Project description:IntroductionAnemia is a global public health problem that has affected a significant number of pregnant mothers worldwide. The World Health Organization has estimated the prevalence of anemia in pregnant women at 18% and 56% in developed and developing countries, respectively. This study aimed to identify factors associated with severe anemia among laboring women in Mekelle city public hospitals, Tigray, Ethiopia.MethodsThis unmatched case-control study involved 264 (88 = cases and 176 = controls) pregnant women who were recruited when they came for delivery service in Mekelle city public hospitals. The data was collected from July to August, 2016. In this study, a systematic sampling technique was used inselecting controls, but the cases were enrolled until the required sample size was reached. Bivariate and multivariate analyses were conducted to find predictors of severe anemia. Statistically significant predictors of severe anemia were identified at P-value <0.05 and 95% confidence interval.ResultsA total of 264 pregnant women who came for delivery services were enrolled in this study. The major predicting variables for the occurrence of severe anemia among laboring women were residency (AOR = 3.28, 95% CI: 1.26-8.48), number of pregnancies (AOR = 2.46, 95% CI: 1.14-5.29), iron folate supplementation (AOR = 3.29, 95% CI: 1.27-8.49), dietary diversification score (AOR = 3.23, 95% CI: 1.19-8.71) and duration of menstrual cycle (AOR = 2.37, 95% CI: 1.10-5.10). The variable 'blood loss during pregnancy' (AOR = 6.63 95% CI: 2.96-14.86) was identified as a strong predictor of the outcome variable, severe anemia.ConclusionThis study identified determinants of severe anemia among laboring women in Mekelle city public hospitals, Northern Ethiopia. To reduce anemia, strengthening health education provision related to the importance of birth spacing and consuming diversified and iron-enriched food should be considered. Moreover, screening of pregnant women for state of anemia during their visits to health facilities, as well as de-worming for intestinal parasites infection are needed.

Project description:BackgroundAdverse birth outcome is a common health problem consisting of several health effects involving pregnancy and the newborn infant. Infants with one or more adverse birth outcomes are at greater risk for mortality and a variety of health and developmental problems. Factors such as the age of the mother, antepartum hemorrhage, history of abortion, gestational age, anemia, and maternal undernutrition have predisposed the mother to adverse birth outcome. For appropriate prevention of the adverse birth outcomes, data pertaining to determinants of adverse birth outcomes are important. Therefore, this study was aimed to assess the determinants of adverse birth outcomes among women who give birth in public hospitals of western Ethiopia.MethodsAn institutional-based unmatched prospective case-control study was conducted from February 15 to April 15, 2020, in selected public hospitals of western Ethiopia. From mothers who gave birth in public hospitals of Wollega zones, 165 cases and 330 controls were selected. Mothers with adverse birth outcomes were cases and mothers without adverse birth were controls. Data was collected by structured interviewer-administered questionnaires. In addition to the interview, the data collectors abstracted clinical data by reviewing the mother and the babies' medical records. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Finally, multivariable logistic regression was used to identify determinants of adverse birth outcomes at P-value < 0.05.ResultsA total of 495 mothers (165 cases and 330 controls) were included in the study with a mean age of 28.48 + 5.908. Low ANC visit (AOR = 3.92: 95% CI; 1.86, 8.2), premature rupture of membrane (AOR = 2.83: 95% CI; 1.72,4.64), being Anemic (AOR = 2: 95% CI; 1.16,3.44), pregnancy induced-hypertension (AOR = 2.3:95% CI; 1.4,3.85), not getting dietary supplementation (AOR = 2.47:95% CI; 1.6,3.82), and physical abuse (AOR = 2.13: 95% CI; 1.05,4.32) were significantly associated with the development of the adverse birth outcome.ConclusionLow antenatal care visit, being anemic, premature rupture of membrane, pregnancy-induced hypertension, not getting dietary supplementation, and physical abuse were determinants of adverse birth outcomes. The clinicians should play a pivotal role to improve antenatal care follow up, counsel, and supplement recommended diets and minimize violence and abuse during pregnancy.

