Global Public Health Implications of Traffic Related Air Pollution: Systematic Review.

Background: Traffic-related air pollution (TRAP) has significant public health implications and a wide range of adverse health effects, including cardiovascular, respiratory, pulmonary, and other health problems. This study aimed to determine the public health impacts of traffic-related air pollution across the world that can be used as an input for protecting human health. Methods: This study considered studies conducted across the world and full-text articles written in English. The articles were searched using a combination of Boolean logic operators (AND, OR, and NOT), MeSH, and keywords from the included electronic databases (SCOPUS, PubMed, EMBASE, Web of Science, CINAHL, and Google Scholars). The quality assessment of the articles was done using JBI tools to determine the relevance of each included article to the study. Results: In this study, 1 282 032 participants ranging from 19 to 452 735 were included in 30 articles published from 2010 to 2022. About 4 (13.3%), 9 (30.0%), 12 (40.0%), 8 (26.7%), 2 (6.7%), 15 (50.0%), 3 (10.0%), 3 (10.0%) 1 (3.3%), and 3 (10.0%) of articles reported the association between human health and exposure to CO, PM10, PM2.5, NOx, NO, NO2, black carbon, O3, PAH, and SO2, respectively. Respiratory diseases, cancer, cognitive function problems, preterm birth, blood pressure and hypertension, diabetes, allergies and sensitization, coronary heart disease, dementia incidence, and hemorrhagic stroke were associated with exposure to TRAP. Conclusions: Exposure to nitrogen dioxide, nitrogen oxide, sulfur dioxide, and fine particulate matter was associated with various health effects. This revealed that there is a need for the concerned organizations to respond appropriately.

Prevalence of hypertensive disorders of pregnancy and pregnancy outcomes in Sub-Saharan Africa: A systematic review and meta-analysis.

Hypertensive disorders of pregnancy are one of the leading causes of poor pregnancy outcomes and are associated with increased rates of maternal mortality, preterm birth, small for gestational age newborns, stillbirth, and neonatal death. The overall and type-specific prevalence of hypertensive disorders of pregnancy and associated pregnancy outcomes are unknown in Sub-Saharan Africa. Therefore, this review aimed to identify the prevalence of hypertensive disorders of pregnancy and associated pregnancy outcomes in Sub-Saharan Africa. A systematic review and meta-analysis were conducted on observational facility-based studies irrespective of publication status, sample size, language, and follow-up duration from 19 countries between the years 2000 and 2018 in Sub-Saharan Africa. A review of studies using PubMed, EMBASE, African Index Medicus, and African Journals Online was completed with independent extraction of studies by review authors using the predefined inclusion criteria. Quality and risk of bias of individual studies were assessed using the Joanna Briggs Institute Checklist. Random effects model was used to estimate the pooled prevalence of hypertensive disorders of pregnancy and type-specific hypertensive disorders of pregnancy. A pooled adjusted odds ratio with 95% confidence interval for each study was calculated using comprehensive meta-analysis version 2 software to estimate the association of hypertensive disorders of pregnancy and its outcomes. The existence of heterogeneity was assessed using I2 and its corresponding P value. We assessed the presence of publication bias using the Egger's test. Subgroup analysis was performed to assess the potential effect of variables, and a sensitivity analysis was conducted to assess any undue influence from studies. The analysis included 70 studies. The pooled prevalence of hypertensive disorders of pregnancy (all types combined), chronic hypertension, gestational hypertension, preeclampsia, and eclampsia were 8% (95% confidence interval = [5, 10]), 0.9% (95% confidence interval = [0.4, 1.8]), 4.1% (95% confidence interval = [2.4, 7]), 4.1% (95% confidence interval = [3.2, 5.1]), and 1.5% (95% confidence interval = [1, 2]), respectively. Compared with normotensive pregnant or postpartum women, women with hypertensive disorders of pregnancy were associated with increased risk of maternal mortality, odds ratio = 17 (95% confidence interval = [9.6, 28.8]); cesarean section, odds ratio = 3.1 (95% confidence interval = [1.7, 5.6]); perinatal mortality, odds ratio = 8.2 (95% confidence interval = [2.8, 24]); low birth weight, odds ratio = 3.2 (95% confidence interval = [2, 5]); and preterm delivery, odds ratio = 7.8 (95% confidence interval = [2.5, 25.3]) according to this analysis. The pooled prevalence of hypertensive disorders of pregnancy was high in Sub-Saharan Africa compared to those reported from other regions. Pregnant or postpartum women with hypertensive disorders of pregnancy have increased risk of maternal mortality, cesarean section, preterm delivery, perinatal mortality, and low birth weight newborn. Therefore, creating awareness of the risks of hypertensive disorders of pregnancy is essential. Pregnant women with hypertensive disorders need due attention to manage appropriately and more importantly to have favorable outcomes in this population.

Magnitude of Cesarean Section Delivery and Its Associated Factors Among Mothers Who Gave Birth at Public Hospitals in Northern Ethiopia: Institution-Based Cross-Sectional Study.

