Determinants of stillbirth among women who delivered in hospitals of North Wollo Zone, Northeast Ethiopia: A case-control study.

BACKGROUND: Stillbirth is a silent tragedy that shatters the lives of women, families, and nations. Though affecting over 2 million infants globally in 2019, it remains overlooked, with no specific targets dedicated to its reduction in the sustainable development goals. Insufficient knowledge regarding the primary risk factors contributing to stillbirths hinders efforts to reduce its occurrence. Driven by this urgency, this study focused on identifying the determinants of stillbirth among women giving birth in hospitals across North Wollo Zone, Northeast Ethiopia. METHODOLOGY: This study employed an institution-based unmatched case-control design, involving a randomly selected sample of 412 women (103 cases and 309 controls) who gave birth in hospitals of North Wollo Zone. Data were collected using a structured data extraction checklist. Data entry was conducted using Epi-data version 3.1, and analysis was performed using SPSS version 25.0. Employing a multivariable logistic regression model, we identified independent predictors of stillbirth. The level of statistical significance was declared at a p-value < 0.05. RESULTS: Our analysis revealed several critical factors associated with an increased risk of stillbirth. Women who experienced premature rupture of membranes (AOR = 5.53, 95% CI: 2.33-9.94), induced labor (AOR = 2.24, 95% CI: 1.24-4.07), prolonged labor exceeding 24 hours (AOR = 3.80, 95% CI: 1.94-7.45), absence of partograph monitoring during labor (AOR = 2.45, 95% CI: 1.41-4.26) were all significantly associated with increased risk of stillbirth. Preterm birth (AOR = 3.46, 95% CI: 1.87-6.39), post-term birth (AOR = 3.47, 95% CI: 1.35-8.91), and carrying a female fetus (AOR = 1.81, 95% CI: 1.02-3.22) were at a higher risk of stillbirth. CONCLUSION: These findings highlight the importance of early intervention and close monitoring for women experiencing premature rupture of membranes, prolonged labor, or induced labor. Additionally, consistent partograph use and enhanced prenatal care for pregnancies at risk of preterm or post-term birth could potentially contribute to reducing stillbirth rates and improving maternal and neonatal outcomes. Further research is needed to investigate the underlying mechanisms behind the observed association between fetal sex and stillbirth risk.

Depression, anxiety and stress, during COVID-19 pandemic among midwives in ethiopia: A nationwide cross-sectional survey.

Introduction: COVID-19 has rapidly crossed borders, infecting people throughout the whole world, and has led to a wide range of psychological sequelae. Midwives who come close in contact with women while providing care are often left stricken with inadequate protection from contamination with COVID-19. Therefore, this study aimed to assess the level of depression, anxiety, and stress (DASS) among midwives in Ethiopia. Methods: A cross-sectional study was conducted from 20 June to 20 August 2020, among 1,691 practicing midwives in Ethiopia. A simple random sampling technique was used to select study participants. Data were collected through a structured telephone interview. A 21-item depression, anxiety, and stress scale (DASS-21) was used. Data were entered using the Google forms platform and were analyzed with SPSS version 24. Both bivariate and multivariable logistic regression analyses were employed. Variables with a p-value < 0.05 in the final model were declared statistically significant. Adjusted odds ratio (AOR) with the corresponding 95% confidence interval (95% CI) was used to determine independent predictors. Results: The prevalence of DASS among midwives in Ethiopia was 41.1, 29.6, and 19.0%, respectively. Being female [AOR = 1.35; 95% CI: 1.08, 1.69], working in rural areas [AOR = 1.39; 95% CI: 1.06, 1.82], having poor knowledge of COVID-19 [AOR = 1.40; 95% CI: 1.12, 1.75], having poor preventive practice [AOR = 1.83; 95% CI: 1.47, 2.28], and substance use [AOR = 0.31; 95% CI: 0.17, 0.56] were significantly associated with depression; while, working in the governmental health facility [AOR = 2.44; 95% CI: 1.24, 4.78], having poor preventive practice [AOR = 1,47; 95% CI: 1.16, 1.85], and having poor attitude [AOR = 2.22; 95% CI: 1.04, 1.66] were significantly associated with anxiety. Furthermore, working in rural areas [AOR = 0.57; 95% CI: 0.39, 0.83], substance use [AOR = 2.06; 95% CI: 1.51, 2.81], having poor knowledge [AOR = 1.44; 95% CI: 1.20, 1.90], and having poor preventive practice [AOR = 1.60; 95% CI: 1.23, 2.10] were associated with stress. Conclusion: In this study, the overall magnitude of depression, anxiety, and stress were high. Addressing knowledge gaps through information, training, and safety protocols on COVID-19 and the provision of adequate personal protective equipment (PPE) is essential to preserve the mental health of Midwives during COVID-19.

