia regional state public hospitals, in 2022. A retrospective unmatched case-control study was employed by recruiting 570 study units (190 cases and 380 controls) in three randomly selected public hospitals from 1 August 2022 to 21 August 2022. Data were collected by using a data extraction checklist adapted from tuberculosis registration logbook. Bivariate and multivariate logistic regression models were employed. A predictor variable with a p-value of less than 0.05 in the multivariate logistic regression model was taken as statistically significant. The odds ratio and 95% confidence level were used to measure the strength of the association. A total of 561 records (187 cases and 374 controls) were included from tuberculosis registers. In this study, the factors independently associated with unsuccessful tuberculosis treatment outcome were older age (AOR = 1.68, 95% CI: 1.142, 2.472), rural residence (AOR = 1.548, 95% CI: 1.055, 2.272), retreatment category (AOR = 2.12, 95% CI: 1.339, 3.357), underweight (BMI < 18.5 kg/m2) (AOR = 1.952, 95% CI: 1.240, 3.071), being HIV positive (AOR = 2.144, 95% CI: 1.372, 3.349) and having no treatment adherence support (AOR = 2.016, 95% CI: 1.270, 3.201). In this study, socio-demographic, clinical, and treatment-related factors contributed to the risk of unsuccessful treatment outcomes. Targeted interventions should be taken into consideration to diminish poor tuberculosis treatment outcomes among high-risk groups throughout the whole tuberculosis treatment course.

Determinants of preterm delivery among mothers who gave birth in hospitals of Wolaita zone, southern Ethiopia, 2023: unmatched case-control study

BackgroundPreterm delivery refers to childbirth that occurs before 37 full weeks’ gestation. Globally, around 13.4 million babies are born preterm annually, a million died due to its complications. Identifying its determinants is mandatory to decrease preterm birth and thereby neonatal deaths. Therefore, this study aimed to identify the determinants of preterm delivery among mothers who gave birth in hospitals in the Wolaita zone, southern Ethiopia.MethodsA hospital-based unmatched case-control study design was conducted from March 29 to May 20, 2023, in the Wolaita zone, southern Ethiopia. Cases were women who gave birth after 28 weeks and before 37 completed weeks, and controls were women who gave birth at and after 37 and before 42 weeks of gestation from the first day of the last normal menstrual period. A consecutive sampling method was used. Data were collected by a structured interviewer-administered questionnaire. Data were coded and entered into Epi data 3.1 and analyzed by using SPSS version 25. Variables that had a P-value < 0.25 in the bivariate logistic regression analysis were entered into a multivariable logistic regression model. Finally, p-value < 0.05 was used to claim statistical significance.ResultFrom a total of 405 eligible participants, 399 respondents (133 cases and 266 controls) participated in this study with a response rate of 98.52%. The result of the multivariable analysis shows that mothers who resided in rural areas [AOR = 2.78:95% CI (1.51–5.12)], not receiving support from their partner [AOR = 2.37:95% CI (1.24–4.51)], less than four antenatal care visits [AOR = 4.52:95%CI (2.38–8.57)], developed pregnancy-induced hypertension [AOR = 5.25:95%CI (2.27–12.14)] and exposed for intimate partner violence [AOR = 2.95:95%CI (1.105–7.85)], had statistically significant association with experiencing preterm delivery.Conclusion and recommendationMost of the determinants for preterm delivery have been proven modifiable. Thus, designing new strategies, providing comprehensive mobile clinic services to address hard-to-reach areas and Health care providers should give due attention to mothers with pregnancy-induced hypertension and exposure to intimate partner violence and increase the awareness of antenatal care follow-up and benefit of support during pregnancy to reduce preterm delivery.