BACKGROUND: Cesarean section is one of the most common surgeries around the world performed whenever abnormal conditions complicate labour and vaginal delivery, threatening the life or health of the mother or the baby. Although the cesarean section is a safe operation, when it is performed without medical need, it puts mothers and their babies at risk of short- and long-term health problems. However, the factors are not persistent and there is limited information concerning the levels of cesarean section delivery and its associated factors in public hospitals of North Wollo Zone. Therefore, this study aimed to assess the magnitude of cesarean section and associated factors in hospitals of North Wollo Zone, Northern Ethiopia. METHODS AND MATERIALS: An institution-based cross-sectional study design was employed among 433 mothers who gave birth in public hospitals of North Wollo Zone, Northern Ethiopia, from March 01 to 30, 2019. A systematic random sampling method was used to select the study participants. A structured questionnaire was used to collect data. Bivariable and multivariable analyses were carried out to identify independent predictors of cesarean section. RESULTS: The magnitude of cesarean section delivery was 30.9% (95% CI, 26.8-35.3). Being urban resident (AOR=4.04, 95% CI: 2.19-7.45), malpresentation (AOR=2.56, 95% CI: 1.29-5.05), having a previous cesarean section (AOR=9.11, 95% CI: 3.77-22.01) and antepartum haemorrhage (AOR=8.65, 95% CI: 3.82-19.56) were statistically and positively associated with cesarean section delivery. CONCLUSION: The magnitude of cesarean section delivery among mothers who gave birth at North Wollo Zone public hospitals was high. Residence, antepartum haemorrhage, having a previous cesarean section, and malpresentation were factors associated with cesarean section. Therefore, health education and giving a clear picture regarding the risks and benefits of cesarean section as well as avoiding unjustified cesarean section delivery should be encouraged.

Clients' Satisfaction with Services for Prevention of Mother-to-Child Transmission of HIV in Public Health Facilities in Diredawa City, Eastern Ethiopia.

BACKGROUND: Ethiopia has a very high burden of HIV infection among children, contracted from their mothers, and nearly two-thirds of pregnant women do not receive prevention of mother-to-child transmission (PMTCT) services. Ensuring clients' satisfaction with PMTCT services is one of the bases to scale up service utilization and mitigate MTCT of HIV. However, in Ethiopia, particularly in the study area, evidence related to clients' satisfaction with PMTCT services is scanty. METHODS: A facility-based cross-sectional study was conducted among women attending antenatal care in Diredawa city. Systematic random sampling was used to select 517 study participants. Interviewer-administered structured and pretested questionnaires were used to collect data. Statistical significance was regarded as P≤0.05 with a 95% CI. RESULTS: Client satisfaction with PMTCT services was 82.2% (95% CI 66.4%-94.3). Receiving the service from a hospital (AOR 2.34; 95% CI 1.5, 3.98), no formal education (AOR 2.53, 95% CI 1.52-4.2), primary education (AOR 2.17 95% CI 1.17-4.04), receiving pre- and post-HIV test counseling from the same provider (AOR 4.93, 95% CI 2.98-7.17), gestational age above first trimester (AOR 1.74, 95% CI 1.12-2.71), and waiting time ≤15 minutes (AOR 2.31, 95% CI 1.28-4.16) were positively associated with client satisfaction with PMTCT services. CONCLUSION: Client satisfaction with PMTCT services is relatively high. Receiving the service from a hospital, no formal education or only primary education, gestational age above first trimester, getting pre- and post-HIV test counseling from the same provider, and waiting time ≤15 minutes to receive services were factors associated with client satisfaction. A greater number of skilled PMTCT-service providers would improve service quality and hasten its delivery. Furthermore, providing mentoring and supportive supervision of health centers with PMTCT programs and keeping the same provider in posttest counseling is also mandatory.

Male involvement in prevention of mother to child transmission of human immunodeficiency virus and associated factors in Enebsiesarmider District, north West Ethiopia, 2018: a cross-sectional study.

