Despite improving access to Severe Acute Malnutrition (SAM) management, information on the quality of the service, as measured by timely recovery, is scare. This study is designed to assess treatment outcomes and factors affecting time-to-recovery from SAM in children 6–59 months admitted to a stabilizing center in Hawassa University Comprehensive Specialized Hospital (HU-CSH), Southern Ethiopia. Institutional-based retrospective cohort study was conducted on 420 randomly selected children aged 6–59 months. The children were managed at the hospital from July, 2015 to June, 2017. Pre-tested structured questionnaire was used to extract data from medical records. Data were analyzed using Kaplan Meir (KM) curve, Log rank test and Cox-Proportional hazards model. The outputs of the bivariable and multivariable Cox model are presented using Adjusted Hazard Ratio (AHR) with the respective 95% Confidence Intervals (CIs). After a maximum of 59 days treatment 69.3% of the children recovered and 10.8% died. The mean (±SD) weight gain rates was 12.7 (±8.9) g/kg/days. The overall incidence density rate of recovery was 3.8 per 100 person-days. The overall median (IQR) time of recovery was 17(10, 24) days. F-100 intake (AHR = 0.502, 95%, CI: 0.29–0.86), Tuberculosis infection (AHR = 1.38, 95% CI: 1.00–1.91) and provision of special medication (IV fluid, IV antibiotic and blood transfusion) (AHR = 0.72, 95% CI: 0.52–0.99) at admission were found to be significant predictors of time-to-recovery from SAM. The overall recovery from complicated SAM children admitted at HU-CSH after a maximum of 59 days treatment was low (69.4%) and a very high proportion of children (10.8%) end up in death. Therefore, HU-CSH should give special focus for those children present with medical comorbidities during admission.
1 November 2018 in Pediatric Health, Medicine and Therapeutics
Background: Home-based neonatal care is associated with a reduction in neonatal mortality in settings with poor access to health facility-based care. The first day of a child’s life is a day of unparalleled opportunity to spare lives and sets the level for a sound future. The aim of this study was to evaluate the prevalence and timing of home-based neonatal care by health extension workers (HEWs) in the rural Sidama Zone of southern Ethiopia. Subjects and methods: A community-based, cross-sectional study was conducted, and a total of 2,040 mothers who had a live birth in the last 6 months were studied from 1 to 31 January 2017. Interviewer-administered data were collected using a standard questionnaire developed by the Saving Newborn Lives Program. A descriptive analysis and logistic regression analyses were done. Results: It was found that 252/2,040 (12.4%) mothers and their neonates were visited by the HEWs during the first month of birth. Out of all households who had a history of visits, 139 (55.2%) had a single visit. Of these, only 66/252 (26.2%) of the first visit were within the first 24 hours. Mothers who received postnatal home visit by the HEWs were at 1.35 times greater odds to have good postnatal practice compared to unvisited mothers (adjusted odds ratio [AOR] 1.35, 95% CI [1, 1.71]). Mothers who gave their last birth at home were 36% less likely to have good postnatal practice compared to those who gave birth in a health institution (AOR 0.64, 95% CI [0.53, 0.79]). Conclusion: Majority of the neonates did not get the recommended number and frequency of home visits. Postnatal home visit by HEWs had a great role in mothers having good postnatal practice. Therefore, all stakeholders should give attention on strengthening supportive supervision, proper implementation of community-based maternal and neonatal care is very crucial.
5 October 2020 in Contraception and Reproductive Medicine
Introduction: Despite Ethiopia’s government’s commitment to alleviating unwanted pregnancy and unsafe abortion by increasing holistic reproductive health service accessibility, the rate of unwanted pregnancy among female students in the universities is distressing and becoming a multisectoral concern. Therefore, this systematic review aimed to assess the prevalence and determinant of emergency contraceptive practice among female university students in Ethiopia. Result: The overall pooled prevalence of emergency contraceptive practice among female university students in Ethiopia was 34.5% [95% CI [20.8, 48.2%]. The pooled odds ratio showed that positive association between practice of emergency contraceptives with age of the students [OR, 0.19; 95% CI: 0.04, 0.98, P = 0.05] Previous contraceptive methods use [OR, 0.22; 95% CI: 0.12, 0.40, P = 0.0001], Marital status [OR, 0.09; 95% CI: 0.02, 0.40, P < 0.002] and knowledge [OR, 0.12; 95% CI: 0.04, 0.37, P < 0.0003]. Conclusion: The practice of emergency contraceptives among university female students was 34.5% and explained by knowledge, age, previous use of contraceptive methods and marital status.