Knowledge on anaemia and benefit of iron-folic acid supplementation among pregnant mothers attending antenatal care in Woldia town, Northeastern Ethiopia: a facility-based cross-sectional study.

BACKGROUND: Anaemia in pregnancy is the leading cause of maternal morbidity and mortality and poor birth outcomes in low- and middle-income countries. The most common cause of anaemia during pregnancy is acute blood loss and iron deficiency due to physiological changes and increasing demand for iron on the mother and growing foetus. Iron and folic acid supplementation is the most widely employed strategy to alleviate iron deficiency anaemia during pregnancy. The mother's knowledge of anaemia and the benefit of iron-folic acid is crucial in reducing the magnitude of anaemia due to iron deficiency. In Woldia town, despite the efforts made to reduce iron deficiency anaemia during pregnancy, information on pregnant mother knowledge on anaemia and the benefit of iron-folic acid and its associated factors are scarce. METHODS: A facility-based cross-sectional study design was conducted, on 414 pregnant mothers attending antenatal care in Woldia town, Northern Ethiopia. Systematic random sampling methods were used to select study participants. The data were entered into Epi-data version 4.2 and analysed using SPSS version 24. Bivariable and multivariable analysis was done to see the association between the dependent variable and independent variables. RESULTS: This study revealed that 54.1% and 57.7% of pregnant women had good knowledge of anaemia and the benefit of iron-folic acid, respectively. Maternal education status (AOR = 2.19, 95% CI 1.32-3.64), good knowledge of iron-folic acid (AOR = 5.85, 95% CI 3.60-9.50) and residence (AOR = 5.43, 95% CI 2.36-12.51) were statistically associated with pregnant mothers knowledge on anaemia. Obtained counselling on the benefit of iron-folic acid (AOR = 2.04, 95% CI 1.11-3.75), having four or more antenatal care visit (AOR = 3.12, 95% CI 1.38-7.07) and good knowledge of anaemia (AOR = 5.88, 95% CI 3.63-9.50) was statistically associated with pregnant mothers knowledge on the benefit of iron-folic acid. CONCLUSIONS: Promoting frequent antenatal care visits and giving counselling on the benefit of iron-folic acid and cause, prevention and treatment of anaemia were essential strategies to raise knowledge of pregnant mother on anaemia and the benefit of iron-folic acid.

Post-abortion family planning use, method preference, and its determinant factors in Eastern Africa: a systematic review and meta-analysis.

BACKGROUND: Utilization of post-abortion family planning is very critical to reduce high levels of unintended pregnancy, which is the root cause of induced abortion. In Eastern Africa, it is estimated that as many as 95% of unintended pregnancies occurred among women who do not practice contraception at all. Therefore, this meta-analysis aimed to assess post-abortion family planning utilization and its determinant factors in Eastern Africa. METHODS: Published papers from Scopus, HINARI, PubMed, Google Scholar, and Web of Science electronic databases and grey literature repository were searched from database inception to January 30, 2020, with no restriction by design and date of publishing. We screened records, extracted data, and assessed risk of bias in duplicate. Cochrane I2 statistics were used to check the heterogeneity of the studies. Publication bias was assessed by Egger and Biggs test with a funnel plot. A random-effects model was calculated to estimate the pooled prevalence of post-abortion family planning utilization. RESULTS: A total of twenty-nine cross-sectional studies with 70,037 study participants were included. The overall pooled prevalence of post-abortion family planning utilization was 67.86% (95% CI 63.59-72.12). The most widely utilized post-abortion family methods were injectable 33.23% (95% CI 22.12-44.34), followed by implants 24.71% (95% CI 13.53-35.89) and oral contraceptive pills 23.42% (95% CI 19.95-26.89). Married marital status (AOR=3.20; 95% CI 2.02-5.05), multiparity (AOR=3.84; 95% CI 1.43-10.33), having a history of abortion (AOR=2.33; 95% CI 1.44-3.75), getting counselling on post-abortion family planning (AOR=4.63; 95% CI 3.27-6.56), and ever use of contraceptives (AOR=4.63; 95% CI 2.27-5.21) were factors associated with post-abortion family planning utilization in Eastern Africa. CONCLUSIONS: This study revealed that the marital status of the women, multiparity, having a history of abortion, getting counselling on post-abortion family planning, and ever used contraceptives were found to be significantly associated with post-abortion family planning utilization.

