Gestational weight gain and its determinants among pregnant women in Gurage zone, Central Ethiopia: a cohort study.

BACKGROUND: The nutritional status of the mothers before pregnancy and the weights gained during pregnancy are very crucial factors affecting the pregnancy outcomes and health of the infants. This study aimed to assess early pregnancy weight, determine the magnitude of gestational weight gain, and investigate the factors affecting gestational weight gain among pregnant women in the Gurage zone, 2022. METHODS: A prospective cohort study was conducted among pregnant women who started antenatal care follow-up before the 16th week of gestation in the selected hospitals and health centers of the Gurage zone, Ethiopia. The gestational weight gain was obtained by subtracting the early pregnancy weight from the last pregnancy weight and categorizing based on the Institute of Medicine (IOM) recommendation. RESULTS: The early pregnancy weight status of the women at enrollment indicates that 10% of them were underweight and 83% of them had normal weight. On average, the study participants gained 13.3 kgs of weight with [95% CI: 13.0, 13.6]. More than half (56%) of them gained adequate weight, a quarter (26%) of them gained inadequate weight, and 18% of them gained excess weight during pregnancy compared to the IOM recommendation. Maternal age, occupational status, and early pregnancy weight status were found to have a statistically significant association with the gestational weight gained. CONCLUSION: Almost half (44%) of the pregnant women gained either inadequate or excess weight during pregnancy. Promoting gestational weight gain within recommended guidelines should be emphasized for younger, employed women and those who are either underweight or overweight.

Experiences, barriers, and facilitators of health data use among performance monitoring teams (PMT) of health facilities in Eastern Ethiopia: A qualitative study.

BACKGROUND: Routine health data is crucial in decision-making and improved health outcomes. Despite the significant investments in improving Ethiopia's Performance Monitoring Team (PMT), there is limited evidence on the involvement, implementation strategies, and facilitators and barriers to data utilization by these teams responding to present and emerging health challenges. Therefore, this study aimed to explore the PMT experiences, facilitators, and barriers to information use in healthcare facilities in Eastern Ethiopia. METHOD: This study employed a phenomenological study design using the Consolidated Framework for Implementation Research (CFIR) to identify the most relevant constructs, aiming to describe the data use approaches at six facilities in Dire Dawa and Harari regions in July 2021. Key informant interviews were conducted among 18 purposively selected experts using a semi-structured interview guide. Thematic coding analysis was applied using a partially deductive approach informed by previous studies and an inductive technique with the creation of new emerging themes. Data were analyzed thematically using ATLAS.ti. RESULTS: Study participants felt the primary function of PMT was improving health service delivery. This study also revealed that data quality, performance, service quality, and improvement strategies were among the major focus areas of the PMT. Data use by the PMT was affected by poor data quality, absence of accountability, and lack of recognition for outstanding performance. In addition, the engagement of PMT members on multiple committees negatively impacted data use leading to inadequate follow-up of PMT activities, weariness, and insufficient time to complete responsibilities. CONCLUSION: Performance monitoring teams in the health facilities were established and functioning according to the national standard. However, barriers to operative data use included PMT engagement with multiple committees, poor data quality, lack of accountability, and poor documentation practices. Addressing the potential barriers by leveraging the PMT and existing structures have the potential to improve data use and health service performance.

Incidence of celiac disease autoimmunity and associations with maternal tuberculosis and pediatric Helicobacter pylori infections in 4-year-old Ethiopian children followed up in an HLA genotyped birth cohort.

Background: The prevalence of celiac disease in the general population is mainly unknown in most of sub-Saharan African countries. The aim of this study was to determine the incidence of celiac disease autoimmunity (CDA) and its associations with latent Mycobacterium tuberculosis (LMTB) and Helicobacter pylori (HP) infections in Ethiopian children aged 4 years in an HLA genotyped cohort study. Methods: Of 1,389 recruited children between 2018 and 2022, 1,046 (75.3%) had been screened at least twice for celiac disease between the ages of 2 and 4 years using a tissue transglutaminase autoantibody (tTGA) ELISA kit. Tissue TGA-positive children were retested using radio-binding assays. CDA was defined as persistent-confirmed tTGA positivity in two consecutive samples. Associations of CDA with LMTB and HP were tested in a subpopulation of 752 children born to mothers who were previously tested for LMTB with IFN-γ and anti-HP antibodies in samples collected at a mean age of 49.3 ± 5.3 months. Results: Screening detected 38 out of 1,046 (3.6%) IgA-tTGA-positive children. Ten (1.0%) were confirmed to be positive, with six (0.6%) children diagnosed with CDA. The incidence of CDA at 4 years of age was 1.2 per 1,000 person-years. LMTB was found in 4 of 6 (66.7%) mothers with CDA children compared with 340 of 734 (46.3%) mothers of children without CDA (p = 0.424), while HP was found in 3 of 6 (50.0%) CDA children compared with 315 of 746 (42.2%) children without CDA (p = 0.702). Conclusion: The incidence of CDA in Ethiopian children is lower than the pooled global incidence. Neither LMTB nor HP infections are associated with CD in Ethiopian children.

