Statistics indicate that Ethiopia has made remarkable progress in reducing child mortality. It is however estimated that there is high rate of perinatal mortality although there is scarcity of data due to a lack of vital registration in the country. This study was conducted with the purpose of assessing the determinants and causes of perinatal mortality among babies born from cohorts of pregnant women in three selected districts of North Showa Zone, Oromia Region, Ethiopia. The study used community based data, which is believed to provide more representative and reliable information and also aimed to narrow the data gap on perinatal mortality. A community based nested case control study was conducted among 4438 (cohorts of) pregnant women. The cohort was followed up between March 2011 to December 2012 in three districts of Oromia region, Ethiopia, until delivery. The World Health Organization verbal autopsy questionnaire for neonatal death was used to collect data. A binary logistic regression model was used to identify determinants of perinatal mortality. Causes of deaths were assigned by a pediatrician and neonatologist. Cases are stillbirths and early neonatal death. Control are live births surviving of the perinatal period’ A total of 219 newborns (73 cases and 146 controls) were included in the analysis. Perinatal mortality rate was 16.5 per 1000 births. Mothers aged 35 years and above had a higher risk of losing their newborn babies to perinatal deaths than younger mothers [AOR 7.59, (95% CI, 1.91-30.10)]. Babies born to mothers who had a history of neonatal deaths were also more likely to die during the perinatal period than their counterparts [AOR 5.42, (95% CI, 2.27-12.96)]. Preterm births had a higher risk of perinatal death than term babies [AOR 8.58, (95% CI, 2.27-32.38)]. Similarly, male babies were at higher risk than female babies [AOR 5.47, (95% CI, 2.50-11.99)]. Multiple birth babies had a higher chance of dying within the perinatal period than single births [AOR 3.59, (95% CI, 1.20-10.79)]. Home delivery [AOR 0.23, (95% CI, 0.08-0.67)] was found to reduce perinatal deaths. Asphyxia, sepsis and chorioamnionitis were among the leading causes of perinatal deaths. This study reported a lower perinatal mortality rate. The main causes of perinatal death identified were often related to maternal factors. There is still a need for greater focus on these interrelated issues for further intervention.
Neonatal mortality is a significant contributor to infant mortality. Causes and predictors of neonatal death are known to vary in different settings and across different contexts. This study aimed to assess predictors, causes, and trends of neonatal mortality amongst neonates admitted to Nekemte Referral Hospital neonatal unit between 2010–2014. Retrospective data was collected for 2090 live born neonates admitted to the neonatal intensive care unit of Nekemte Referral Hospital by reviewing records between 2010 to 2014. Variables were collected from the neonatal registration book and patient card on the predictors, causes, and trends of neonatal death using a standard checklist developed by the World Health Organization (WHO). Data was analyzed using Epi info version 3.5.1, and SPSS version 25 for windows. The level of significance was set at P<0.05 with the corresponding confidence intervals at 95%. A logistic regression model was used for analysis and to control for confounders. Microsoft Excel 2007 was used to construct the trend analysis. There were 183 deaths in the cohort equivalent to 8.8% of deaths among total admitted neonates during the study period. Early neonatal deaths accounted for 8% and late neonatal deaths accounted for 0.71% of deaths among total admitted neonates. Main predictors identified for an increased risk of neonatal mortality were; neonates from rural residents [AOR 1.35, (95% CI, 1.35–1.87)], birth order of greater than five [AOR 5.10, (95% CI, 1.15–22.63)], home delivery [AOR 3.41, (95% CI, 2.24–5.19)], very low birth weight [AOR 6.75, (95% CI, 3.63–12.54)] and low birth weight [AOR 2.81, (95% CI, 1.95–4.05)] and inability to cry at birth [AOR 2.21, (95% CI, 1.51–3.22)]. The trend analysis showed a sharp fall for the neonatal mortality over the last five years with a mean reduction of 16%. Data from the Nekemte Referral Hospital Neonatal Intensive Care Unit analysis revealed majority of the deaths were occurred during early neonatal period. The main predictors of neonatal mortality identified from this study needs strengthening an appropriate public health intervention through addressing antenatal care, curbing home delivery.
