Factors associated with age-specific maternal health-seeking behaviours among women: A Multiple Indicator Cluster Survey-based study in 10 African countries.

Background: Maternal health-seeking behaviours (MHSB) are crucial for maintaining maternal health and reducing the maternal mortality ratio (MMR). However, little is known about age-specific MHSB in African countries. This study aims to examine the association between composite indicators of maternal characteristics, household conditions, and socioeconomic factors with MHSB among women from different childbearing age groups in 10 African countries. Methods: Based on the responses of 77 303 women and 68 391 households in 10 African countries to a nationally-representative round of the Multiple Indicator Cluster Survey (MICS6), we used age at childbearing to categorize women into groups according to their recent MHSB. In both pooled and age-specific analysis, multivariable logistic regression was applied to identify the predictors associated with MHSB. These factors were ranked with four sets of regression models. Results: This cross-sectional study found a prevalence of 27.69% (95% confidence interval (CI) = 26.93%-28.46%), 45.14% (95% CI = 44.29%-46.00%), and 28.60% (95% CI = 27.82%-29.40%) for four or more antenatal care visits (ANC4), intrapartum care (IPC), and postnatal care (PNC) service utilization, respectively. In the full sample, high household wealth ranked as the strongest determinant for all three MHSB, followed by mass media exposure for ANC4 utilization (odds ratio (OR) = 1.45; 95% CI = 1.20-1.76, P < 0.001), and higher education levels (secondary school education) for IPC and PNC utilization (IPC: OR = 1.49; 95% CI = 1.23-1.79, P < 0.001, PNC: OR = 1.39; 95% CI = 1.20-1.62, P < 0.001). However, higher maternal parity (three births and above) was associated with lower utilization of ANC4 (OR = 0.86; 95% CI = 0.76-0.96, P < 0.007), and residence in rural areas was associated with a lower IPC and PNC utilization (IPC: OR = 0.65; 95% CI = 0.54-0.79, P < 0.001, PNC: OR = 0.70; 95% CI = 0.57-0.85, P < 0.001). Conclusions: Our study provided further information on the direct and indirect factors associated with the utilization of maternal health services by women of different childbearing ages in 10 African countries. Additionally, the heterogeneous results among different childbearing age groups suggest that age-specific programmes and national policies are crucial for improving MHSB, and thus reducing MMR in Africa.

Analysis of Differentially Expressed Genes in Endothelial Cells Following Tumor Cell Adhesion, and the Role of PRKAA2 and miR-124-3p.

Tumor cell adhesion to the endothelium is one pattern of tumor-endothelium interaction and a key step during tumor metastasis. Endothelium integrity is an important barrier to prevent tumor invasion and metastasis. Changes in endothelial cells (ECs) due to tumor cell adhesion provide important signaling mechanisms for the angiogenesis and metastasis of tumor cells. However, the changes happened in endothelial cells when tumor-endothelium interactions are still unclear. In this study, we used Affymetrix Gene Chip Human Transcriptome Array 2.0. and quantitative real-time PCR (qPCR) to clarify the detailed gene alteration in endothelial cells adhered by prostate tumor cells PC-3M. A total of 504 differentially expressed mRNAs and 444 lncRNAs were obtained through chip data analysis. Gene Ontology (GO) function analysis showed that differentially expressed genes (DEGs) mainly mediated gland development and DNA replication at the biological level; at the cell component level, they were mainly involved in the mitochondrial inner membrane; and at the molecular function level, DEGs were mainly enriched in ATPase activity and catalytic activity. Kyoto Encyclopedia of Genes and Genomes (KEGG) signal pathway analysis showed that the DEGs mainly regulated pathways in cancer, cell cycle, pyrimidine metabolism, and the mTOR signaling pathway. Then, we constructed a protein-protein interaction functional network and mRNA-lncRNA interaction network using Cytoscape v3.7.2. to identify core genes, mRNAs, and lncRNAs. The miRNAs targeted by the core mRNA PRKAA2 were predicted using databases (miRDB, RNA22, and Targetscan). The qPCR results showed that miR-124-3p, the predicted target miRNA of PRKAA2, was significantly downregulated in endothelial cells adhered by PC-3M. With a dual luciferase reporter assay, the binding of miR-124-3p with PRKAA2 3'UTR was confirmed. Additionally, by using the knockdown lentiviral vectors of miR-124-3p to downregulate the miR-124-3p expression level in endothelial cells, we found that the expression level of PRKAA2 increased accordingly. Taken together, the adhesion of tumor cells had a significant effect on mRNAs and lncRNAs in the endothelial cells, in which PRKAA2 is a notable changed molecule and miR-124-3p could regulate its expression and function in endothelial cells.