RESUMO
Background and Aims: Stillbirth is a public health as well as a development problem in low and middle-income countries. The studies that found out maternal age as a factor for the risk of stillbirth reported different findings. This systematic review and meta-analysis is believed to fill the inconclusiveness of these findings. Hence, the aim of this systematic review and meta-analysis is to estimate the pooled effect of advanced maternal age on stillbirth in Africa. Methods: PubMed & HINARY databases and Google Scholar search engine were searched to access the primary studies. The extracted data using Microsoft excel was exported to Stata 15 software for analysis. The presence of heterogeneity was checked using Cochran's Q statistic and the I 2 test. Publication bias was examined by using funnel plot and Egger's test. The pooled effect measure with DerSimonian and Laird method of random-effect model was reported using odds ratio (OR) with respective 95% confidence interval. Results: Totally, 14 articles are included for the systematic review and meta-analysis. The stillbirth reported by the studies ranges from 15 to 146.7 per 1000 births. The overall OR of advanced maternal age (≥35 years) on stillbirth is 1.42 (1.18, 1.71) when compared with the age group of 20-35 years. The cumulative effect of getting pregnant at advanced age on stillbirth was slightly increasing from year to year. Conclusion: Advanced maternal age is a risk factor for stillbirth. Health Information Communication on the risk of getting pregnant at the advanced ages on stillbirth should be well addressed to all women of reproductive age group.
RESUMO
Background and Aims: Malaria elimination programs have also encountered numerous challenges, such as widespread asymptomatic carriers in endemic areas, which should be taken into account in malaria-control programs for effective transmission interruption. The purpose of this research was to determine the prevalence of symptomatic and asymptomatic malaria infections and associated factors, in pastoral communities. Methods: A community-based cross-sectional study was conducted among selected districts in the Waghemra Zone, Northeast Ethiopia, from September to December 2022. A structured questionnaire was employed to collect sociodemographic data and associated risk factors. Plasmodium species were detected using light microscopy and a rapid diagnostic test. Data entry and analysis were carried out using SPSS version 26 software. The association between dependent and independent variables was explored by using multivariable logistic regression analyses. A statistically significant association was declared at a p-value of <0.05. Results: The overall prevalence of malaria was 21.2% (134/633), with the predominant Plasmodium falciparum infections accounting for 67.8% (87/134). Among asymptomatic participants, 7.5% (34/451) and 10.2% (46/451) were diagnosed by rapid diagnostic test and light microscopy, respectively. On the other hand, the prevalence of symptomatic malaria was 44.5% (81/182) and 48.4% (88/182) as diagnosed by rapid diagnostic test and light microscopy, respectively. The presence of stagnant water near the houses, the utilization of insecticide-treated mosquito nets, the number of insecticide-treated mosquito nets, and outdoor stays at night were all positively linked with the prevalence of malaria. Conclusions: The overall prevalence estimate for symptomatic and asymptomatic malaria was high. Malaria is still a public health problem in the study area. Malaria infection was associated with the presence of stagnant water near the houses, the utilization of insecticide-treated mosquito nets, the number of insecticide-treated mosquito nets, and outdoor stays at night. Improved access to all malaria interventions is needed to interrupt the transmission at the community level.
RESUMO
Background: Implanon is a long-acting contraceptive method that is extremely effective in preventing pregnancy with a clinical failure rate of less than 1%. Despite these, the rate of Implanon discontinuation is a common problem in various societies and exposes women to unwanted conception and its consequences. Objective: The current study sought to find and consolidate relevant literature on Implanon discontinuation and associated factors in Ethiopia. Methods: Medline, PubMed, Cochrane Library, EMBASE, and Google Scholar databases were systematically searched for studies published in English before December 2021. The included studies were critically appraised using the JBI instrument for observational studies. STATA version 16 was used for analysis. The presence of statistical heterogeneity was checked using Cochran's Q test, and its level was quantified using I 2 statistics. A pooled estimate of the proportion of outcome variables was calculated. To measure the effect size, pooled odds ratios with 95% CI were computed. Results: The pooled prevalence of Implanon discontinuation in Ethiopia was 32.89%, 95% CI: 24.11%, 41.66%. Experiencing side effects (OR = 2.52, 95% CI 1.75, 3.65), having no children (OR = 1.69, 95% CI 1.15, 2.47), not having received preinsertion counselling (OR = 1.65, 95% CI 1.36, 2.00), having no postinsertion appointment (OR = 2.97, 95% CI 2.10, 4.21), and not satisfied with the service (OR = 2.72, 95% CI 2.47, 5.59) were significantly associated with Implanon discontinuation. Conclusion: The pooled prevalence of Implanon discontinuation in Ethiopia was high. Experiencing side effects, having no child, not receiving preinsertion counselling, having no follow-up appointment, and not being satisfied with the service were significantly associated with Implanon discontinuation. Therefore, healthcare providers should offer preinsertion counselling in accordance with national family planning guidelines, emphasizing the method's advantages and side effects.
