Conectar
Although the WHO and the Centers for Disease Control and Prevention (CDC) classify preconception health risks (PCHRs) into biomedical, behavioural and social categories, this classification remains theoretical, mainly inconsistent and lacks a scientifically robust framework. Data-driven clustering techniques may help clarify this complexity for policymakers and healthcare providers. This study aimed to assess the status of PCHRs and identify latent classes of these risks among women preparing for pregnancy.
This community-based cross-sectional study was conducted from 31 July to 16 August 2024 in Tigray, Ethiopia, among 865 married women planning to conceive within the next 6 months. Data were gathered through face-to-face interviews using a structured questionnaire. Risk factor indicators covering lifestyle behaviours, substance use, nutritional risks and related factors were developed based on guidelines from the WHO, the CDC and national recommendations. Latent class analysis (LCA) was employed to identify distinct classes of PCHRs, with the optimal number of classes determined using statistical fit indices, adequacy criteria and interpretability. The study also evaluated the overall distribution of PCHRs among participants.
The study took place in Tigray, Ethiopia, among married women intending to become pregnant within 6 months.
Burden of PCHRs and identified distinct latent classes of these risks within the participants.
All participants were exposed to at least four PCHRs, with 84.2% experiencing between 6 and 12 risk factors. The optimal LCA model identified four distinct classes of PCHRs: lifestyle behavioural risks (n=458, 52.9%), reproductive health risks and chronic medical conditions (n=106, 12.25%), nutritional risks and environmental exposure (n=149, 17.23%) and social determinants of health (n=152, 17.57%).
Our study reveals a high baseline level of PCHRs, with all participants exhibiting multiple risk factors for adverse pregnancy outcomes. The identification of four distinct risk profiles underscores the need for tailored risk-specific interventions, particularly in conflict-affected settings. Our findings point out the need for targeted preconception care and risk stratification in national health strategies to improve maternal and child health outcomes.
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).
by Gebremedhin Gebreegziabher Gebretsadik, Andargachew Kassa Biratu, Alemayehu Bayray Kahsay, Amanuel Gessessew, Zohra S. Lassi, Hailemariam Segni, Afework Mulugeta
BackgroundAdverse pregnancy outcomes continue to pose a significant global public health challenge, especially in low- and middle-income countries. Although preconception care (PCC) interventions are advised to address this problem, their adoption remains inadequate, supported by scarce evidence particularly in conflict-impacted areas such as Tigray, Ethiopia, where rates of poor outcomes like neural tube defects are notably higher than in other regions. This study investigates the experience of pregnant women regarding the use of PCC in the Tigray, northern Ethiopia.
MethodsA community-based cross-sectional study was conducted from July 31 to August 16, 2024, involving 764 pregnant women in their first or second trimester. Participants were consecutively enrolled from clusters until the predetermined sample size was achieved. Data were collected through interviewer-administered questionnaires in accordance with World Health Organization, and Centers for Disease Control and Prevention, and national guidelines. PCC uptake was measured as the receipt of any service component (screening, counseling, or management) during healthcare consultations. We used SPSS version 27.0 to analyze PCC uptake and its associated factors. Descriptive and binary logistic regression statistics were used in the analysis. Finally, data was presented using text, tables, and figures as appropriate.
ResultsIn this study, the overall uptake of PCC services was 7.2%. All participants in the current pregnancy were exposed to at least one risk factor for adverse pregnancy outcomes. Factors such as women’s decision-making power, having information about PCC, HIV screening during the current pregnancy, and perceived susceptibility to preconception risks showed a statistically significant positive association with the uptake of PCC services.
ConclusionThe uptake of PCC services was very low. Addressing the low uptake of PCC services requires a multifaceted strategy, including public health campaigns via media and social forums, strengthened health extension programs, and the integration of a reproductive life plan tool to improve health-seeking behavior among women.
To develop and validate a risk prediction model for preterm premature rupture of membranes (PPROM) to enable early identification of at-risk women and support clinical decision-making in North Wollo Zone, Ethiopia.
A hospital-based retrospective cross-sectional study.
Six public hospitals in the North Wollo Zone, Northern Ethiopia.
A total of 1098 pregnant women were included in the study using systematic random sampling.
Occurrence of PPROM.
Data were collected between 20 November 2023 and 20 March 2024, using structured interviews and medical record reviews. A risk prediction model was developed using Least Absolute Shrinkage and Selection Operator and logistic regression. Model performance was assessed through area under the curve (AUC), calibration plots and the Hosmer-Lemeshow test. Internal validation was conducted via bootstrap resampling. A simplified risk score was created to categorise women into high-risk and low-risk groups, and its clinical utility was evaluated using decision curve analysis.
Among the 1098 participants (100% response rate), the mean age was 21.54 years (IQR: 18–26), with 57.2% aged 20–34 years. The prevalence of PPROM was 10.75% (95% CI 9.01% to 12.77%). Seven significant predictors were identified: maternal age
PPROM remains a significant obstetric complication in the study area. The validated risk prediction model showed moderate to good performance and can be used to support early screening and risk-based management in antenatal care (ANC). Integrating the tool into routine ANC services, along with health education and management of modifiable risk factors, may help reduce PPROM-related adverse outcomes. Further external validation is recommended.
by Bethelhem Bashe, Desalegn Dawit Assele, Worku Ketema, Mulugeta Sitot Shibeshi
BackgroundCerebral palsy is a frequent physical disability of childhood, causing motor impairment, sensory impairment, cognitive and behavioral issues, and secondary musculoskeletal deformities, with a global incidence of 1–4 per 1,000 children. It significantly impacts children’s quality of life and imposes an economic burden on families and healthcare systems. There is limited evidence of the risk factors of cerebral palsy in Ethiopia, including in the study setting. We investigated factors associated with cerebral palsy among children attending Hawassa University Comprehensive Specialized Hospital.