Determinants of neonatal jaundice among neonates admitted to five referral hospitals in Amhara region, Northern Ethiopia: an unmatched case-control study.

BACKGROUND: Neonatal jaundice is associated with a significant risk of neonatal morbidity and mortality. It is a major cause of hospital neonatal intensive care unit admission and readmissions during the neonatal period. Hence, the study aimed to identify the determinant factors of neonatal jaundice among neonates admitted at five referral hospitals in Amhara region, Northern Ethiopia. METHOD: A hospital-based unmatched case-control study design was employed, on 447 neonates (149 cases and 298 controls) at referral hospitals in Amhara region, Northern Ethiopia, from 1 March to 30 July 2019. Consecutive sampling method was used to select both the cases and controls. The collected data were entered into Epi data V.4.2 and then exported into SPSS window V.24 for analysis. Bivariable and multivariable analysis were carried out by using binary logistic regression. A p value of <0.05 was considered as significant difference between cases and controls for the exposure variable of interest. RESULTS: The median (±IQR) age of neonate at the time of admission and gestational age were 3±2 days and 38 (±3) weeks, respectively. Prolonged duration of labour (adjusted OR (AOR)=2.45, 95% CI 1.34 to 4.47), being male sex (AOR=3.54, 95% CI 1.99 to 6.29), low birth weight (AOR=5.06, 95% CI 2.61 to 9.82), birth asphyxia (AOR=2.88, 95% CI 1.38 to 5.99), sepsis (AOR=2.49, 95% CI 1.22 to 5.11) and hypothermia (AOR=2.88, 95% CI 2.63 to 14.02) were the determinant factors for neonatal jaundice. CONCLUSIONS: Prolonged duration of labour, hypothermia, sepsis, birth asphyxia, low birth weight and sex of neonate were independent determinants of neonatal jaundice. Early recognition and management of identified modifiable determinants are the recommended interventions.

Determinants of Severe Acute Malnutrition Among HIV-positive Children Receiving HAART in Public Health Institutions of North Wollo Zone, Northeastern Ethiopia: Unmatched Case-Control Study.

BACKGROUND: Over half of the children living with HIV/AIDS suffer from severe acute malnutrition especially in countries having food insecurity like Ethiopia. However, determinants of severe acute malnutrition among HIV-positive children receiving care and treatment in antiretroviral therapy clinics in Ethiopia are not abundantly investigated. The aim of this study was to assess the determinants of severe acute malnutrition among HIV-positive children receiving highly active antiretroviral therapy in public health institutions of the North Wollo Zone, Northeastern Ethiopia. METHODS: An institutional-based unmatched case-control study was conducted on 204 under-fifteen, HIV-positive children (68 cases and 136 controls). The data were collected by reviewing medical records and by interviewing attendants. Binary and multiple logistic regressions were employed, and odds ratio with 95%CI was used to interpret results. A p-value of <0.05 was considered as a significant difference between cases and controls for the exposure variable of interest. RESULTS: A total of 204 under-fifteen, HIV-positive children were included in this study. Of them, 49.5% were males. About 79.4% of those children had acquired HIV infection through vertical transmission. Poor adherence to ART Adj-OR: 5.72 (1.08-30.27), duration on ART Adj-OR: 5.54 (1.44-21.24), severe immunodeficiency Adj-OR: 6.41 (1.09-37.86), advanced WHO clinical stage Adj-OR: 3.58 (1.03-12.43), oropharyngeal disease Adj-OR: 4.72 (1.13-19.73) and chronic diarrhea Adj-OR: 3.98 (1.05-15.04) were identified to be determinants of SAM in those children. CONCLUSION: Determinant factors for SAM among HIV-positive children were chronic diarrhea, severe immunodeficiency, duration and adherence to ART, oropharyngeal disease and advanced WHO clinical stage. Therefore, it is better if interventions are developed and implemented to address these identified factors.