5 December 2019 in Contraception and Reproductive Medicine
Background: Family planning plays a key role in improving the health of the mother and the child. Yet there are still significant levels of demand for family planning that are unmet and these can lead to unintended pregnancy. So, women’s demand for contraceptive utilization to limit, space, or delay the number of family size can be increased by integrating family planning service at each service delivery points. Objective: The main aim of this study was to assess the demand for modern contraceptive and associated factors among currently married women of the reproductive age group in rural kebeles of Nunu Kumba District, 2015. Methods: A community-based cross-sectional study design was conducted from January 15–30, 2015 among 584 systematically selected currently married women of reproductive age in six rural kebeles of Nunu Kumba District. A pre-tested and interviewer-administered questionnaire was used to collect the data. Data were analyzed using SPSS version 20. Descriptive statistics were done to summarize the data. A multivariate logistic regressions analysis method was employed and odds ratio with 95% confidence interval was used to control for possible confounders. P-value < 0.05 was used to declare a significant association. Results: The total demand for modern methods of contraceptive was 450 (77.1%) of which 325 (55.7%) of them were current user and 125 (21.4%) of them were had unmet need for modern contraceptive methods. Being in the younger age group (15–24 and 25–34 years [AOR = 0.196; 95% CI: 0.055, 0.692] and [AOR = 0.179, 95% CI: 0.043, 0.745] respectively, husband having no intention for more children [AOR = 4.124, 95% CI: 1.891, 8.996], number of children alive [AOR = 2.617, 95% CI: 1.056, 6.486], and couples ever not discussed on family planning [AOR = 0.340, 95% CI: 0.187, 0.619] were factors associated with demand for modern methods of contraception. Conclusion: The total demand for modern methods of contraceptive was high in the study area except for long-acting and permanent methods with high unmet need for spacing than for limiting. Therefore, any program aimed at promoting family planning at the district level should look for ways and means of increasing demand for long-acting and permanent family planning methods and encouraging husband involvement to increase its utilization.
1 October 2021 in Journal of Multidisciplinary Healthcare
Background: Diarrhea is a major leading cause of under-five morbidity and mortality in developing countries. Although the health extension program has been implemented for decades, diarrhea continues to be a major public health problem. Objective: To determine determinants of diarrhea among under-five-year-old children in the health extension model and non-model families of Wama Hagelo District 2019. Methods: A community-based comparative cross-sectional study was conducted among 512 under-five children among 257 model and 255 non-model health extension families. A multi-stage sampling technique was used. Households with at least one under-five child were selected using a simple random sampling method. Data were collected using an interviewer-administered questionnaire. Bivariate analysis was done to select candidate variables at p ≤ 0.2. Determinants of childhood diarrhea were determined by a multivariable logistic regression model at p-value less than 0.05. Results: The two-week prevalence of diarrhea among under-five children in model and non-model families was 7.8% (95% CI=4.5– 11.1%) and 27.8% (95% CI 22.3– 33.3%), respectively. Unimproved water sources (AOR [95% CI] =5.5[2.2, 97.7]) and no vaccination against Rotavirus (AOR [95% CI] = 49.8 [4.2– 94.8]) were associated with diarrhea among under-five children in model families. Family size > 5 (AOR [95% CI] = 5.2 [1.7– 17.6]), using unimproved water sources (AOR [95% CI] = 7.2 [1.6– 13.2]), not using latrine (AOR [95% CI] = 6 [1.8– 20.6]), child not vaccinated against Rotavirus (AOR [95% CI] = 10.9 [2.9– 41.1]), child not supplemented with vitamin A (AOR [95% CI] = 3.2 [1.4– 7.2]), and not being health extension model families (AOR [95% CI] = 2.4 [1.15– 4.99]) predict diarrhea among under-five children in non-model families. Conclusion: Diarrhea was more frequent among non-model than model families. Family size, type of water source, using a latrine, place of childbirth, child vaccination against Rotavirus, and vitamin A supplementation were independently associated with the occurrence of diarrhea in under-five children. Encouraging all non-model families to become models in implementing all health extension packages by strengthening community participation is important to decrease childhood diarrhea in under-five children.
