Maternal outcomes of pre-eclampsia with severe features and its determinants at Abebech Gobena Mothers and Childrens Health and Saint Peter's Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study.

OBJECTIVE: The main objective of this study was to determine the prevalence and factors associated with unfavourable maternal outcomes among pregnant women with pre-eclampsia with severity features (PEWSF) at Abebech Gobena Maternal and Children's Health and St. Peter's Hospital, Addis Ababa, Ethiopia, 2023. DESIGN: A hospital-based cross-sectional study was conducted from 1 January 2023 to July 2023. The data was collected using a structured and pre-tested questionnaire through face-to-face interviews and a review clinical chart. Data was entered using EpiData V.4.6 and analysed using SPSS V.26.0 statistical software. Binary logistic regression analysis was run to identify predictors of maternal outcome. SETTING: Two hospitals in Addis Ababa, Ethiopia. PARTICIPANTS: 348 pregnant women with PEWSF were included. OUTCOME MEASURES: Unfavourable maternal outcome was defined as mothers with PEWSF that develop at least one complication, that is, eclampsia, abruption placenta, Haemolysis, Elevated Liver Enzymes and Low Platelet Count (HELLP) syndrome, acute renal failure, disseminated intravascular coagulation, cardiac failure, stroke, postpartum haemorrhage, pulmonary oedema and death. RESULTS: The overall prevalence of unfavourable maternal outcomes was 33.9% (N=118) (95% CI=28.7 to 38.8). Abruptio placenta (17.2%), HELLP syndrome (15.5%) and postpartum haemorrhage (13.8%) were common complications that occurred among mothers with PEWSF. Age above 35 years (adjusted OR (AOR) (95% CI)=2.70 (1.31 to 5.59)), rural residence (AOR (95% CI)=1.94 (1.07 to 3.53)), unemployment (AOR (95% CI)=0.35 (0.20 to 0.62)), severe blood pressure on admission (AOR (95% CI)=2.32 (1.03 to 5.19)) and complain of severe headache (AOR (95% CI)=1.91 (1.16 to 3.16)) were significant associates of unfavourable maternal outcomes. CONCLUSIONS: The prevalence of unfavourable maternal outcomes was high compared with other studies in Ethiopia. Maternal age, residence, occupation, blood pressure on admission and severe headache have shown a statistically significant association with unfavourable maternal outcomes. Socioeconomic development and early identification of severe signs and symptoms of pre-eclampsia are needed to reduce unfavourable outcomes.

Prevalence and determinants of adverse perinatal outcomes of preeclampsia with severe features at two selected public hospitals in Addis Ababa, Ethiopia.

Background: Preeclampsia is a new onset of hypertension and either proteinuria or end-organ failure after 20 weeks of gestation. It is a prevalent cause of perinatal mortality, morbidity, and neonatal complications in developing nations including Ethiopia. Thus, the aimed to assess the prevalence and determinants of adverse perinatal outcomes among women with preeclampsia with severity features (PEWSF) at two selected public hospitals in Addis Ababa, Ethiopia, 2023. Method: A cross-sectional study was carried out among 348 mothers between January 1, 2023, and July 1, 2023. A structured, pre-tested questionnaire was used to gather data from in-person interviews and a review of the patient's medical record. The statistical program Epi-Data version 4.6 was used to enter the data, and SPSS version 26.0 was used for analysis. Binary logistic regression analysis was used to find factors that were associated with unfavorable perinatal outcomes. A p-value of less than 0.05 was used to declare the significance level. Result: The overall prevalence of unfavorable perinatal outcomes was 59.2% (95% CI: 54.0-63.8). Among the complications, low birth weight, prematurity, NICU admission, and a low fifth-minute APGAR score, encompass 48.9%, 39.4%, 20.4%, and 14.7%, respectively. No formal education [OR = 5.14, 95% CI: (1.93-13.63)], unemployment [OR = 0.42, 95% CI: (0.24-0.73)], referral cases [OR = 2.03, 95% CI: (1.08-4.06), inadequate antenatal care (ANC) contact [OR = 3.63, 95% CI: (1.22-10.71)], and family history of hypertension [OR = 1.99, 95% CI: (1.03-3.85)] have shown a statistically significant association with unfavorable perinatal outcomes. Conclusion: In this study, the prevalence of unfavorable perinatal outcomes was high compared to other studies in Ethiopia. Level of education, occupation, mode of admission, ANC contact, and family history of hypertension were significant predictors of unfavorable perinatal outcomes. Socio-economic development, improving referral systems, and adequate antenatal care contact are needed to improve unfavorable outcomes. Additionally, antenatal screening and specialized care for high-risk mothers, e.g., those with a family history of hypertension are recommended.