Risk Factors Associated with Gastritis among Adult Patients Attending at Capital Hospital in Mogadishu- Somalia

Background: Gastritis, an inflammatory disorder affecting the lining of the stomach, is a prevalent health concern across the globe, particularly in developing regions like Somalia. This study aims to investigate the primary risk factors linked to gastritis among adults receiving care at Capital Hospital in Mogadishu.  Methods: An unmatched case-control study was executed from June 1 to July 30, 2024, involving 63 adult participants, with 21 patients diagnosed with gastritis through endoscopic procedures and 42 controls. A semi- structured questionnaire was employed to gather data on socio-demographic characteristics, dietary patterns, lifestyle habits, medical histories, and medication usage. Statistical analysis was performed using SPSS version 26.  Results: The investigation revealed a gastritis prevalence of 78.8%, with acute cases constituting 48.9% and chronic cases 29.9%. Female participants were identified as having a protective effect against gastritis (Adjusted Odds Ratio [AOR]=0.05, p=0.023), whereas the routine use of non-steroidal anti-inflammatory drugs (NSAIDs) significantly raised the risk (Crude Odds Ratio [COR]=5.03, p=0.041). Interestingly, the presence of Helicobacter pylori was associated with a reduced risk of developing gastritis (COR=0.11, p=0.032). Other lifestyle and dietary factors did not show significant correlations.  Conclusions: The results underscore the protective influence of gender and the associated risks of NSAID intake regarding gastritis among Somali adults. The unexpected finding of H. pylori infection linked to lower gastritis risk deserves further exploration. There is an urgent need for targeted public health strategies to address the effects of gastritis in Somalia.

Pregnancy-Induced Hypertensive Disorders predictors among pregnant and delivery mothers receiving care in public health institutions in Sidama, Ethiopia: a multicenter case control study

BackgroundPregnancy-Induced Hypertensive Disorders (PIHD) include conditions like Pre-Eclampsia, Eclampsia, and Gestational Hypertension, impacting 5–10% of pregnancies globally. These disorders are responsible for 16% of maternal deaths in Sub-Saharan Africa and account for 16.9% of maternal mortality in Ethiopia, representing 10% of the country's total maternal deaths.ObjectiveTo identify predictors of PIHD among pregnant and delivery women in public hospitals and primary health care units (health centers) in Sidama, Ethiopia.MethodsA multi-center unmatched case–control study was conducted on women in antenatal care and obstetrics/gynecology departments at 12 randomly selected public health institutions, including one specialized teaching hospital, two general hospitals, three primary hospitals, and six health centers. The study involved 920 women (230 cases and 690 controls) selected from December 2023 to February 2024. Cases included pregnant or delivery women at 20 + weeks gestation with PIHD such as pre-eclampsia, eclampsia, gestational hypertension, and chronic hypertension with superimposed preeclampsia. Controls were normotensive pregnant women or delivering mothers without PIHD after 20 weeks gestation. Data was manually verified, entered, and validated using Epidata software, followed by analysis with SPSS 22. Univariate analysis assessed predictors of PIHD, while binary logistic regression evaluated the relationships between factors. Model fitness was checked using collinearity assessments and the Hosmer–Lemeshow test, with variables having a P value < 0.05 deemed independent predictors.ResultsOut of 920 planned participants, 686 were included, resulting in a response rate of 94.35%. Factors associated with PIHD in women included age at first conception (AOR = 1.26), mid (AOR = 6.05) and high (AOR = 5.01) wealth index levels, multigravidity (AOR = 4.34), pregnancy age ≥ 42 weeks (AOR = 3.65), maternal mid-upper arm circumference (MUAC) (AOR = 1.29), hemoglobin levels of 6.5–10.9 g/dL (AOR = 5.59), pre-pregnancy Body Mass Index (BMI) ≥ 25 kg/M2 (AOR = 0.81), preexisting hypertension (AOR = 8.97), family history of diabetes mellitus (AOR = 20.02), former alcohol consumption (AOR = 0.27), and total physical activity during pregnancy (AOR = 0.54).ConclusionsThe study identifies key predictors of PIHD in women, including age at conception, wealth index, multigravidity, gestational age, and pre-pregnancy BMI. It underscores the link between socioeconomic status and maternal health, highlighting that financial resources alone don’t ensure better outcomes without educational access. The research advocates for a health intervention strategy focusing on socioeconomic factors and public health initiatives to reduce maternal health disparities while exploring the role of partner stability and psychosocial aspects.

Determinants of stunting among adolescent girls in schools of Digo Tsion Town, Northwest Ethiopia: Unmatched case control study.