Project description:Background:Hypoglycemia is an acute medical situation that occurs when blood glucose level falls below 70?mg/dl. Although prevention of hypoglycemia is one cornerstone in the management of diabetes mellitus, its prevention practice among patients with diabetes mellitus is insufficiently studied. Moreover, the existed scarce literature in Ethiopia revealed hypoglycemia prevention practice is inadequate. Thus, this study tried to assess hypoglycemia prevention practices and associated factors among diabetic patients. Methods:Hospital-based cross-sectional study design was employed from March 1 to April 1, 2018, in the central zone of Tigray regional state of Ethiopia. A total of 272 diabetes mellitus patients selected by a systematic random sampling method were included in the study. Data were entered into Epi-data version 3.1 and exported to SPSS version 23 for further analysis. The binary logistic regression model (AOR, 95% CI, and p value?<?0.05) was used to determine the predictors of hypoglycemia prevention practice. Results:The mean age of respondents was 43.62 years, and about 100 (63.2%) participants had good hypoglycemia prevention practice. Good knowledge on hypoglycemia (AOR?=?10.34; 95% CI [5.41, 19.89]), having a glucometer at home (AOR?=?3.02; 95% CI [1.12, 8.12]), favorable attitude towards diabetes mellitus (AOR?=?2.36 CI [1.26, 4.39]), and being governmental employee (AOR?=?5.19, 95% CI [1.63, 16.58]) were positive predictors of good hypoglycemia prevention practice. However, being divorced (AOR?=?0.13, 95% CI [0.32, 0.53]) was found negatively associated with good hypoglycemia prevention practice. Conclusion:Only two-thirds of the study participants were found to have good hypoglycemia prevention practices. Healthcare personnel and Ethiopian diabetic association should promote patients' attitude towards DM and knowledge on hypoglycemia by strengthening information, education, and communication program. Stakeholders should also try to provide glucometers to diabetic patients.

Project description:BackgroundDrug use evaluation is a systematic approach to determining the appropriateness of drug use, identifying drug therapy problems, and proposing interventions. Ceftriaxone is one of the most widely used drugs in hospitals, requiring the performance of drug use evaluation. This study was aimed at evaluating the appropriateness of ceftriaxone use at Kahsay Abera and Mearg hospitals in the Western zone of Tigray, Ethiopia.MethodsAn institution-based retrospective cross-sectional study design was conducted in both hospitals from December 2015 to August 2016 using standardized and pretested data collection formats. Systematic random sampling was used, and a total of 800 patients' medication records (patients who took ceftriaxone) from both hospitals (400 each) were assessed in this study. Statistical analysis was performed by using the statistical package for social sciences (version 20).ResultsThe overall appropriateness of ceftriaxone use in Kahsay Abera and Mearg hospitals was 247 (61.75%) and 252 (63.0%), respectively. The majority of inappropriate use of ceftriaxone was noted in indication errors at both Kahsay Abera (71.2%) and Mearg hospitals (52.0%). The treatment duration in Kahsay Abera (69%) and Mearg hospitals (88%) was in the range of 2-7 days. Mostly, a 2-gram ceftriaxone daily dose was prescribed in both Kahsay Abera and Mearg hospitals, accounting for 285 (71.25%) and 318 (79.5%), respectively. In this study, the top three diseases, indicated for ceftriaxone in both hospitals, were typhoid fever, urinary tract infection, and pneumonia in descending order. Among the medications coadministered with ceftriaxone, the top three coprescribed drugs with ceftriaxone in Kahsay Abera Hospital were metronidazole (17.25%), tramadol 68 (11.28%), and diclofenac (8.96%), but in Mearg Hospital, next to metronidazole, drugs like paracetamol and doxycycline were the most common coprescribed medicines along with ceftriaxone.ConclusionThe appropriateness of ceftriaxone use in Kahsay Abera and Mearg hospitals was 247 (61.8%) and 252 (63%), respectively, in which about one-third of patients' charts were not compliant with the standard treatment guidelines of Ethiopia for general hospitals. In Kahsay Abera and Mearg hospitals, the empiric use of ceftriaxone was 262 (65.5%) and 375 (93.8%), respectively.