Harmful cultural practices during perinatal period and associated factors among women of childbearing age in Southern Ethiopia: Community based cross-sectional study.

INTRODUCTION: Although the maternal mortality ratio has decreased by 38% in the last decade, 810 women die from preventable causes related to pregnancy and childbirth every day, and two-thirds of maternal deaths occur in Sub-Saharan Africa alone. The lives of women and newborns before, during, and after childbirth can be saved by skilled care. The main factors that prevent women from receiving care during pregnancy and childbirth are harmful cultural practices. The aim of this study was to assess the level of harmful cultural practices during pregnancy, childbirth, and postnatal period, and associated factors among women of childbearing age in Southern Ethiopia. METHODS: A community-based cross-sectional study design was conducted in the Gurage zone, among representative sample of 422 women of reproductive age who had at least one history of childbirth. A simple random sampling technique was used to recruit participants. Data were collected by six experienced and trained data collectors using a pretested structured questionnaire with face to face interviews. Harmful cultural practices are assessed using 11 questions and those who participate in any one of them are considered as harmful cultural practices. Descriptive statistics were performed and the findings were presented in text and tables. Binary logistic regression was used to assess the association between each independent variable and outcome variable. RESULTS: Harmful cultural practices were found to be 71.4% [95%CI, 66.6-76.0]. The mean age of study participants was 27.6 (SD ± 5.4 years). Women with no formal education [AOR 3.79; 95%CI, 1.97-7.28], being a rural resident [AOR 4.41, 95%CI, 2.63-7.39], having had no antenatal care in the last pregnancy [AOR 2.62, 95%CI, 1.54-4.48], and pregnancy being attended by untrained attendants [AOR 2.67, 95%CI, 1.58-4.51] were significantly associated with harmful cultural practice during the perinatal period. CONCLUSION: In this study we found that low maternal education, rural residence, lack of antenatal care and lack of trained birth attendant were independent risk factors associated with women employing harmful cultural practices during the perinatal period. Thus, strong multi-sectoral collaboration targeted at improving women's educational status and primary health care workers should take up the active role of women's health education on the importance of ANC visits to tackle harmful cultural practices.

Distribution of HLA-DQ risk genotypes for celiac disease in Ethiopian children.

Most patients with celiac disease are positive for either HLA-DQA1*05:01-DQB1*02 (DQ2.5) or DQA1*03:01-DQB1*03:02 (DQ8). Remaining few patients are usually DQA1*02:01-DQB1*02 (DQ2.2) carriers. Screenings of populations with high frequencies of these HLA-DQA1-DQB1 haplotypes report a 1% to 3% celiac disease prevalence. The aim was to determine the prevalence of HLA-DQ risk haplotypes for celiac disease in Ethiopian children. Dried blood spots collected from 1193 children from the Oromia regional state of Ethiopia were genotyped for HLA-DQA1 and DQB1 genotyping using an asymmetric polymerase chain reaction (PCR) and a subsequent hybridization of allele-specific probes. As references, 2000 previously HLA-genotyped children randomly selected from the general population in Sweden were included. DQ2.2 was the most common haplotype and found in 15.3% of Ethiopian children, which was higher compared with 6.7% of Swedish references (P < .0001). Opposed to this finding, DQ2.5 and DQ8 occurred in 9.7% and 6.8% of Ethiopian children, which were less frequent compared with 12.8% and 13.1% of Swedish references, respectively (P < .0001). The DQ2.5-trans genotype encoded by DQA1*05-DQB1*03:01 in combination with DQ2.2 occurred in 3.6% of Ethiopian children, which was higher compared with 1.3% of Swedish references (P < .0001). However, when children with moderate high to very high-risk HLA genotypes were grouped together, there was no difference between Ethiopian children and Swedish references (27.4% vs 29.0%) (P = .3504). The frequency of HLA risk haplotypes for celiac disease is very similar in Ethiopian and Swedish children. This finding of importance will be useful in future screening of children for celiac disease in Ethiopia.

Voluntary Blood Donation Knowledge, Attitudes, and Practices in Central Ethiopia.