Stunting is a height-for-age (Z-score) less than minus two standard deviations below the mean of reference standard. It is the most important sign of long-term chronic undernutrition and public health problem in Ethiopia. However, little information was known regarding determinants of stunting among adolescents since it had mostly been investigated in late infancy, especially among children under the age of five. Therefore, identifying determinants of stunting among adolescent girl is still crucial. To identify determinants of stunting among adolescent girls in schools of Digo Tsion Town, Northwest Ethiopia, 2022. Case-control study was conducted among 417 adolescent girls (104 cases and 313 controls) in schools of Digo Tsion Town with computer generated simple random sampling technique. World Health Organization Anthroplus 2007 software was used for analyzing anthropometrics data. Data was collected by epicollect5 mobile application through interview by using structured questionnaire. The data was entered in epi data 4.6 and exported into Statistical Package for Social Science version 26. Variables with p- value ≤ 0.25 in bivariable analysis were candidate for multivariable analysis. Model fitness was checked by Hosmer and Lemon Show fitness of test. Variables having a P-value < 0.05 in multivariable analysis were declared as statistically significant at 95% Cl. The result was presented by statement, figures, and tables. A total of 409 (100 cases and 309 controls) adolescent girls participated, with a response rate of 96% for cases and 98.72% for controls. Food insecurity (AOR = 2.13, CI [1.15, 3.93]), low dietary diversity score (AOR = 1.99, CI [1.06, 3.73]), drinking coffee/tea immediately while eating meals (AOR = 2.19, CI [1.22, 3.95]), not getting nutritional counsel (AOR = 2.07, CI [1.17, 3.66]), chronic illness (AOR = 3.78, CI [1.16, 12.3]), and not visited by health extension workers at home (AOR = 1.85, CI [1.03, 3.31]) were statistically significant determinants of stunting. Stunting among adolescents is influenced by a low dietary diversity score, a food-insecure household, drinking coffee or tea immediately while eating a meal, not receiving nutritional counseling, having a chronic illness, and not being visited by health extension workers at home. Future researchers would do better to undertake prospective studies. Health extension workers are better able to provide nutritional counsel for adolescent.

Determinants of hepatitis B virus infection among pregnant women in Bench Sheko zone, Southwest Ethiopia: a case-control study.

Hepatitis B Virus (HBV) infection during pregnancy poses serious risks by raising the likelihood of chronic infection in newborns by 90% and the risk of cirrhosis and liver cancer by 25% in chronic infections. This study aimed to identify determinants of HBV infection among pregnant women in the Bench Sheko zone, Southwest Ethiopia. An unmatched case-control study was conducted from May 15 to July 15, 2022, in selected health facilities of the Bench Sheko zone, Southwest Ethiopia. Medical charts were reviewed to collect the HBsAg status of participants, as all pregnant women attending antenatal care underwent routine screening. It involved 228 pregnant women (76 HBV-positive cases and 152 HBV-negative controls). Data were collected using structured questionnaires, and analyzed using SPSS 21. A multivariable logistic regression was performed to identify significant determinants of HBV infection, and statistical significance was declared at p-value <0.05. After controlling potential confounders, having no formal education (AOR = 4.94, 95% CI: 2.01, 8.29; P = 0.007), urban residency (AOR = 2.56, 95% CI: 1.43, 6.86; P = 0.010), history of unsafe abortion (AOR = 3.87, 95% CI: 2.17, 6.98; P < 0.001), sharing sharp materials (AOR = 8.43, 95% CI: 5.54, 10.9; P < 0.001), contact with HBV-infected persons in the family (AOR = 2.18, 95% CI: 1.72, 4.87; P < 0.001), tribal scarification (AOR = 3.23, 95% CI: 1.24, 8.91; P = 0.017), and history of unsafe tooth extraction (AOR = 4.52, 95% CI: 2.18, 9.76; P = 0.039) were identified as significant predictors of HBV infection. The study identifies multiple factors contributing to HBV infection in pregnant women. Therefore, it is crucial to promote safe abortion practices and the responsible use of sharp materials, avoid high-risk contact with infected individuals within the family, raise awareness about the risks associated with tribal scarification while advocating for safer practices, and offer education on safe tooth extraction methods to reduce the risk of HBV.