Nursing patient record practice and associated factors among nurses working in North Shewa Zone public hospitals, Ethiopia.

Background: Nursing documentation is an essential component of nursing practice and has the potential to improve patient care outcomes. Poor documentation of nursing care activities among nurses has been shown to have negative impacts on healthcare quality. Objective: To assess the nursing documentation practice and its associated factors among nurses working in the North Shewa Zone public hospitals, Ethiopia. Method: An institution-based cross-sectional study was conducted at the North Shewa Zone public hospitals. A simple random sampling technique was used to select 421 nurses. A pretested, structured, self-administered questionnaire was used to gather the data. Data were entered into Epi Data version 3.1, and SPSS version 25 was used for further analysis. Binary logistic regressions were performed to identify the independent predictors of nursing documentation practice. Adjusted odds ratio was calculated and a p-value less than 0.05 with 95% confidence interval (CI) was considered as statistically significant. Result: A total of 421 respondents took part, giving the survey a 100% response rate. The overall good practice of nursing care documentation was 51.1%, 95% CI (46.6, 55.8). In addition, 43.2%, 95% CI (38.5, 48.0) and 35.6%, 95% CI (30.9, 40.1), of nurses had good knowledge of and favorable attitudes toward nursing care documentation. Availability of operational standards for nursing documentation [adjusted odds ratio (AOR) = 1.76; 95% CI: 1.18, 2.64], availability of documenting sheets (AOR = 1.51; 95% CI: 1.01, 2.29), and a monitoring system (AOR = 1.61; 95% CI: 1.07, 2.41) were significantly associated with nursing care documentation practice. Conclusion: Nearly half of nursing care was not documented. The practice of nursing care documentation was significantly influenced by the availability of operational standards, documenting sheets, and monitoring systems. To improve the documentation practice, a continuous monitoring system and access to operational standards and documenting sheets are needed.

Perceived stress and its associated factors among people living in post-war Districts of Northern Ethiopia: A cross-sectional study.

BACKGROUND: War and conflict environments result in long-term physical and psychological consequences. Sexual violence, displacement, malnutrition, death, illness, injury, torture, and disability are some of the physical effects, whereas stress, depression, aggressive behaviors, and anxiety are some of the emotional complications of war. Hence, evidence-based interventions are required particularly to monitor mental health disorders. Thus, we aimed to investigate the prevalence of perceived stress and its associated factors among people living in post-war situations, Northern Ethiopia. METHOD: A community-based cross-sectional study design was employed among 812 samples from April 1 to May 15, 2022. The study participants were selected using a multistage sampling technique. The data was collected through face-to-face interviews using a structured and pre-tested tool. Data were cleaned and entered into Epi-Data version 4.6 and transferred to SPSS version 25 for analysis. Binary logistic regression analysis was performed to identify determinants of perceived stress. The Hosmer-Lemeshow goodness-of-fit was applied to test for model fitness and a p-value of <0.05 was considered statistically significant. RESULT: The prevalence of perceived stress was 76.1%, 95% CI (72.9-78.8). Age above 45 years (AOR (CI) = 2.45 (1.07-5.62), poor educational level (AOR (CI) = 5.92 (2.36-14.8), large family size (AOR (CI) = 0.48 (0.31-0.74), alcohol consumption (AOR (CI) = 0.63 (0.42-0.94), smoking (AOR (CI) = 0.17 (0.06-0.56), and exposure to multiple traumatic events (AOR (CI) = 2.38 (1.23-4.62) have shown a statistically significant association with perceived stress. CONCLUSION: This study revealed that more than three-fourths of participants living in post-war settings were found to have perceived stress. Older age, poor level of education, large family size, alcohol consumption, smoking, and the number of traumatic events were significant associates of perceived stress. Psychotherapy that can effectively address the medical, social, and psychological well-being of the community is important to reduce the burden of perceived stress.