Prevalence and factors associated with intestinal parasitic infections among food handlers working at higher public University student's cafeterias and public food establishments in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Intestinal infection is still an important public health problem in low-income countries. Food handlers may be infected by a wide range of enteropathogens and have been implicated in the transmission of many infections to the public. Therefore, the aim of this review was to produce the pooled prevalence and factors associated with intestinal parasitic infections among food handlers working at higher public University student's cafeterias and public food establishments in Ethiopia. METHODS: Articles published in PubMed/Medline, Hinari, Web of Science, Science Direct, and Google Scholar were used using a search strategy. Observational studies (cross-sectional) revealing the prevalence and factors associated with intestinal parasitic infections at higher public University student's cafeterias and public food establishments were incorporated. Meta-analysis was computed using STATA version 14 statistical software. Heterogeneity of the study was assessed using Cochrane Q test statistics and I2 test. The pooled prevalence of the intestinal parasitic infection and associated factors among food handlers was calculated by the random-effect model. RESULTS: Out of 138 reviewed studies, 18 studies were included to estimate the pooled prevalence of intestinal parasitic infections among food handlers in Ethiopia. All the eighteen articles were included in the analysis. This study revealed that the pooled prevalence of intestinal parasitic infections was 28.5% (95% CI: 27.4, 29.7). E. hystolitica /E. dispar complex 6.38 (95% Cl: 5.73, 7.04), A.lumbricodes 4.12 (95% Cl: 3.56, 4.67), and G. lamblia 3.12(95% Cl: 2.65, 3.60) were the most common intestinal parasitic infections in this study. Untrimmed fingernail 3.04 (95% CI: 2.19, 4.22), do not washing hands after defecation 2.71 (95% CI: 1.93, 3.82), do not washing hands after touching any body parts 2.41 (95% CI: 1.64, 3.56), do not made medical checkup 2.26 (95% CI: 1.57, 3.25), and do not receive food safety training 1.79 (95% CI: 1.30, 2.45) were factors significantly and positively associated with intestinal parasitic infections. CONCLUSION: Parasitic infections among food handlers were significantly high. Untrimmed fingernail, do not washing hands after defecation, do not washing hands after touching any body parts, do not made regular medical checkup and do not receive food safety training were factors that increase the prevalence of intestinal parasitic infections.

Surgical site infection and its associated factors following cesarean section in Ethiopia: a cross-sectional study.

OBJECTIVE: This study aimed to determine the magnitude and associated factors of surgical site infection following cesarean section at Felegehiwot referral hospital, Amhara, Bahir Dar, Ethiopia, 2018. An institution-based retrospective cross-sectional study was conducted from April 1 to May 30, 2018, at Felegehiwot referral hospital. Retrospective chart review was implemented on 383 women who gave birth via cesarean section at Felegehiwot hospital from October 1, 2016 to September 30, 2017. Systematic random sampling technique was implemented to select patient medical charts. RESULTS: This study revealed that the prevalence of surgical site infection following cesarean section was 7.8% with the [95% CI 5.2-10.5%]. Rupture of membrane before cesarean section (AOR = 13.9, 95% CI 2.99-64.8), vertical skin incision/longitudinal abdominal incision (AOR = 4.77, 95% CI 1.74-13.06), duration of operation lasting longer than 30 min (AOR = 4.9, 95% CI 1.8-13.1), interrupted skin closure technique (AOR = 6.29, 95% CI 2.07-19.11) were statistically associated with surgical site infection following cesarean section.

Risk factors for low birth weight in hospitals of North Wello zone, Ethiopia: A case-control study.

BACKGROUND: Low birth weight at birth is an important underlying contributor for neonatal and infant mortality. It accounts for nearly half of all perinatal deaths. Identifying predictors of low birth weight is the first essential step in designing appropriate management strategies. Hence, this study aimed to identify risk factors for low birth weight in hospitals of northeastern Ethiopia. METHODS: An institution based case-control study design was conducted from 10th April to 15th December 2016. Three hundred sixty mother-infant pairs (120 low birth weight babies as cases and 240 normal birth weights as controls) were included in the study. Data were collected by face-to-face interview. Univariable and multivariable logistic regression models were computed to examine the effect of independent variables on outcome variable using SPSS 20.0. Variables with p-value <0.05 were considered statistically significant. RESULTS: The mean (±SD) gestational age and birth weight (±SD) were 39.2 (±1.38) weeks and 2800 (±612), grams respectively. Partner's education/being illiterate (AOR: 4.09; 95% CI 1.45, 11.50), antenatal care visit at private health institutions (AOR: 0.13; 95% CI 0.02, 0.66), having history of obstetric complications (AOR: 5.70; 95% CI 2.38, 13.63), maternal weight during pregnancy (AOR: 4.04; 95% CI 1.50, 10.84) and gravidity (AOR: 0.36; 95% CI 0.18, 0.73) were significantly associated with low birth weight. Additionally, a site for water storage and water treatment were significant environmental factors. CONCLUSION: Maternal weight during pregnancy, paternal education, previous obstetric complication and place of antenatal follow-up were associated with low birth weight. The risk factors identified in this study are preventable. Thus, nutritional counseling, health education on improvement of lifestyle and early recognition and treatment of complications are the recommended interventions.