Only about 39% of infants in low- and middle-income countries are exclusively breast-fed for the first six months. In particular, human immunodeficiency virus (HIV) positive women report confusion about the best feeding methods. Exclusive Breastfeeding (EBF) practices in HIV positive mothers are sub-optimal in Ethiopia. This study aimed to identify the main factors influencing EBF among HIV positive breast-feeding mothers. A facility based cross-sectional study was carried out from September 2017 to June 30 2018 among HIV positive mothers with infants aged 6–23 months. Thirteen public health facilities (7 health centers and 6 hospitals) that provided anti-retroviral treatment (ART) and Prevention of mother-to-child transmission (PMTCT) services, found in three districts of West, East and Kellem Wollega Zones, were randomly selected. Respondents were recruited by systematic random sampling techniques from these facilities using client registers as a sampling frame. Data were collected using face to face interviews with a pre-tested questionnaire. Data were entered into EPI info Version 3.5.1 and analyzed using SPSS Version 20 for windows. Candidate variables for the final multi-variable model were selected considering P≤ 0.05 at bivariable analysis. Associations were declared at P≤ 0.05 by assuming Confidence Intervals did not cross ‘1’with corresponding 95%. A total of 218 HIV positive mothers were included in this study. Of these, only 122 (56.0%) practiced EBF in the first six months. The proportion of study participants who initiated EBF within the first hour of delivery was 134 (61.8%). Mean age of study participants was 28.6years with SD ± 4. Mothers’ having received advice on EBF [AOR 3, 95% CI (1.2–6.7)], disclosure of HIV status to someone close to them including their husband [AOR 6, 95% CI (1.2–29.6)] and believing HIV can be transmitted during delivery [AOR 5.2, 95% CI (1.1–24.0)] were found to increase the likelihood of EBF practices among the study participants (P-value ≤ 0.05). In this study, only just over half of the mothers practiced EBF for the first six months. Care providers should continue to encourage mothers to practice EBF in the first six months and to disclosure of HIV status to someone close to them including their partner. Efforts should be in place to curb the risk of HIV/AIDS transmission during delivery. Continues advise for mothers to practice EBF in the first 6 months is still needed.
Endoscopy is essential for diagnosis and management of gastrointestinal disorders. However, its accessibility in Africa is limited by the need for extensive training and costly equipment. This study aimed to assess the feasibility of a weekend outreach endoscopy service led by a trained gastroenterologist in southwest Ethiopia, where endoscopy services were previously unavailable.A weekend outreach endoscopy service was launched in 2019 at a primary hospital in Jimma City, located 360 km from Addis Ababa. Procedures were performed using the Fujinon EPX-2500-HD system. Demographic data, endoscopy findings, and histology results were documented electronically. Findings were compared with those from four Ethiopian referral hospitals offering full-time endoscopy services.A total of 2165 esophagogastroduodenoscopies (EGDs) were performed with a diagnostic yield of 93.3%. The most common indications for EGD were dyspepsia (53.7%) and dysphagia (17.0%). Patients who underwent endoscopy for alarm symptoms as an indication had a 77% to 83% chance of having a major finding compared with those with dyspepsia without an alarm symptom (24%). Squamous cell carcinoma (40.2%), adenocarcinoma (29.6%), and chronic nonspecific inflammation (16.2%) were the predominant histologic findings among those who had a biopsy (n = 425).The study demonstrates the feasibility and effectiveness of a weekend outreach endoscopy service led by a trained gastroenterologist in a rural Ethiopian setting. The unexpectedly high prevalence of upper gastrointestinal disorders, including cancers, and the long duration of symptoms before endoscopy likely reflect delayed diagnoses due to limited access to endoscopy. Moreover, presence of alarm symptoms predicted major endoscopic findings. Expanding endoscopy services, increasing public awareness, and further research into risk factors and preventive strategies for these diseases are recommended.