Relationship between maternal anemia during pregnancy and the risk of preeclampsia: A multicenter case-control study.

Introduction: Anemia, defined as a low hemoglobin level, is a common condition in pregnancy that can have adverse effects on maternal and fetal outcomes. Anemia can result from various causes, such as iron deficiency, vitamin B12 deficiency, folate deficiency, hemolysis, or bleeding. The association between anemia and preeclampsia is not fully understood, but some studies have suggested that anemia may increase the risk of developing preeclampsia, especially in women with iron deficiency or chronic inflammation. Objective: To assess the association of anemia during pregnancy and the risk of developing preeclampsia. Study Design and Setting: A multicenter unmatched case-control study was conducted. The study was conducted from 2 December 2020 to 1 January 2021 in West and North Gojjam zone governmental hospitals, North West Ethiopia. A total of 337 pregnant women (113 cases and 224 controls) who consented verbally and attended antenatal or delivery services were enrolled in the study. Population: The participants of this study were mothers attending attended antenatal care and delivery services. Data Management: The analysis involved manual checking, data entry using EpiData Manager, and subsequent analysis using SPSS version 23, with logistic regression and p-values <0.05 determining statistical significance. Results: Being nonanemic, high consumption of fat related, mid-upper arm circumference ≥25.6 cm, frequent consumption of milk products, and fruits and vegetables rich in vitamin A were found to be factors associated with the risk for developing preeclampsia. Conclusion and recommendations: Being nonanemic, diets that are characterized by a high intake of vitamin A-rich fruits and vegetables and milk products were significantly associated with a low risk of preeclampsia. On the other hand, high intake of fatty foods and obesity were associated with the development of preeclampsia. Therefore, preventing anemia encouraging and promoting healthy eating habits during pregnancy by including vitamin A-rich fruits and vegetables and milk products can effectively prevent the development of preeclampsia.

Sweetened Areca Nut, A Risk in Dental Caries among Adolescents in Pune, Maharashtra? A Case-Control Study

Abstract Introduction: Smokeless tobacco (SLT) causes dental caries and so does chewing of areca nut (sweetened supari) due to the presence of sugar. Since conflicting views exist about whether areca nut causes dental caries or not, and since studies are undertaken in adults and data on adolescents are not available, this study was carried out. Since those were cross-sectional or longitudinal studies, this case-control study was undertaken to understand if flavored/sweetened areca nut is a risk factor for dental caries. Material and Method: This unmatched case-control study was conducted among the male students of 8th to 10th standard in the age group of 12–16 of four Madhyamik Vidyalaya’s (MVs) in Pimpri–Chinchwad (urban area), Pune. A directed acyclic graph (DAG) was drawn to determine the independent variables to be selected for the study and minimal variables to be adjusted during data analysis. Selection of cases was based on diagnostic and eligibility criteria. The data on the use of sweetened areca nuts and the presence of caries were collected through oral examination and a semistructured questionnaire administered by the principal investigator on a one-to-one basis between August 2022 and October 2022. Data were analyzed using epiinfoTM 7.2.5.0. Results: This study of 146 males in the age group of 13 to 16 years had 61 students as cases and 85 as controls. No significant difference was observed between the group with (cases) and without (controls) dental caries for areca nut use (pack years) whether consumed daily or less frequently for 1 year or more. While the exposure rate to areca nut among cases was 44.26%, for the control group it was 36.47%. The odds ratio of sweetened areca nut as being the risk factor for dental caries was 1.38 at 95% CI (0.70–2.71) with P = 0.44. Conclusion: This study revealed that the adolescent users of sweetened areca nuts studying in government schools had a higher exposure odds ratio for dental caries. However, it was not significant statistically. Information bias including recall may have influenced the outcome.

