Effect of topical emollient oil application on weight of preterm newborns: A systematic review and meta-analysis.

BACKGROUND: Synthesizing current evidence on interventions to improve survival outcomes in preterm infants is crucial for informing programs and policies. The objective of this study is to investigate the impact of topical emollient oil application on the weight of preterm infants. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. To identify relevant studies, comprehensive searches were conducted across multiple databases, including PubMed, Cochrane, Scopus, Clinical trials, ProQuest Central, Epistemonikos, and gray literature sources. The inclusion criteria were based on the PICO (Population, Intervention, Comparison, and Outcomes) format. Study quality was assessed using the Cochrane risk of bias tool for randomized trials (RoB 2.0). Data analysis was performed using StataCrop MP V.17 software, which included evaluating heterogeneity, conducting subgroup analysis, sensitivity analysis, and meta-regression. The findings were reported in accordance with the PRISMA checklist, and the review was registered with PROSPERO (CRD42023413770). RESULTS: Out of the initial pool of 2734 articles, a total of 18 studies involving 1454 preterm neonates were included in the final analysis. Fourteen of these studies provided data that contributed to the calculation of the pooled difference in mean weight gain in preterm neonates. The random effects meta-analysis revealed a significant pooled difference in mean weight gain of 52.15 grams (95% CI: 45.96, 58.35), albeit with high heterogeneity (I2 > 93.24%, p 0.000). Subgroup analyses were conducted, revealing that preterm infants who received massages three times daily with either sunflower oil or coconut oil exhibited greater mean differences in weight gain. Meta-regression analysis indicated that the type of emollient oil, duration of therapy, and frequency of application significantly contributed to the observed heterogeneity. A sensitivity analysis was performed, excluding two outlier studies, resulting in a pooled mean weight difference of 78.57grams (95% CI: 52.46, 104.68). Among the nine studies that reported adverse events, only two mentioned occurrences of rash and accidental slippage in the intervention groups. CONCLUSION: The available evidence suggests that the application of topical emollient oil in preterm neonates is likely to be effective in promoting weight gain, with a moderate-to-high level of certainty. Based on these findings, it is recommended that local policymakers and health planners prioritize the routine use of emollient oils in newborn care for preterm infants. By incorporating emollient oils into standard care protocols, healthcare providers can provide additional support to promote optimal growth and development in preterm infants.

A generalized Poisson regression analysis of determinants of early neonatal mortality in Ethiopia using 2019 Ethiopian mini demographic health survey.

Neonatal mortality within the first few days of life is a pressing issue in sub-Saharan Africa, including Ethiopia. Despite efforts to achieve the targets set by the Sustainable Development Goals, the rate of neonatal mortality in Ethiopia has increased from 29 to 33 deaths per 1000 live births. This study aimed to investigate and identify significant determinants of neonatal mortality within the first 72 h of life in Ethiopia. Utilizing data from the 2019 Ethiopia Demographic and Health Survey, we employed Generalized Poisson regression analysis following rigorous model fitness assessment. Our study encompassed 5527 weighted live-born neonates. Among women in their reproductive years, 3.1% (n = 174) experienced at least one very early neonatal death. Multiple births (Incidence Risk Ratio (IRR) = 3.48; CI = 1.76, 6.887) and birth order six or above (IRR = 2.23; CI = 1.008, 4.916) were associated with an increased risk of neonatal death within the first 72 h. Conversely, household size (IRR = 0.72; CI = 0.586, 0.885) and additional feeding practices (IRR = 0.33; CI = 0.188, 0.579) were found to mitigate the risk of very early neonatal mortality per mother in Ethiopia. Interventions targeting the identified risk factors and promoting protective factors can contribute to reducing very early neonatal mortality rates and improving the well-being of mothers and their newborns. Further research and implementation of evidence-based strategies are needed to address these challenges and ensure better neonatal outcomes in Ethiopia.

Diabetes mellitus and its associated factors among human immunodeficiency virus-infected patients on anti-retroviral therapy in Northeast Ethiopia.

OBJECTIVE: The aim of this study was to determine the prevalence of diabetes mellitus and its associated factors among human immunodeficiency virus-infected patients on anti-retroviral therapy in Northeast Ethiopia. RESULTS: A facility based cross-sectional study was conducted among 408 HIV-infected adults (≥ 18 years old) attending an ART clinic in Northeast Ethiopia from January to March 30, 2018. The mean (± SD) age of studied patients was 37 ± 10.3 years, and 273 (66.9%) were female. Of the total participants, 36 (8.8%, 95% CI 6.4% to 11.8%) had diabetes and 61 (15.0%, 95% CI 11.5% to 18.6%) had impaired fasting glucose level (111-125 mg/dl). Only fourteen (3.4%) participants knew their diabetes status during data collection. In the multivariate analysis, older age (age > 45 years; AOR = 3.51, 95% CI 1.52-8.10, P = 0.003), a family history of diabetes (AOR = 6.46, 95% CI 3.36-21.29, P < 0.001), duration of ART (AOR = 2.67, 95% CI 1.16-6.17, P = 0.021), and hypertension (AOR = 2.62, 95% CI 1.20-5.72, P = 0.016) were independently associated with increased odds of diabetes. These results highlight the need for regular diabetes screening among HIV-infected patients on ART in order to prevent or reduce disease-related outcomes of these patients in this study setting.

Hypertension in HIV-Infected Patients Receiving Antiretroviral Therapy in Northeast Ethiopia.

BACKGROUND: With prolonged survival and aging of persons with HIV on combination antiretroviral therapy (ART), hypertension has emerged as a significant cause of morbidity and mortality globally. However, little is known about the burden of this comorbid condition among adults living with HIV in sub-Saharan Africa. In this study, we aimed to determine the prevalence and factors associated with hypertension among HIV-infected patients receiving ART in Northeast Ethiopia. METHODS: A cross-sectional study was conducted at the ART clinic of Dessie Referral Hospital, Northeast Ethiopia, between January and May 2018. HIV-infected patients who were on ART for at least 12 months were included in the study. Demographic, clinical, and laboratory data were collected from each participant. Hypertension was defined as a systolic blood pressure (BP) of ≥140 mmHg and/or diastolic BP of ≥90 mmHg or a reported use of antihypertensive medication. Univariable and multivariate analyses were performed to identify factors associated with hypertension. RESULTS: A total of 408 patients were studied with a mean (±SD) age of 37 ± 10.3 years, and 66.9% were female. The prevalence of hypertension was 29.7% (95% CI, 25.3-35.0%). Nearly 75% of the patients with hypertension were previously undiagnosed. In a univariate analysis, older age, male gender, a family history of hypertension, duration of HIV infection, duration on ART, high body mass index, low CD4 count, diabetes, and renal impairment were associated with hypertension. Multivariate analysis revealed older age (AOR = 2.08; 95% CI, 1.13-3.83), male gender (AOR = 1.64; 95% CI, 1.01-2.65), longer duration on ART (AOR = 1.91; 95% CI, 1.14-3.20), high body mass index (AOR = 3.32; 95% CI, 1.13-9.77), and diabetes (AOR = 2.76; 95% CI, 1.29-5.89) as independent risk factors of hypertension. CONCLUSIONS: Hypertension is highly prevalent among HIV-infected patients on ART attending our clinic in Northeast Ethiopia but is mostly undiagnosed. These findings highlight the need for integrating hypertension management into routine HIV care to prevent adverse outcomes and improve health of people living with HIV on ART.