MethodsAn institution-based, unmatched case-control study was conducted among children who visited Hawassa University Comprehensive Specialized Hospital from January 2019 to December 2023. Consecutive cases were recruited until the required sample size was reached, and controls were randomly selected. Data were extracted from 80 cases and 160 control charts. Binary logistic regression analysis was used to identify risk factors for cerebral palsy. An adjusted odds ratio with a 95% confidence interval was reported to show the strength of the association. The significance of the association was declared at a p-value Results
A total of 240 participants (80 cases and 160 controls) were enrolled in the study. Maternal infection during pregnancy [AOR:4.1; 95%; 1.39, 12.1], low birth weight [AOR:4.1; 95%; 1.49, 11.2], prolonged labor [AOR:3.2; 95%;1.47, 7.00], history of perinatal asphyxia [AOR: 2.65; 95%;1.06, 6.65], and central nervous system infection during infancy [AOR:3.4; 95%; 1.21, 9.64] were risk factors for cerebral palsy.
ConclusionPerinatal asphyxia, maternal infection, low birth weight, prolonged labor, and CNS infection during infancy are significantly associated with cerebral palsy. Public health education should promote awareness about cerebral palsy, encourage antenatal care, and educate healthcare professionals on emergency obstetrics and newborn care. Appropriate measures should be taken to reduce the incidence of CNS infections during infancy.
by Tadesse Tarik Tamir, Berhan Tekeba, Alebachew Ferede Zegeye, Deresse Abebe Gebrehana, Mulugeta Wassie, Gebreeyesus Abera Zeleke, Enyew Getaneh Mekonen
IntroductionSolitary childbirth—giving birth without any form of assistance—remains a serious global public health issue, especially in low-resource settings. It is associated with preventable maternal complications such as hemorrhage and sepsis, and poses significant risks to newborns, including birth asphyxia, infection, and early neonatal death. In Ethiopia, where many births occur outside health facilities, understanding the spatial and socio-demographic patterns of solitary childbirth is vital for informing targeted interventions to improve maternal and child health outcomes. This study aims to identify and map the spatial distribution of solitary childbirth across Ethiopia and to analyze its determinants using data from the 2019 national Interim Demographic and Health Survey.
MethodWe analyzed data from the 2019 Interim Ethiopian Demographic and Health Survey to determine the spatial distribution and factors of solitary birth in Ethiopia. A total weighted sample of 3,884 women was included in the analysis. Spatial analysis was used to determine the regional distribution of solitary birth, and multilevel logistic regression was employed to identify its determinants. ArcGIS 10.8 was used for spatial analysis, and Stata 17 was used for multilevel analysis. The fixed effect was analyzed by determining the adjusted odds ratio with a 95% confidence interval.
ResultThe prevalence of solitary childbirths in Ethiopia was 12.73%, with a 95% confidence interval spanning from 11.71% to 13.81%. The western and southern parts of Oromia, all of Benishangul-Gumuz, most parts of the SNNPR, and the west of Amhara regions were hotspot areas for solitary birth. Having no formal education, not attending ANC visits, and residing in pastoral regions were significantly associated with higher odds of solitary birth in Ethiopia.
CocnlusionA notable proportion of women are experiencing childbirth alone, which highlights a significant aspect of maternal health in the country, reflecting both the challenges and improvements in childbirth practices. The distribution of solitary births exhibited spatial clustering with its hotspot areas located in western and southern parts of Oromia, all of Benishangul-Gumuz, most parts of the SNNPR, and west of Amhara regions. Lack of education, not having an ANC visit, and being a resident of pastoral regions were significant determinants of solitary birth. The implementation of maternal and child health strategies in Ethiopia could benefit from considering the hotspot areas and determinants of solitary birth.
This study aimed to assess functional disability and associated factors among people with severe mental illness attending public hospitals in Harar town, Eastern Ethiopia.
An institution-based cross-sectional study was conducted in public hospitals found in Harar town, Eastern Ethiopia, from 1 April to 10 May 2023.
A total of 342 patients with severe mental illness attending public hospitals in Harar town, Eastern Ethiopia, were included.
The main outcome of this study was functional disability, which was measured using a 12-item version of the WHO Disability Assessment Schedule.
In this study, the mean (±) score of functional disability among patients with severe mental illness was 31.8 (±9.6) (95% CI: 30.7 to 32.8). The multiple linear regression model revealed that unemployment (β: 1.93; 95% CI: 0.28 to 3.59), total illness duration (5–10 years and above 10 years) (β: 3.71; 95% CI: 1.95 to 5.48 and β: 4.51; 95% CI: 2.41 to 6.62, respectively), age at illness onset (β: –0.37; 95% CI: –0.45 to –0.28), having drug side effects (β: 3.05; 95% CI: 1.46 to 4.63), medication non-adherence (β: 6.15; 95% CI: 4.56 to 7.73) and having high perceived stigma (β: 2.27; 95% CI: 0.72 to 3.82) were significantly associated with functional disability.
Patients with severe mental illness had a high mean functional disability score. Unemployment, age at onset of mental illness, total duration of illness, medication side effects, medication non-adherence and higher perceived stigma were factors that were associated with functional disability. Given the mean functional disability score observed among respondents, a multipronged intervention strategy that prioritises early detection and management of severe mental illness, particularly targeting individuals at risk, is recommended to mitigate disability and enhance quality of life.
FreshRSS 