Project description:IntroductionAntenatal care (ANC), health facility birth and postnatal care services are proved to reduce maternal and newborn morbidity and mortality. In Ethiopia, even though antenatal care coverage is good, still home birth is high. This study aimed to assess the prevalence and determinants of home birth among women who were booked for ANC in public hospitals in Wolaita zone, southern Ethiopia.MethodsA cohort study was conducted from February to May 2017 among 554 third trimester pregnant mothers who visited public hospitals of Wolaita Zone, southern Ethiopia for ANC service. All women were interviewed twice: the first interview was done face-to-face in the health facility in which they were having ANC follow up to gather information about basic socio-demographic and obstetric characteristics; the second interview was done via telephone after they gave birth to get information about the place of birth. Epi-Data version 3.1 was used for data entry and the Statistical Package for the Social Sciences (SPSS) version 22 was used for data analysis.ResultsA total of 68 (13.5%; 95% Confidence Interval (CI): 10.5%-16.6%) women who were booked for ANC gave birth at home. Being uneducated (AOR = 2.46, 95% CI: [1.10-5.10]), starting ANC visit late (>16weeks) (AOR = 2.27, 95% CI: [1.14-4.50]), time taken to reach at health facility for ANC service (>30minutes) (AOR = 8.94, 95% CI: [4.50-17.72]), waiting time of greater than 30 minutes for ANC in health facilities (AOR = 1.18, 95% CI: [1.06-2.30]) and lack of knowledge about danger signs of pregnancy (AOR = 4.18, 95%CI: [1.80-9.70]) were significantly associated with home birth.ConclusionsHome birth among ANC booked women is low compared to other studies. Yet, giving attention to women with no education and those coming from far areas while providing advice on birth preparedness and pregnancy danger signs may be useful to further reduce the rate of home birth. Advising mothers to start ANC early and trying to reduce ANC waiting time could also be of importance.

Project description:BackgroundWorldwide, preterm birth accounts for 1 million deaths of infants each year and 60% of these deaths occur in developing countries. In addition to the significant health consequences on the infant, preterm birth can lead to economic costs. There was a lack of study in western Ethiopia, and most of those studies conducted in other parts of a country were based on card review with a cross-sectional study design. The risk factors of preterm birth may vary from region to region within the same country due to variation in socioeconomic status and health care service coverage. Therefore, this study aimed to identify determinants of preterm birth in western Ethiopia.MethodsAn institutional-based case-control study was conducted from February 15 to April 15, 2020, in western Ethiopia. The eligible 188 cases and 377 controls were randomly selected for this study. Cases were women who gave birth after 28 weeks and before 37 completed weeks of gestation, and controls were women who gave birth at and after 37 weeks of gestation from the first day of the last normal menstrual period. Data were collected by a structured interviewer-administered questionnaire. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Multivariable logistic regression was used to identify determinants of preterm birth at P-value <0.05.ResultsFrom a total of 565 eligible participants, 516 (172 cases and 344 controls) participated in this study with a response rate of 91.3%. The result of the multivariable analysis shows that mothers who developed pregnancy-induced hypertension (AOR = 3.13, 95% CI; 1.78, 5.50), only one time ANC visits (AOR = 5.99, 95% CI; 2.65, 13.53), experienced premature rupture of membrane (AOR = 3.57, 95% CI; 1.79, 7.13), birth interval less than two years (AOR = 2.96, 95% CI; 1.76, 4.98), developed anemia during the current pregnancy (AOR = 4.20, 95% CI; 2.13, 8.28) and didn't get dietary supplementation during the current pregnancy (AOR = 2.43, 95% CI; 1.51, 3.91) had statistically significant association with experiencing preterm birth.ConclusionAntenatal care service providers should focus on mothers with pregnancy-induced hypertension, premature rupture of membrane, and anemia during pregnancy, and refer to the senior experts for early management to reduce the risk of preterm delivery. Antenatal care services such as counseling the mother on the benefit of dietary supplementation during pregnancy, antenatal care follow up, and lengthening birth interval should be integrated into the existing health extension packages. New and inclusive strategies such as the establishment of comprehensive mobile clinic services should also be designed to reduce the burden of preterm birth among women living in the rural community. Lastly, we recommend future researchers to conduct longitudinal and community-based studies supplemented with qualitative methods.

