Epilepsy is the most common major neurologic complication in pregnancy, with estimated prevalence among pregnant women ranging from 0.2% to 0.7%.^1-3 While approximately 40% of the 18 million women with epilepsy (WWE) in the world are of child-bearing age, managing maternal epilepsy and monitoring the health of the developing fetus remain some of the most perplexing and engaging issues in the fields of neurology and obstetrics.⁴

Background and Purpose— The aim of this study is to estimate the risk of ischemic stroke during a 3-year follow-up period after a tuberculosis diagnosis using a nationwide, population-based study and a retrospective cohort design. Method— The study cohort comprised 2283 patients who had received treatment for tuberculosis, except tuberculosis of the meninges and central nervous system, between 2000 and 2003; 6849 randomly selected subjects comprised the comparison cohort. Cox proportional hazard regressions were performed as a means of comparing the 3-year ischemic stroke-free survival rate between these 2 cohorts. Results— Of the 9132 sampled patients, 392 (4.3%) experienced ischemic stroke during the 3-year follow-up period, including 136 (6.0% of the tuberculosis patients) from the study cohort and 256 (3.7%) from the comparison cohort. After adjusting for patient age, gender, hypertension, diabetes, coronary heart disease, hyperlipidemia, malignancy, monthly income, and the geographical region and urbanization level of the community in which the patient resided, the hazard ratio of ischemic stroke for tuberculosis patients was 1.52-times (95% CI, 1.21–1.91; P <0.001) higher than for comparison patients. Conclusion— We conclude that patients with a tuberculosis diagnosis are at an increased risk for ischemic stroke but not hemorrhagic stroke in the next 3 years. Further research is necessary to investigate these findings in tuberculosis-endemic areas.

Malaria in pregnancy is a critical public health challenge, and intermittent preventive treatment for malaria during pregnancy (IPTp) has proven to be an effective intervention. However, access to and use of malaria interventions, including IPTp, remains a considerable problem among African women. This cross-sectional study investigated factors, including antenatal care (ANC) attendance (both numbers of visits and timing of the first visit) and socio-demographics, associated with the uptake of the recommended IPTp dose among Malawian women. A nationally representative sample of women with a live birth in the 2 years preceding the survey from the Malawi Demographic Health Survey 2015–2016 dataset was analysed. Self-reported data on socio-demographics, ANC attendance and IPTp uptake were collected using a questionnaire and analysed using logistic models. Of the 6549 included women, 1981 (30.2%) took the recommended three or more IPTp doses. Despite inadequate ANC visits, early ANC initiation increased the likelihood of these women taking the recommended IPTp dose; women who initiated ANC in the first [adjusted odds ratio (aOR) = 2.24; 95% confidence interval (CI) = 1.44–3.49] and second (aOR = 2.19; 95% CI = 1.56–3.08) trimesters were more likely to take the recommended IPTp dose compared to late initiators. The effect of the number of ANC visits on IPTp uptake was significant in married women (aOR = 1.68, 95% CI = 1.42–1.98), and the timing of first ANC visit was associated with IPTp uptake only among rural women (aOR = 2.13, 95% CI = 1.54–2.95). ANC attendance is vital in IPTp uptake. The results highlight the need for health care providers to encourage women, particularly those in high-risk groups, to make frequent ANC visits and receive early ANC initiation to ensure high coverage of the recommended IPTp dose.

Background: Self-medication with over-the-counter (OTC) drugs is an important public health concern, especially in the vulnerable population of pregnant women due to potential risks to both the mother and fetus. Few studies have studied how factors, such as knowledge, affect self-medication. This study investigated self-medication and its associated factors among pregnant women attending healthcare services in Malang, Indonesia. Methods: A cross-sectional study was conducted from July to September 2018 in five healthcare services. A self-administered questionnaire was used and the data were analyzed using multiple regression models. Results: Of 333 female participants, 39 (11.7%) used OTC medication. Women with a higher level of knowledge of OTC medication were more likely to self-medicate—adjusted odds ratio (aOR) = 2.15, 95% confidence interval (CI) = 1.03–4.46. Compared with those with less knowledge, pregnant women with more correct knowledge of the possible risk of self-medication were less likely to self-medicate—aOR = 0.29; 95% CI = 0.14–0.60. The effect of a higher level of knowledge of OTC medication was significant among women who had middle school and lower education—aOR = 8.18; 95% CI = 1.70–39.35. The effect of correct knowledge on the possible risks of self-medication was significant only among women with high school and higher education—aOR = 0.17; 95% CI = 0.07–0.42. Conclusion: Imparting specific knowledge of the potential risks of using non-prescribed medication during pregnancy may help pregnant women navigate and more safely manage their OTC use. We also suggest further collecting data from more healthcare services, such as hospitals, to obtain more findings generalizable to the Indonesian community.