Immediate postpartum anemia and associated factors at shewarobit health facilities, Amhara, Ethiopia, 2022: a cross sectional study.

BACKGROUND: Immediate postpartum anemia occurs when the amount of red blood cell count is reduced or hemoglobin concentration is below 10 g/dl in the immediate postpartum. It occurs primarily due to inadequate iron intake before and during pregnancy and blood loss during delivery. The aim of this study is to assess the proportion of immediate postpartum anemia and associated factors among mothers who gave birth at Shewarobit health facilities; in Amhara, Ethiopia. METHODS: Institutional-based cross-sectional study was conducted from June to September 2022. A systematic random sampling method was employed to select the study participants. The data were collected through interviewer-assisted questions. Data were entered into Epi Data software version 4.6.0.4 and exported to SPSS 21 for analysis, and descriptive statistics were computed. Logistic regression was applied, and P-values less than 0.05 were considered statistically significant. RESULTS: This study was conducted among 307 study participants and, the proportion of immediate postpartum anemia was 41.4% [95% CI: 36.7-46.6]. Having postpartum hemorrhage [AOR = 4.76, 95% CI: 2.44-9.28], not taking iron and folic acid supplementation [AOR = 6.19, 95% CI: 2.69, 14.22], having a prolonged second stage of labor [AOR = 2.52, 95% CI: 1.16-5.44], and mid-upper arm circumference < 23 cm [AOR = 2.02, 95% CI: 1.11-3.68] were factors significantly associated with immediate postpartum anemia. CONCLUSIONS: The proportion of immediate postpartum anemia was public problem in Shewarobit health facilities. Following the progress of labor using a partograph, closely monitoring and immediate intervention of PPH, and prevent undernutrition during antenatal care is recommended.

Early-onset of sexual activity as a potential risk of cervical cancer in Africa: A review of literature.

INTRODUCTION: In most African countries, cervical cancer is the most common cancer among women, both in terms of incidence and fatality. In the existing literature, age is risk factor for developing cervical cancer since it occurs mainly after the middle life of women. However, there have been contradictory findings in the literature on whether early sexual intercourse is linked to cervical cancer, with some studies indicating no relationship and others reporting an increased risk. Hence, this review analyzed data from recently published studies on cervical cancer. METHODS: Seven databases (MEDLINE via PubMed, Google Scholar, Scopus, Medscape, EMBASE, African Journals Online and Science Direct) were searched for papers published from January 2000 to March 2022 in English. Ten studies were included in analysis. The statistical analysis was performed using STATA 11. Heterogeneity between-study was explored by forest plot and inconsistency index (I2). The publication bias was checked by a funnel plot and Egger's test. The pooled estimates of odds ratios were calculated by a random-effects model. RESULTS: In the subgroup analysis, there was no significant association between early sexual activity and cervical cancer. However, the overall pooled analysis of these ten studies revealed that there is an association between early sexual debut and cervical cancer. In the random effect model, we found a pooled odds ratio of 2.95 (95% CI = 1.06, 4.83), indicating that women who began sexual intercourse before the age of 18 had a higher risk of getting cervical cancer than adult women. CONCLUSION: In this analysis, women who began having early sexual debut had a greater risk of developing cervical cancer than those who initiated sexual intercourse later in life. Delaying the age of first sexual activity among adolescents could help prevent the occurrence of cervical cancer.

Determinants of neonatal mortality among neonates admitted to neonatal intensive care unit of Dessie comprehensive and specialized hospital, Northeast Ethiopia; An unmatched case-control study.

Background: According to the World health organization, neonatal mortality is defined as the death of babies within the first 28 days of their lives. The newborn period is the most vulnerable period for a child's survival, with the bulk of neonatal deaths occurring on the first day and week. According to a recent study, about a third of all newborn deaths occur within the first day of life, and nearly three-quarters occur within the first week. This study aimed to assess the determinants of neonatal mortality among neonates admitted to the neonatal intensive care unit in Dessie comprehensive and specialized hospital, northeast Ethiopia. Methodology: Health institution-based unmatched case-control study was conducted among neonates admitted to Dessie comprehensive and specialized hospital, Ethiopia from February 01 up to March 30, 2020. After keeping cases and controls in separate frames, study participants were chosen using a simple random sampling procedure until the sample size was met. Epi data version 7.0 and SPSS version 25 were used for data entry and analysis respectively. P ≤ 0.05 was used as a cut point of statistical significance in multivariable binary logistic regression. Results: A total of 698 (233 cases and 465 controls) participated in the study. Pregnancy induced hypertension (AOR = 3.02; 95% CI; 1.47-6.17), public hospital delivery (AOR = 3.44; 95% CI; 1.84-6.42), prematurity (AOR = 2.06; 95% CI; 1.43-2.96), being referred (AOR = 4.71; 95% CI; 3.01-7.39), and hypothermia (AOR = 2.44; 95% CI; 1.56-3.82) were determinant factors of neonatal mortality. Conclusion: Pregnancy-induced hypertension, public hospital delivery, prematurity, referral, and hypothermia were found to be the determinant factors of neonatal mortality. It would be important to give due attention to neonates delivered from mothers with a history of hypertensive disorder. Besides better to give due attention to neonates delivered in public health institutions, prematurely delivered, referred, and hypothermic neonates. Lastly, further research should be conducted to investigate the additional determinants of neonatal mortality.