Project description:IntroductionDespite the international emphasis in the last few years on the need to address the unmet health needs of pregnant women and children, progress in reducing maternal mortality has been slow. This is particularly worrying in sub-Saharan Africa where over 162,000 women still die each year during pregnancy and childbirth, most of them because of the lack of access to skilled delivery attendance and emergency care. With a maternal mortality ratio of 673 per 100,000 live births and 19,000 maternal deaths annually, Ethiopia is a major contributor to the worldwide death toll of mothers. While some studies have looked at different risk factors for antenatal care (ANC) and delivery service utilisation in the country, information coming from community-based studies related to the Health Extension Programme (HEP) in rural areas is limited. This study aims to determine the prevalence of maternal health care utilisation and explore its determinants among rural women aged 15-49 years in Tigray, Ethiopia.MethodsThe study was a community-based cross-sectional survey using a structured questionnaire. A cluster sampling technique was used to select women who had given birth at least once in the five years prior to the survey period. Univariable and multivariable logistic regression analyses were carried out to elicit the impact of each factor on ANC and institutional delivery service utilisation.ResultsThe response rate was 99% (n=1113). The mean age of the participants was 30.4 years. The proportion of women who received ANC for their recent births was 54%; only 46 (4.1%) of women gave birth at a health facility. Factors associated with ANC utilisation were marital status, education, proximity of health facility to the village, and husband's occupation, while use of institutional delivery was mainly associated with parity, education, having received ANC advice, a history of difficult/prolonged labour, and husbands' occupation.ConclusionsA relatively acceptable utilisation of ANC services but extremely low institutional delivery was observed. Classical socio-demographic factors were associated with both ANC and institutional delivery attendance. ANC advice can contribute to increase institutional delivery use. Different aspects of HEP need to be strengthened to improve maternal health in Tigray.

Project description:BackgroundMedication administration error is a medication error that occurs while administering a medication to a patient. A variety of factors make pediatrics more susceptible to medication errors and its consequences. In low-income countries, like Ethiopia, there is no sufficient evidence regarding medication administration error among pediatrics. The aim of this study is, therefore, to determine the magnitude and factors associated with medication administration error among pediatric population.MethodsA prospective observational based cross sectional study design was conducted from January to April 2017. Data collection was done using pre-tested structured questionnaire and blind observation checklist to health professionals in charge of administering selected medications. A total of 1282 medication administrations were obtained using single population proportion formula from patients in the selected public hospitals and the samples were selected using multistage sampling technique. Multivariable logistic regression using odds ratio and 95% confidence interval was used to determine the relationship between the independent and dependent variables. Variables with p-value <?0.05 were considered as independent factors for medication administration error.ResultA total of 1251 medication administrations were observed from 1251 patients. The occurrence of medication administration error was 62.7% with 95% CI (59.6%, 65.0%), wrong dose being the most common type of medication administration error with an occurrence rate of 53.7%. Medications administered for pediatric patients less than 1 month age, administered by bachelor degree holder health professionals, prepared in facilities without medication preparation room, prepared in facilities without medication administration guide and administer for patients who have two or more prescribed medications were more likely to have medication administration error than their counterparts with AOR (95% CI) of 7.54(2.20-25.86), 1.52 (1.07-2.17), 13.45 (8.59-21.06), 4.11 (2.89-5.85), and 2.42 (1.62-3.61), respectively.ConclusionThis study has revealed that there is high occurrence of medication administration error among pediatric inpatients in public hospitals of Tigray, Northern Ethiopia.. Age of patients, educational level of medication administrators, availability of the medication preparation room and guide, and the number of medications given per single patient were statistically significant factors associated with occurrence of medication administration error.

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