Background Complications of prematurity are the leading cause of under-5 mortality globally and 80% of newborn deaths are of low birth weight (LBW) babies. Early identification of LBW and preterm infants is crucial to initiate timely interventions. Objective To evaluate the feasibility and diagnostic accuracy of alternative neonatal anthropometric measurements in identifying LBW and preterm infants in Africa. Methods In this systematic review and meta-analysis, we evaluated the diagnostic performance of infant foot length, mid-upper arm circumference (MUAC), head and chest circumferences against birth weight and gestational age. Pooled correlation between the index and the reference methods was estimated. Multiple anthropometric thresholds were considered in estimating the pooled sensitivity, specificity and area under receiver operating characteristic curve (AUC). Results 21 studies from 8 African countries met the inclusion criteria. Correlation coefficients with birth weight were 0.79 (95% CI 0.70 to 0.85) for chest circumference, 0.71 (95% CI 0.62 to 0.78) for MUAC and 0.66 (95% CI 0.59 to 0.73) for foot length. Foot length measured by rigid ruler showed a higher correlation than tape measurement. Chest circumference with 28.8 cm cut-off detects LBW babies with AUC value of 0.92 (95% CI 0.71 to 0.97). Foot length identified preterm infants, with 82% sensitivity, 89% specificity and AUC of 0.91 (95% CI 0.69 to 0.98) at a 7.2 cm optimal cut-off point. MUAC had an AUC of 0.83 (95% CI 0.47 to 0.95) for preterm detection. In identifying LBW babies, foot length and MUAC have AUC values of 0.89 (95% CI 0.70 to 0.96) and 0.91 (95% CI 0.73 to 0.97) at 7.3 cm and 9.8 cm optimal cut-off points, respectively. Foot length and MUAC are relatively simple and minimise the risk of exposing infants to cold. Conclusion Newborn foot length, MUAC, head and chest circumferences have comparable diagnostic accuracy in identifying LBW and preterm babies. Using foot length and MUAC in low-resource settings are the most feasible proxy measures for screening where weighing scales are not available. PROSPERO registration number CRD42023454497.
1 February 2024 in Journal of Multidisciplinary Healthcare
Background: Diabetes and hypertension are major synergistic risk factors for microvasculopathy, microangiopathy, and neuropathy problems among patients with chronic disorder. Control of hypertension and diabetes have significant value in delaying these complications. The key for delaying complications in diabetes and hypertension is the quality of care. Objective: This study explored the quality of diabetes-hypertension care in health care facilities with high disease burden in Sidama region. Methodology: An institution-based cross-sectional study was carried out. Patients with diabetes and hypertension were included in the study. In this study, we included 844 patients were included in the study. For data collection, the application software Kobo Collect was utilized. For data analysis, SPSS version 25 was used. Logistic regression was used to identify factors associated with quality of care. To measure quality, we employed patient outcome indicators focusing on long-term complications of the eye, heart, fasting blood pressure, and neuropathic complications. Ethical approval clearance was obtained from Hawassa University, College of Medicine and Health Sciences ethical review board. Results: The mean age of patients was 47.99 ± 15.26 years, with a range of 18– 90 years, while men make up 62% of the overall number of respondents. In terms of marital status, 700 (82.9%) were married. Concerning place of residence; 433 (51.3%) were from rural area. The primary diagnosis is diabetes for 419 (49.6%) patients, and nearly 23% of patients have both diabetes and hypertension. In terms of blood pressure, the average systolic pressure was 129.6 mmHg and the average diastolic pressure was 82.6 mmHg. Among the study participants, 391 (46.33%) patients received poor quality of chronic disease care. Patients living alone, patients who have professional work, fasting blood glucose in normal range, patients with higher education, and patients with serum creatinine receive relatively good chronic illness care.
Background: Low birth weight (LBW) and preterm birth significantly contribute to increased risks of neonatal mortality, particularly in sub-Saharan Africa. Early identification of and timely intervention for these vulnerable infants remains challenging. Simple anthropometric measurements, such as foot length (FL), have emerged as potential alternatives to identify small and vulnerable newborns. This study aims to assess the accuracy of FL as a screening tool to identify LBW and preterm babies and to establish appropriate cut-off points for the local context. Methods: A facility-based cross-sectional study was conducted at Hawassa University Comprehensive Specialised Hospital and Bushulo Mother, Newborn and Child Health Specialty Centre and Primary healthcare from 15 May 2024 to 6 July 2024; 396 mother-newborn dyads were included using a consecutive sampling technique. Data were collected through interview, medical record review and FL measurement using digital calliper. Birth weight was measured using calibrated digital weight scales. Descriptive statistics, correlation analysis and receiver operating characteristic (ROC) curves were used to assess the distribution of measured characteristics and determine optimal FL cut-off points for identifying LBW and preterm babies. Results: The study included 61 (15.4%) LBW and 48 (12.3%) preterm babies. FL showed a strong correlation with birth weight (r=0.79) and moderate correlation with gestational age (r=0.62). The optimal cut-off point for identifying LBW babies was 70.65 mm, yielding 93.4% sensitivity, 91.6% specificity and an area under receiver operator curve (AUC) of 0.97 (95% CI: 0.95 to 0.98). For preterm babies, the optimal cut-off was 69.95 mm, with 76.7% sensitivity, 91.1% specificity and an AUC of 0.91 (95% CI: 0.86 to 0.96). Conclusion: FL has demonstrated excellent diagnostic accuracy to identify LBW and preterm newborns. Optimal accuracy of identifying LBW and preterm babies in similar populations can be achieved at 70.65 and 69.95 mm cut-off points, respectively. In designing FL-based screening tools, appropriate cut-off points for the required level of accuracy should be considered.