BACKGROUND: Globally, male involvement has been identified as a priority target area to be strengthened in the prevention of mother to child transmission (PMTCT) of HIV. However, there are limited studies on husband involvement in the prevention of mother to child transmission of HIV in Ethiopia. Therefore, this study aimed to assess male involvement in the prevention of mother to child transmission of HIV and associated factors among males whose wives gave birth in the last six months before the survey in Enebsiesarmider district, Northwest Ethiopia. METHODS: A Community-based cross-sectional study was employed to assess male involvement in the prevention of mother to child transmission of human immunodeficiency virus and associated factors in Enebsiesarmider District, Northwest Ethiopia. The study was conducted from February 10-30, 2018. A total of 525 participants were involved in the study. A stratified cluster sampling method was used to recruit study participants. Data were collected using a structured interviewer-administered questionnaire. Data were entered using the epi Data software and exported to SPPS for analysis. Descriptive statistics including mean, a proportion were used to describe study variables. Multivariable logistic regression was employed to describe variables with the outcome variable. RESULT: Overall male involvement in PMTCT was found to be 26.1% [95%CI, 22.1-29.5]. Respondents who have attended secondary education and above were more likely get involved in PMTCT than who have no formal education [AOR 2.45, 95%CI, 1.47-4.11], Respondents who have good knowledge on PMTCT [AOR 2.57, 95%CI, 1.58-4.18], good knowledge on ANC [AOR 2.10, 95%CI, 1.28-3.44], low cultural barriers [AOR 2.20, 95%CI, 1.34-3.63] low health system barriers [AOR 2.40, 95%CI, 1.37-4.20] were variables that significantly increase male involvement in PMTCT practices. CONCLUSION: Male involvement in PMTCT was found to be low in the study area. Therefore, the district health office in collaboration with local health care providers shall design strategies for enhancing male involvement through creating a husband's knowledge regarding the merit of prevention of mother to child transmission through the provision of adequate information for all male partners at ANC clinic is recommended.

Seroprevalence of Hepatitis B Virus and Associated Factors Among Pregnant Women Attending Antenatal Care in Public Health Facilities in Jigjiga Town, Eastern Ethiopia.

BACKGROUND: Hepatitis B virus (HBV) remains a major global public health problem affecting millions of people across the world. The risk of developing a chronic hepatitis B virus infection is affected by the age at the time of acquiring infection. For instance, around 95% of these infections are acquired during the perinatal period. Although evidences indicate the wider effects of hepatitis B virus and its negative consequences, there are limited studies and a scarcity of data in Eastern Ethiopia. Therefore, this study was aimed at determining seroprevalence of HBV and associated factors among pregnant women attending antenatal care in the public health facilities of Jigjiga town, Eastern Ethiopia, from March 4 to April 4, 2019. METHODS: A facility-based cross-sectional study was employed among pregnant women in the public health facilities of Jigjiga town, Eastern Ethiopia. A total of 589 pregnant women were enrolled in the study using a systematic sampling technique. Data were collected using a pretested interviewer administered questionnaire. Five milliliters of venous blood samples was collected and tested for HBV using ELISA diagnostic test. The collected data were entered in to Epidata version 3.1 and exported to SPSS version 20 for statistical analysis. Descriptive statistics was carried out using frequency tables and summary measures. Multivariable analysis was done to identify the true effects of the selected predictor variables on the outcome variable after controlling for possible confounders. Statistical significance was declared at p-value <0.05. RESULTS: Overall, 8.5% (95% CI: 6.5-10.7) of the study participants were seropositive for HBsAg. Having any surgical history [AOR = 3.41, 95% CI (1.26-9.24)], family history of HBV [AOR = 4.96, 95% CI (2.11-10.60)], history of sharing sharps [AOR = 2.78, 95% CI (1.13-6.83)] and having multiple sexual partners [AOR = 6.12, 95% CI (2.12-17.64)] were significant predictors of HBV infection. CONCLUSION: The seroprevalence of HBV was relatively high in this study area. Having a history of surgery, family history of hepatitis, history of sharing sharps and multiple sexual partners were significantly associated with HBV infection. Therefore, health information dissemination and awareness creation on mode of transmission of HBV are very crucial.

Delay in diagnosis of pulmonary tuberculosis in low-and middle-income settings: systematic review and meta-analysis.

BACKGROUND: Assessment of delays in seeking care and diagnosis of tuberculosis is essential to evaluate effectiveness of tuberculosis control programs, and identify programmatic impediments. Thus, this review of studies aimed to examine the extent of patient, health system, and total delays in diagnosis of pulmonary tuberculosis in low- and middle- income countries. METHODS: It was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Electronic databases were searched to retrieve studies published from 2007 to 2015 including Pubmed central, Springer link, Hinari and Google scholar. Searching terms were pulmonary tuberculosis, health care seeking, health care seeking behavior, patient delay, diagnostic delay, health system delay, provider delay, and doctor delay. Retrieved studies were systematically reviewed and summarized using Comprehensive Meta-analysis software. RESULTS: Forty studies involving 18,975 patients qualified for systematic review, and 14 of them qualified for meta-analysis. The median diagnostic delay ranged from 30 to 366.5 days [IQR = 44-77.8], with a 4-199 days [IQR = 15-50] and 2-128.5 days [IQR = 12-34] due to patient and health system delays, respectively. The meta-analysis showed 42% of pulmonary tuberculosis patients delayed seeking care by a month or more; uneducated patients [pooled OR = 1.5, 95%CI = 1.1-1.9] and those who sought initial care from informal providers [pooled OR = 3, 95%CI = 2.3-3.9] had higher odds of patient delay. CONCLUSION: Delay in diagnosis is still a major challenge of tuberculosis control and prevention programs in low- and middle- income settings. Efforts to develop new strategies for better case-finding using the existing systems and improving patients' care seeking behavior need to be intensified.