Dropout from a maternal and newborn continuum of care after antenatal care booking and its associated factors in Debre Berhan town, northeast Ethiopia.

Background: Continuum of care (CoC) is the continuity of care from the beginning of pregnancy to the postnatal period to improve maternal, neonatal, and child health. Dropout from the maternal CoC remains a public health challenge in Ethiopia. There are limited studies on women who dropped out of the CoC. The available studies have focused on the time dimension of the CoC, and there is a paucity of data on the place dimension of the CoC. Thus, this study aimed to determine the prevalence of dropout from the maternal CoC and its associated factors in Debre Berhan town, northeast Ethiopia. Methods: A community-based cross-sectional study design was conducted among 842 mothers from September to October 2020. A cluster sampling technique was applied, and data were collected through face-to-face interviews using a structured and pre-tested questionnaire. Data were cleaned and entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. Descriptive statistics, and bivariable and multivariable logistic regression analyses were performed to summarize the findings, and a p-value of <0.05 was considered statistically significant. Result: The overall prevalence of dropout from the maternity continuum of care was 69.1% [95% CI (66.0-72.3)]. The prevalence of dropout from ANC, skilled birth attendant, and PNC visits was 45.4, 0.5, and 48.7%, respectively. Rural residents, partners' level of education, monthly income, the timing of the first ANC visit, antenatal counseling about a continuum of care, and the level of satisfaction with the service delivery were significantly associated with ANC dropout. Maternal age and occupation, partners' age, media exposure, parity, the timing of the first ANC visit, the place of ANC visit, and the time spent for an ANC visit were significantly associated with dropout from PNC visits. Husbands' occupation, monthly income, number of alive children, the timing of the first ANC visit, and the time spent for an ANC visit had a statistically significant association with dropout from the maternity CoC. Conclusion: Dropout from the CoC in the study area was high. Socioeconomic development, partner involvement, antenatal counseling, efficient service delivery, and media exposure are vital to improving the high dropout rate from the maternal continuum of care.

Adverse obstetric outcome and its associated factors in public hospitals of North Ethiopia: does parity make a difference?

BACKGROUND: Direct obstetric causes account for nearly 75% of all maternal deaths. Controversy prevails in the effect of grand multiparity on adverse obstetric outcomes. This study thus aimed to determine and compare the obstetric outcomes in low multiparous (LM) and grand multiparous (GM) women in Public Hospitals of North Ethiopia. METHOD: An institution-based comparative cross-sectional study was done among 540 (180 GM and 360 LM) participants from January 1 to March 30, 2021. The data was collected through face-to-face interviews and a review of clinical records and birth registries. Epi-Data version 4.6 was used for data entry and analysis was performed using SPSS version 25.0 statistical software. A p-value of ≤ 0.05 (2-tailed) was used to consider the significance of statistical tests. RESULT: The prevalence of adverse obstetric outcomes was 32.6% (95% CI: 28.7-36.5). Antepartum hemorrhage, anemia, and postpartum hemorrhage were higher in grand multiparous women. Whereas, prolonged labor, induction/augmentation, prelabor rupture of membrane, episiotomy, and post-term pregnancy was higher in low multiparous women. Income (AOR (CI) = 3.15 (1.30-7.63), alcohol consumption (AOR (CI) = 3.15 (1.49-6.64), preterm delivery (AOR (CI) = 9.24 (2.28-27.3), cesarean delivery (AOR (CI) = 13.6 (6.18-30.1), and low birth weight (AOR (CI) = 3.46 (1.33-9.03) significant predictors of adverse obstetric outcomes. However, parity did not show a statistically significant difference in obstetric outcomes. CONCLUSION: In the study area, obstetric complications were high compared to a systematic review and meta-analysis study done in the country (26.88%). Socio-economic status, alcohol consumption, gestational age at delivery, mode of delivery, and birth weight were significant associates of the obstetric outcome. There was no statistically significant difference in obstetric outcomes between GM and LM women. Socio-economic development, avoiding alcohol consumption, early identification and treatment of complications, and adequate nutrition and weight gain during pregnancy are needed regardless of parity.

Perception of University Students Towards National Efforts at Controlling COVID-19 Pandemics, the Practice of Prevention Measures and its Associated Factors During School Reopening.