Risk Factors for COVID-19 Mortality in Epidemic Treatment Centers: A Case-Control Study from Decentralized Regions of Senegal

Introduction: The COVID-19 pandemic is an emerging viral zoonosis caused by SARS-CoV2. It is responsible for a systemic infection in humans, primarily respiratory. In Senegal, the Thiès Region confirmed its first case on March 14, 2020. The second epidemic wave occurring in 2021 was marked by high fatality, justifying our study on the factors associated with deaths among COVID-19 patients hospitalized at the Epidemic Treatment Centers (CTE) of the Regional Health Directorate of Thiès (Senegal). Patients and Methods: Unmatched case-control study, 1 case to 2 controls, relating to COVID-19 deaths recorded in the Thiès Regional Health Directorate from January 1 to December 31, 2021. All patients who tested positive for COVID-19 (PCR/Antigenic test) hospitalized in CTEs were included. All confirmed COVID-19 patients who died were referred to as “cases,” and all recovered patients as “controls.” The sampling of deaths was exhaustive, standardized sociodemographic, clinical, therapeutic and evolutionary data collected from patient files after a pilot trial with quality control. The data was entered on kobo collect and analyzed on Epi info7. Quantitative variables (mean, standard deviation) and qualitative variables (proportions. Measures: odds ratio, chi2 or Fisher exact test, significance threshold set at p&lt;0.05) were used. Results: A total of 348 patients were recruited in this study including 116 deaths and 232 recovered, the average age was 68.9 years +/- 14.24 for the deceased patients compared to 61.5 +/- 14.24 for the recovered, with male predominance in both groups. The most common clinical signs (cases/controls) were dyspnea (98.3/84.49%), fever (71.5/68.1%), asthenia (57.8/65.4%). and cough (52.6/58.1%). Complications were dominated by acute respiratory distress (87.9/3.8%), (11.2%/0.4%) and pulmonary embolism (03.5/0%). The factors associated with deaths found after multivariate analysis by logistic regression were male sex (OR: 4.11, 95% CI : 1.45 – 11.61 and p = 0.0076), patients aged over 60 years (OR=1.77, 95% CI: 1.0018-3.1438, p=0.049), complications such as stroke (OR=31.00; 95% CI: 5.69-168.73 and p=0 .0001), shock (OR22.61; 95% CI: 1.44-353.67 and p=0.026) and acute respiratory distress syndrome (OR: 204.09 95% CI : 70.44-591.30 and p = 0.000). Conclusion: The factors associated with COVID-19 deaths in the CTEs of Thiès Region are age, male gender, the presence of complications; stroke in particular, the state of Shock and ARDS.

Anorectal Malformations (ARM) and associated maternal factors among children at Tikur Anbessa Specialized Hospital and St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: An unmatched case-control study

Anorectal Malformations (ARM) and associated maternal factors among children at Tikur Anbessa Specialized Hospital and St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: An unmatched case-control study

Infectious and obstetric determinants of anemia among pregnant women in Southwest Ethiopia.

Anaemia, characterized by low red blood cell or haemoglobin levels, impairs oxygen transport in the body and poses a major global public health issue, particularly affecting pregnant women and children. This study focuses on identifying the factors contributing to anaemia among pregnant women receiving antenatal care (ANC) at Mizan-Tepi University Teaching Hospital (MTUTH) in southwest Ethiopia. A hospital-based unmatched case-control study was conducted from July 1 to August 30, 2022, involving 370 pregnant women (90 with anaemia and 280 without). Data collection included questionnaires, laboratory tests (Hgb and stool examination), and anthropometric measurements. SPSS version 21 was used for data analysis, with binary logistic regression identifying factors associated with anaemia. The significance level was set at a p-value <0.05. The study achieved a 100% response rate for both cases and controls. Factors identified as determinants of anaemia among pregnant women included malaria infection (AOR = 7.83, 95% CI: 3.89-15.8), hookworm infection (AOR = 2.73, 95% CI: 1.39-5.34), short birth interval (AOR = 7.11, 95% CI: 3.59-14.2), and history of unsafe abortion (AOR = 5.40, 95% CI: 2.46-11.8). This study found that malaria infection, hookworm infection, birth interval <33 months, and a history of unsafe abortion are factors contributing to anaemia in pregnant women. Strategies such as distributing insecticide-treated bed nets (ITNs) to combat malaria, improving sanitation, anthelmintic drugs, promoting family planning to prevent unwanted pregnancies and unsafe abortions, and providing preconception care can help reduce the incidence of anaemia.