Menstrual irregularity and its associated factors among college students in Ethiopia, 2021.

Background: Menstrual irregularity can occur at any age, but it is most common among women under the age of 23 years. Menstrual irregularity is a foremost gynecological problem and a cause of anxiety to students and those close to them. These students experience monthly absenteeism, premenstrual symptoms, and a lack of concentration due to menstrual problems, all of which interfere with their education. Therefore, this study aimed to assess the magnitude of menstrual irregularity and associated factors among college students in Debre Berhan Town, North Shewa, Amhara Regional State, Ethiopia, in 2021. Methods: An institution-based cross-sectional study was conducted from June to July 2021 in Debre Berhan town. Data was collected using self-administered questionnaires in 420 eligible female college students by systematic random sampling technique. Weight and height were measured and Body Mass Index (BMI) was calculated after data collection. Each questionnaire was checked for completeness, cleaned, coded, entered into EPI-DATA, and then transported to SPSS software. Bi-variable and multivariable logistic regression analyses were employed to determine the association of each independent variable with the dependent variable. P ≤ 0.05 were used to declare association and select predictors. Results: In the current study, 395 students participated with a response rate of 93.6%. Of all the total respondents, the magnitude of menstrual cycle irregularity was 33.4% (95% CI 28.6-38.2). Age < 20 years old [AOR = 3.88, 95% CI (1.25-12.18)], age of menarche ≤ 12 years [AOR = 4, 95% CI (1.18-13.9), sleeping hours ≤ 5 h [AOR= 2.26, 95% CI (1.04-4.93)], perceived stress [AOR = 2, 95% CI (1.53-3.23)] and being overweight [AOR = 2, 95% CI (1.13-3.23) were the variables significantly associated with the magnitude of menstrual irregularity. Conclusion and recommendation: This study shows that more than one-third of the college students in Debre Berhan town have experienced menstrual irregularity. Being less than 20 years old, having a history of early menarche, being overweight, and perceived stress were a variable significantly associated with menstrual irregularity. To control menstrual irregularity, girls should control their weight and lead a healthy lifestyle, including getting adequate sleep which could be aided by training on time management.

Prevalence of exclusive breastfeeding practice and its association with maternal employment in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Exclusive breastfeeding is defined as the practice of providing only breast milk for an infant for the first 6 months of life without the addition of any other food or water, except for vitamins, mineral supplements, and medicines. Findings are inconsistent regarding the prevalence of exclusive breastfeeding in Ethiopia. Full-time maternal employment is an important factor contributing to the low rates of practice of exclusive breastfeeding. Empowering women to exclusively breastfeed, by enacting 6 months' mandatory paid maternity leave can increase the rate of exclusive breastfeeding in the first 6 months of life up to 50%. The purpose of this review was to estimate the pooled prevalence of exclusive breastfeeding and its association with full-time maternal employment in the first 6 months of life for infants in the context of Ethiopia. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used in this systematic review and meta-analysis. All observational studies reporting the prevalence of exclusive breastfeeding and its association with maternal employment in Ethiopia were considered. The search was conducted from 6 November 2020 to 31 December 2020 and all papers published in the English language from 1 January 2015 to 31 December 2020 were included in this review. RESULTS: Forty-five studies were included in the final analysis after reviewing 751 studies in this meta-analysis yielding the pooled prevalence of EBF 60.42% (95% CI 55.81, 65.02) at 6 months in Ethiopia. Those full-time employed mothers in the first 6 months were 57% less likely to practice exclusive breastfeeding in comparison to mothers not in paid employment in Ethiopia (OR 0.43; 95% CI 0.31, 0.61). CONCLUSIONS: Full-time maternal employment was negatively associated with the practice of exclusive breastfeeding in comparison to unemployed mothers. The prevalence of exclusive breastfeeding in Ethiopia is low in comparison to the global recommendation. The Ethiopian government should implement policies that empower women. The governmental and non-governmental organizations should create a conducive environment for mothers to practice exclusive breastfeeding in the workplace.

Surgical site infection and its association with rupture of membrane following cesarean section in Africa: a systematic review and meta-analysis of published studies.

