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Premature birth is the leading cause of neonatal morbidity and mortality. Understanding perceptions, beliefs and attitudes towards preterm births, and how these factors influence care provision at health facilities and at home is crucial for improving preterm newborns’ health outcomes.
We conducted an exploratory qualitative study at Batu and Meki communities in the East Shewa Zone of Oromia Region, Ethiopia. We conducted in-depth interviews (n=81) and focus group discussions (n=8) using semistructured guides. The study participants included women who had preterm births, family members, community members, healthcare workers and expert stakeholders. We audio-recorded, transcribed the interviews and coded the transcripts. We employed the socioecological model to present perceptions, beliefs and attitudes towards preterm birth at individual, interpersonal, organisational and societal levels.
Giving birth to a preterm newborn is often associated with fear, stress, unhappiness, concern and worry. At the individual level, preterm newborns’ mothers often feel guilt and self-blame. Families tend to keep preterm birth a secret due to perceptions of ‘incompleteness’. At the interpersonal level, preterm newborns are often stigmatised and families are disappointed by mothers who give birth prematurely. However, some believe that preterm newborns are accepted within the community. At the organisational level, healthcare providers find the causes of preterm birth unpredictable, they do not consider preterm births prevalent, and consider some of them as abortion. There is also a common belief that preterm infants have a low survival rate, leading to the deprioritisation of their care. At the societal level, some believe preterm births are caused by divine will as punishment for sins committed by the mother, while others think they occur naturally. Preterm newborn’s death is often not acknowledged as true loss and families are discouraged from grieving.
Our study found that the beliefs, perceptions and attitudes surrounding preterm birth, held by families, communities, healthcare providers and society at large, influence the care that preterm newborn–mother dyads receive both at home and within health facilities. Addressing these requires a multifaceted approach targeted at deeply ingrained attitudes and perceptions.
by Dessie Abera, Adane Mihret, Surafel Fentaw, Eyob Beyene, Abel Abera Negash, Woldaregay Erku Abegaz
BackgroundExtended-spectrum β-Lactamase and Carbapenemase-producing Enterobacterales cause severe infections and currently, they are spreading beyond hospitals and becoming a serious global health concern. They often colonize the gut silently, facilitating the transmission of resistant bacteria between patients and family members.
ObjectiveWe sought investigate the prevalence and molecular characteristics of Extended-spectrum β-Lactamases-producing Enterobacterales (ESBL-PE), Carbapenem-resistant Enterobacterales (CRE), and factors associated there in among admitted adult patients and their family members at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
MethodsA case-control study was conducted among 100 patients and their respective 100 family members from February 2023 to October 2023. Stool specimens were collected and processed using standard microbiological techniques. Antimicrobial susceptibility testing and ESBL production were determined using VITEK 2 system. Carbapenemase production was tested using modified carbapenem Inactivation method, and detection of resistance genes was performed by PCR.
ResultIntestinal colonization with ESBL-PE was higher in patients (39.0%) than their respective family members (24.0%) (P = 0.028). Among patients, ESBL production was common in E. coli, 40.3% and K. pneumoniae, 34.7% than their family members 24.2% and 22.2%, respectively. Of the ESBL-PE isolates, 84.6% from patients and 100% from family members carried at least one ESBL encoding gene, with blaCTX-M being the predominant. Colonization with CRE and Carbapenemase-Producing Carbapenem-Resistant Enterobacterales was found to be 19.0% and 10.0%, respectively. These were identified only among patients, with blaNDM and blaOXA-48 are the most prevalent genes. Older age (>53 years) (P = 0.02) and previous ICU admission (P Conclusion
ESBL-PE colonization was more prevalent in patients compared to their family members, with blaCTX-M identified as the most common gene. Exclusive detection of carbapenemase genes among patients, and the association of previous ICU admission with ESBL-PE colonization, highlights the need for targeted screening and strengthened infection prevention.
by Halid Worku Jemil, Sonia Worku Semayneh, Altaseb Beyene Kassaw, Kassahun Dessie Gashu
IntroductionSevere stunting is one of the primary public health challenges in LMIC including Eastern African Countries, which affects millions of children. In addition, it was a major contributor for mortality and related complication of children aged under five. However, there is limited study conducted severe form of stunting by employing Machine learning (ML) in Eastern African Countries. Therefore, our study was demonstrated to predict and identify its major determinants using ML algorithms, furthermore, to improve model explainablity. Our study used Shapley Additive explanations (SHAP) and ARM to identify the determinants of severe stunting among under-five.
Methodscross-sectional study was conducted using DHS data from 2012–2022 in East Africa. 136,074 children were the source populations, and 76,019 children were the study population. Data were analyzed using Python version 3.7 and R version 4.3.3 for data preprocessing, modeling, and statistical analysis. Model performance was evaluated using accuracy and AUC. Furthermore, the SHAP analysis and ARM was used to further explain and interpret the determinants of severe stunting among children under five.
ResultsThe Random Forest performed the best in this analysis, with an accuracy of 87% and an AUC score of 0.83. The analysis indicated that women’s who do not practicing exclusive breastfeeding (SHAP value = +0.41), being from Burundi (SHAP value = +0.04), children being underweight (SHAP value = +0.25), lived in poor household (SHAP value = +0.40), child gender being male(SHAP value = +0.23), mothers height being short (SHAP value = +0.03), mothers being underweight (SHAP value = +0.18), child size at birth being small (SHAP value = +0.21), women’s being delivered in home(SHAP value = +0.07), mothers education being primary (SHAP value = +0.20), unimproved toilet (SHAP value = +0.06), distance to health facility being a big problem (SHAP value = +0.02), were associated with increase the risk of severe stunting among under five.
ConclusionThe Random Forest was the best-performing model for predicting severe stunting in Eastern African countries. To decrease the effects of severe stunting, integrated interventions should provide support for mothers with lower socioeconomic conditions, strengthen maternal education, empower women to practice exclusive breastfeeding, encourage facility deliveries, increase access for households to sanitary facilities, provide education on personal and environmental hygiene, provide mothers with information on the importance of complementary feeding for children as well as for the mothers, and provide near health facilities for mothers and essential care services.
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