Unsuppressed HIV Viral Load and Related Factors in Patients Receiving Antiretroviral Treatment in Tanganyika Province, Democratic Republic of Congo (DRC)

Antiretroviral treatment (ART) has revolutionized the management of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), enabling long-term viral load (VL) suppression in patients. Despite the proven effectiveness of ART, a significant proportion of patients with HIV receiving ART fail to achieve viral load suppression (VLS). This study aimed to identify factors associated with low VLS in the Tanganyika province. An unmatched case–control study was conducted from January 2022 to June 2023, including 22 care facilities with viral load data. Data were collected from patient records. For each reviewed record, the patient was invited for an interview upon providing informed consent. Data were analyzed using SPSS version 27. In a multivariable binary logistic regression model, variables with a p-value &lt; 0.05 and a 95% confidence interval for the adjusted odds ratio were considered significantly associated with unsuppressed VL. A total of 462 individuals, including 156 cases and 306 controls, were included in the study. The mean age (standard deviation) of participants was 42.12 (±11.6) years. The following covariates were significantly associated with unsuppressed VL: poor HIV status disclosure to a confidant [adjusted OR = 2.10, 95% CI (1.33–3.31), p = 0.001], poor ART adherence [adjusted OR = 2.01, 95% CI (1.25–3.23), p = 0.004], ART interruption [adjusted OR = 3.43, 95% CI (2.00–5.88), p &lt; 0.001], no participation in support groups [adjusted OR = 2.16, 95% CI (1.25–3.71), p = 0.005], baseline WHO clinical stage 3 and 4 [adjusted OR = 2.24, 95% CI (1.32–3.79), p = 0.003], opportunistic infections (OIs) [adjusted OR = 2.30, 95% CI (1.27–4.16), p = 0.006], and non-communicable chronic diseases (NCDs) [adjusted OR = 2.30, 95% CI (1.10–4.79), p = 0.026]. Given the clear association between several factors and unsuppressed VL, prevention should involve the implementation of innovative strategies targeting at-risk patient groups. Strengthening the monitoring of these factors among active patients at each appointment is recommended to achieve this goal.

Determinants of measles second dose vaccination dropout among children aged 18-24 months in Ejere woreda, central Ethiopia; unmatched case-control study.

Measles continues to pose a significant public health challenge, especially in low- and middle-income countries. Despite the implementation of national vaccination programs, measles outbreaks persist in some parts of Ethiopia, and the determinants of dropout from the second measles vaccine dose are not well understood. Hence, this study aimed to assess determinants of measles second dose vaccination dropout among children aged 18-24 months in Ejere woreda, central Ethiopia. A community-based unmatched case-control design was conducted in the Ejere Woreda of the Oromia regional state in Ethiopia between February 14 and April 6, 2023. Data were collected using a pre-tested structured questionnaire. The collected data were coded and entered into Epi-data version 3.1 and then transported to SPSS version 27 for statistical analysis. Descriptive analysis like frequency, mean, and percentage was calculated. Binary and multivariable logistic regression analysis was done. Finally, variables with a p-value <0.05 were considered statistically significant. A total of 446 mothers/caregivers, comprising 110 cases and 336 controls, participated in this study, making the response rate 97.8%. Lack of a reminder for the measles vaccine during postnatal care (PNC) (AOR = 5.19; 95% CI: 2.34, 7.83), having ≤2 antenatal care (ANC) contacts (AOR = 4.95; 95% CI: 2.86, 9.24), long waiting times during previous vaccination (AOR = 2.78; 95% CI: 1.19, 4.38), children of mothers/caregivers without formal education (AOR = 6.46; 95% CI: 2.81, 11.71), mothers/caregivers of children who were unaware of the importance of the second dose of measles (AOR = 8.37; 95% CI: 4.22, 15.08), and mothers/caregivers whose children did not receive at least two doses of vitamin A (AOR = 4.05; 95% CI: 2.15, 8.11) were significant determinants of measles second dose vaccination dropout. Implementing targeted interventions during antenatal care and when mothers visit health facilities for other vaccines can significantly improve the uptake of the second dose of the measles vaccine. These strategies not only enhance overall vaccination coverage but also mitigate the risk of measles outbreaks in the community.