INTRODUCTION: Surgical site infection occurs within 30 days after a surgical procedure and involves the skin, subcutaneous tissue, and soft tissue. Surgical site infection following cesarean section is a common postoperative complication and is associated with maternal morbidity and mortality in resource-limited settings. Even though the proportion of surgical site infection and some risk factors were reported by kinds of literature, varying results were stated across studies. There is also limited knowledge on the association between postpartum surgical site infection and the rupture of membrane. Hence, this systematic review and meta-analysis was designed to estimate the pooled proportion of surgical site infection and its association with rupture of membrane following cesarean section in Africa. METHODS: Studies published from January 01, 2000 to January 30, 2020 were searched from MEDLINE via PubMed, Scopus, Medscape, Web-science and CINAHL databases to search relevant published articles. We also performed a manual search of reference lists of key articles to retrieve additional relevant articles. Initially, 559 records were identified and 15 studies included in the analysis. The statistical analysis was performed using STATA 11. Heterogeneity between-study was explored by forest plot and inconsistency index (I2). The publication bias was checked by a funnel plot and Egger's test. Pooled estimates of proportion and odds ratio were calculated by a random-effects model with a 95% confidence interval (CI). RESULTS: The overall pooled proportion of surgical site infection following cesarean section was 10.21% (I2 = 86.8, p < 0.000; 95% CI = 8.36, 12.06). The odds of developing surgical site infection among women who had the rupture of membrane before delivery were nearly 6 times higher than those who had not a rupture of the membrane (AOR = 5.65, 95% CI: 3.95-8.07). CONCLUSIONS: The proportion of surgical site infections following the cesarean section is relatively high. Women who had rupture of the membrane before delivery were more likely to develop surgical site infections following the cesarean section. Due attention should be given to the provision of prophylactic antibiotics that can reduce surgical site infection after cesarean delivery.

Unmet need for family planning in Ethiopia and its association with occupational status of women and discussion to her partner: a systematic review and meta-analysis.

BACKGROUND: Unmet need refers to fecund women who either wish to postpone the next birth (spacers) or who wish to stop childbearing (limiters) but are not using a contraceptive method. Many women who are sexually active would prefer to avoid becoming pregnant but are not using any method of contraception. These women are considered to have an unmet need for family planning. Therefore, the objective of this systematic review and meta-analysis is to estimate the pooled prevalence of unmet need for family planning and its association to occupational status of women and discussion to her partner among fecund women in Ethiopia. METHOD: A systemic review and meta-analysis was conducted using published and unpublished research on the prevalence of unmet need for family planning and its association to occupational status of women and discussion to her partner among fecund women in Ethiopia. Data extraction was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were accessed through electronic web-based search from PubMed, Cochrane Library, Google Scholar, CINAHL, and Embase. All statistical analysis were done using STATA version 14 software using random effects model. The pooled prevalence was presented in forest plots. RESULTS: A total of 9 studies with 9785 participants were included, and the overall pooled estimated prevalence of unmet need for family planning among fecund women in Ethiopia was 34.90% (95% CI: 24.52, 45.28%). According to subgroup analysis the estimated prevalence of unmet need for family planning in studies conducted in Amhara was 32.98% (95% CI: 21.70, 44.26%), and among married women was 32.84% (95% CI: 16.62, 49.07%). Additionally, housewife women were 1.6 times more likely have unmet need for family planning compared to government employed women (OR: 1.6, 95% CI: 1.29, 1.99). Moreover, women who don't discuss to partner were 1.87 times more likely to have unmet need for family planning compared to women who had discussion to her partner (OR 1.87; 95% CI: 1.52, 2.31). CONCLUSION: The analysis revealed that the overall prevalence of unmet need for family planning among fecund women in Ethiopia was high. Family planning programs should identify strategies to improve communication in family planning among couples and to ensure better cooperation between partners.

Preparedness and Responses of Healthcare Providers to Combat the Spread of COVID-19 Among North Shewa Zone Hospitals, Amhara, Ethiopia, 2020.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging respiratory disease that is caused by a novel coronavirus and was first detected in December 2019 in Wuhan, China. The disease is highly infectious, and its main clinical symptoms include fever, dry cough, fatigue, myalgia, and dyspnea. Healthcare providers are in front in fighting the coronavirus spread by making themselves the risk of contracting the disease. OBJECTIVE: To assess the preparedness and responses of healthcare providers to combat the spread of COVID-19 among North Shewa Zone Hospitals, Amhara, Ethiopia. METHODS: Facility-based cross-sectional study was conducted from April to May 2020 among 422 healthcare providers in the North Shewa Zone, Amhara, Ethiopia using a self-administered questionnaire. Study subjects were selected through systematic random sampling based on their proportional distribution of sample size to each hospital. A structured questionnaire was used to collect the data. The data were coded and entered into the Epi data 4.2.1 version and the analysis was carried out in Statistical Package for Social Science 25 versions. RESULTS: Four hundred four participants involved in the study have been given a response rate of 95.7%. The self-satisfaction of healthcare providers revealed 301 (74.5%) of study participants feel unsafe in their workplace. Two-third, 260 (64.4%), of them responded that they feel anxious while working with febrile patients. Nearly one-third (31%), 27.4%, 15.9%, 14.5%, 14.2% of HCPs had access to gloves, facemask, goggle, shoe, and apron respectively in hospitals. CONCLUSION: Protecting healthcare workers is a public health priority. Access to essential personal protective equipment during the COVID-19 pandemic was limited. The poor perception of healthcare professionals about not having enough support from medical institutions and public health authorities raises the need to urgently implement strategies to protect healthcare workers in the time of the COVID-19 pandemic.