Conectar
To assess the association between the maternal continuum of healthcare and child immunisation in East Africa using propensity score matching (PSM).
Cross-sectional study using Demographic and Health Survey data.
This study was conducted in East African countries.
This study included a weighted sample of 13 488 women with children aged 12–23 months.
Child immunisation was the outcome variable of this study.
The PSM estimates indicate that the average treatment effect on the treated for complete child immunisation was 0.0583, meaning that children of mothers who received a complete maternal continuum of care had a 5.83% higher probability of being fully immunised compared with children of mothers with incomplete care. Expressed relative to the treated group’s mean, this corresponds to a 7.48% increase. Additionally, our results indicated that the population average treatment effect was 0.0629. This means that, on average, a complete continuum of maternal healthcare increases the probability of full child immunisation by approximately 6.29% across the entire population.
The study highlights that children whose mothers receive comprehensive maternal healthcare are more likely to complete their childhood immunisations. This finding underscores the need to integrate immunisation services into maternal healthcare programmes to enhance vaccination coverage and promote better child health. To maximise this connection, improving access to maternal healthcare, especially in underserved regions, is crucial, along with ensuring that immunisation is a regular part of maternal care.
by Mesay Milkias, Semagn Mekonnen, Hailemariam Getachew, Hailemariam Mulugeta, Siraj Ahmed, Melkamu Kebede, Belete Destaw, Medhanit Melese, Zemedu Aweke
BackgroundPost-operative pain is among the major post-cesarean problems, with an incidence ranging from 25.5% to 80%. Despite its simplicity, the effectiveness of wound infiltration with a mixture of bupivacaine and tramadol is still unknown. Therefore, this study aims to compare the analgesic effectiveness of wound infiltration with bupivacaine versus a combination of bupivacaine and tramadol for postoperative pain management among parturients undergoing cesarean section under spinal anesthesia.
MethodologyA double-blind, parallel, randomized controlled trial was conducted on 60 parturients. Parturients were randomized to take either bupivacaine (B = 30) or a combination of bupivacaine and tramadol (BT = 30). The homogeneity of variance was assessed using Levene’s test, and normality was assessed using the Shapiro-Wilk test. A numeric rating scale was used to measure pain severity. The independent t-test and the Mann-Whitney U test were used, respectively, for parametric and non-parametric data. A generalized estimating equation was used to assess repeated measurements.
ResultIn total, 60 parturients were analyzed with no dropouts. The severity of pain at the 6th hour was six times greater in the B group compared to the BT group (OR = 6.289, CI, 2.097–18.858, P = 0.001). The mean tramadol consumption was lower in the BT group (140.00 ± 48.066 mg) than in the B group (175.00 ± 34.114 mg), with a statistically significant mean difference of 10.761 (95% CI, 13.459 to 56.541), t (58) = 3.252, P = 0.002, (d = 0.839). The mean first analgesia request time was higher in the mixture of the BT group (367.33 ± 50.099 min) than in the B group (216.33 ± 68.744 min), with a statistically significant difference of 15.530 (95% CI, −182.087 to −119.913), t (58) = 5.6553, P = 0.001.
ConclusionWound infiltration with a combination of bupivacaine and tramadol is more effective than bupivacaine alone for postoperative analgesia in pregnant patients who underwent cesarean section under spinal anesthesia. This clinical trial study was registered at the Pan African Clinical Trial Registry with a unique trial registration number of PACTR202310525672884 (13/10/2023).
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