BACKGROUND: Increasing the availability of safe blood is a major challenge in developing countries. Given the scant amount of community-based data in Africa, this study examines the knowledge, attitudes, and practices of blood donation of Ethiopian adults. METHODS: A cross-sectional study was conducted on 421 adult residents of Adama town using face-to-face interviews with translated questionnaires. Knowledge and attitude levels were assessed using a set of questions and those who answered above mean for knowledge and attitude questions were categorized as above-average knowledge level and favorable attitude, respectively. The data were coded and entered into EPI Info™ version 7, transferred to SPSS version 25 for cleaning and analysis. All variables with p<0.25 in the bivariable analysis were examined as candidate variables in the multivariable logistic regression models. RESULTS: Less than half, 47% (95% CI: 42-52%) of the study participants have above-average knowledge level about blood donation and 48% (95% CI: 43-53%) have favorable attitudes towards blood donation. Only 17% (95% CI: 13-21%) of study participants ever donated blood of which 14.6% of them donated for replacement and less than 2% (1.95%) are voluntary donors. Younger age of 18-25 AOR: 95% CI: 3.40 (1.30, 12.43), having good knowledge AOR: 95% CI: 2.21 (1.26, 3.89) and favorable attitude AOR: 95% CI: 10.25 (4.90, 21.44) were factors independently associated with blood donation practice. CONCLUSION: The level of blood donation practiced in the study area is low. Low knowledge and poor attitudes are independent predictors of low inclination to donate, so awareness creation and improving attitudes in blood donation campaigns, particularly among older people is necessary to increase voluntary blood donation.

Prevalence of unintended pregnancy and associated factors among pregnant mothers in Jimma town, southwest Ethiopia: a cross sectional study.

BACKGROUND: Unintended pregnancy is a pregnancy that occurred when no children were desired or earlier than desired. One in three births in Ethiopia were unintended, which is major contributor to maternal morbidity and mortality. The objective of this study was to assess prevalence of unintended pregnancy and associated factors among pregnant women in Jimma. METHODS: Community based cross-sectional study was conducted from May to June, 2016. Estimated sample size of 356 was allocated proportionally to the randomly selected kebeles based on number of pregnant women in their kebeles and simple random sampling technique was used in selecting participants. Data were collected by structured questionnaires with face to face interview, analyzed by SPSS and multivariate logistic regression was fitted to identify factors independently associated with unintended pregnancy. RESULTS: The prevalence of unintended pregnancy among the study participants was 36.5% (95% CI: 31-42%), of which 97 (27.2%) were unwanted and 33 (9.3%) were mistimed. The most common reasons for failure to avoid unintended pregnancy were because they believed they were not fertile 54 (41.5%) and 26 (20%) became pregnant despite the use of contraceptive methods. Age of the mother over 35 years, lower educational status of the partner, higher family size, smaller number of children desired and less knowledge of modern contraceptive methods were independent predictors of unintended pregnancy. CONCLUSION: The prevalence of unintended pregnancy was high in the study area and programs aimed at reducing unintended pregnancy should target older couple. In addition, improving educational status of the partner and knowledge of modern contraceptive methods is demanded.

Determinants of HIV infection among children born to mothers on prevention of mother to child transmission program of HIV in Addis Ababa, Ethiopia: a case control study.

BACKGROUND: Despite wide spread use of Antiretroviral Therapy (ART) by pregnant women living with Human Immunodeficiency Virus (HIV), the transmission rate is still higher by 18% after breastfeeding ends. The aim of this study was to identify factors affecting mother-to-child HIV transmission. METHODS: Unmatched case-control study was conducted in Addis Ababa, from April to May, 2017. A case was HIV positive mother who had been on PMTCT program with her child confirmed HIV positive at or before 24 months and control was HIV positive mother who had been on PMTCT program with her child tested definitive HIV negative at 24 months. Accordingly, 44 cases were identified and for each case four controls with the nearest date of birth to the cases were selected from same health facilities. Primary data collected from the mothers were supplemented by record reviews and entered to Epidata version 3.1 and analyzed using SPSS version 22. Multivariate logistic regression was fitted to identify factors independently associated with mother-to-child HIV transmission. RESULTS: Lack of participation in mother-to-mother support program (AOR: 5.1; 95% CI: 1.4, 18.1), low partner involvement (AOR: 6.9; 95% CI: 1.4, 13.4), poor ART adherence (AOR:3.1; 95% CI: 1.3, 7.5), positive syphilis test results (AOR: 3.2; 95% CI: 1.2, 8.6), maternal malnutrition (AOR: 3.1; 95% CI: 1.4, 6.8), unplanned pregnancy (AOR: 10.3; 95% CI: 3.9, 27.2), home delivery (AOR: 5.3; 95% CI: 1.4, 19.4) and mixed feeding of the child during first six months of life (AOR: 12.5; 95% CI: 2.9, 52.7) were significantly associated with MTCT of HIV. CONCLUSIONS: Mother-to-mother support, male partner involvement in PMTCT of HIV, strengthening antenatal care, counseling mothers on appropriate infant feeding options are important to reduce mother -to- child transmission of HIV.