Background: The Coronavirus disease 2019 (COVID-19) pandemic has affected many communities including students. Even if restrictions are being lifted in some countries, i.e., Ethiopia, COVID-19 is not gone yet. Adjusting to the "new normal", an emerging prevention response to the virus, can greatly recover public health and education. Thus, this study aimed to assess students' perception of national efforts at controlling the COVID-19 pandemic, including approaches to prevention measures, and associated factors during campus re-entry. Methods and Materials: We conducted a cross-sectional study among 682 Debre Berhan University (DBU) students from December 1 to 15, 2020, when students had just gone back to school. The data was entered into Epi-Data version 4.6 and exported to SPSS version 25.0 statistical software for analysis. The perception and practice of the participants were assessed using a scoring system. Binary logistic regression was run to identify the significant (p ≤ 0.05) predictors of COVID-19 prevention practice. Result: The overall high perception and good practice of prevention behaviors were 32%, 95% CI (28.8-35.2), and 37.5%, 95% CI (33.7-41.2), respectively. Being female [AOR (CI) = 1.67 (1.17-2.37)], have a rural residence [AOR (CI) = 1.56 (1.07-2.29)], fathers' education [AOR (CI) = 1.94 (1.06-3.56)], having respiratory disease [AOR (CI) = 2.81 (1.32-5.95)], and information sources from YouTube [AOR (CI) = 1.87 (1.19-2.91)] were significant factors for COVID-19 prevention practice. Besides, a high perception of national efforts at controlling COVID-19 [AOR (CI) = 2.94 (2.04-4.25)] was positively associated with the practice of prevention measures. Conclusion: During school reopening, most students had a low perception of national efforts at controlling COVID-19 and poor prevention practices. Socio-demographics, having a chronic illness, information sources, and perception of national efforts were factors of COVID-19 prevention practice. Thus, raising the perception of the national efforts, promoting precautionary measures, managing chronic illnesses, and disseminating information through YouTube are critical to preventing and controlling COVID-19 during campus re-entry.

Magnitude and Determinant Factors of Postpartum Depression Among Mothers Attending Their Postnatal and Vaccination Services at Public Health Institutions of Addis Ababa, Ethiopia.

Background: The postpartum period is known as a high-risk period for the onset of different maternal mental health problems. Globally, 10-20% of postnatal mothers suffer from depressive symptoms. This study aimed to assess the magnitude and determinant factors of postpartum depression among mothers attending their postnatal and vaccination services at public health institutions in Addis Ababa, Ethiopia. Methodology: Health institution-based cross-sectional study was conducted among 461 postnatal mothers attending public health institutions in Addis Ababa from 15 May 2021 to 15 July 2021. A multistage sampling technique was employed to select the public health institutions and a systematic random sampling method was used to get selected, postnatal mothers. Epidata version 3.1 and SPSS version 25 were used for data entry and analysis, respectively. P-value ≤ 0.05 was used as a cut point of statistical significance in multivariable binary logistic regression. Results: From total postnatal mothers 91(19.7%) of them had postpartum depression. Occupational status [AOR = 3.39, 95% CI: 1.04, 8.15], marital status [AOR = 2.69, 95% CI =1.33, 5.45], income management [AOR = 3.76, 95% CI: 1.53, 8.21], sex of baby [AOR = 5.07, 95% CI: 1.24, 20.69], history of child death [AOR = 6.93, 95% CI: 2.67, 15.79], unplanned pregnancy [AOR = 3.08, 95% CI: 1.65, 7.93], negative life event [AOR = 2.39, 95% CI: 1.03, 5.39], substance use during pregnancy [AOR = 6.23, 95% CI: 2.72, 20.05], history of depression [AOR = 5.08, 95% CI: 1.79, 14.39], and marriage satisfaction [AOR = 6.37, 95% CI: 2.63, 14.29] were determinant factors of postpartum depression. Conclusion: The prevalence of postpartum depression in this study is high compared to national findings. Occupational status, marital status, income management, sex of baby, history of child death, unplanned pregnancy, negative life event, substance use during pregnancy, history of depression, and marital satisfaction were determinant factors of postpartum depression. The ministry of health should integrate mental health services with existing maternal health care services. It would be better if all healthcare professionals working in the maternal and child health unit will routinely screen postpartum depressive symptoms and link them to mental health services.