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Prevalence and associated factors of zinc deficiency among pregnant women and children in Ethiopia: a systematic review and meta-analysis.

ABSTRACT: BACKGROUND:Pregnant women and children are the most vulnerable groups to zinc deficiency. Despite the presence of few primary studies, studies that could provide strong evidence that would help policymakers to develop appropriate interventional strategies in addressing zinc deficiency among pregnant women and children are limited in Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to estimate the national pooled prevalence and associated factors of zinc deficiency among pregnant women and children. METHODS:We searched Pub Med, Scopus, CINAHL, Google Scholar, and Google for studies reported on zinc deficiency and associated factors among pregnant women and children. Search terms were 'zinc deficiency', 'zinc status', 'associated factors', 'children', 'pregnant women', and 'Ethiopia' using the boolean operators 'OR' or 'AND'. Searches were using English language. A preferred reporting item for systematic reviews and meta-analysis (PRISMA) checklist was used. Two authors independently reviewed the studies. The effect sizes of the meta-analysis were the prevalence of zinc deficiency and adjusted odds ratio (AOR) of the associated factors. Finally, the Comprehensive Meta-Analysis (CMA) version 3.3.07 was used for statistical analysis by applying the random-effects model and publication bias was assessed using funnel plots and Egger's test. RESULTS:Thirteen studies (7 among pregnant women having total participants of 2371 pregnant women and 6 among children with total participants of 5154 children) were included in this systematic review and meta-analysis. Using the random-effects model, the pooled prevalence of zinc deficiency was 59.9% (95%CI: 51.9, 67.7%) and 38.4% (95%CI: 28.6, 49.4) among pregnant women and children, respectively. The associated factors for zinc deficiency among pregnant women were coffee intake (adjusted odds ratio (AOR) =1.76), low intake of animal source foods (AOR?=?2.57), and inadequate diet diversity (AOR?=?2.12). CONCLUSION:Overall, zinc deficiency among pregnant women and children is a significant public health concern in Ethiopia. Promoting dietary modification to enhance the bioavailability of zinc, improving diet diversity, and consuming animal source foods would help in alleviating and/or minimizing the problem among the target groups. Zinc supplementation could also be considered for pregnant women and children.

SUBMITTER: Berhe K

PROVIDER: S-EPMC6907210 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Prevalence and associated factors of zinc deficiency among pregnant women and children in Ethiopia: a systematic review and meta-analysis.

Berhe Kidanemaryam K Gebrearegay Freweini F Gebremariam Hadush H

BMC public health 20191211 1

<h4>Background</h4>Pregnant women and children are the most vulnerable groups to zinc deficiency. Despite the presence of few primary studies, studies that could provide strong evidence that would help policymakers to develop appropriate interventional strategies in addressing zinc deficiency among pregnant women and children are limited in Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to estimate the national pooled prevalence and associated factors of zinc defici ...[more]

PMID: 31829213

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Project description:BackgroundHomebirth preference is the intention/plan to give birth outside health facilities with the help of unskilled birth attendants. The preference to give birth at home without a skilled birth attendant leads to care-seeking delays, intrapartum mortality, multiple stillbirths, and postpartum morbidities and mortality. Therefore, this study aimed to estimate the pooled prevalence of homebirth preference and associated factors among pregnant women in Ethiopia.MethodsSearch of Google Scholar, Medline, PubMed, Cochrane Library and Web of Science were done for this study from 20th August 2022 to 6th November 2022. For data extraction and analysis, the standardized data extraction checklist and Stata version 14 were used respectively. Sentence as "Cochrane Q test statistics and I2 statistics were used to check heterogeneity of the studies. The pooled prevalence of homebirth preference was estimated using a random-effects model. The association between homebirth preference and independent variables was determined using an odd ratio with a 95% confidence interval. A funnel plot and Egger's test were used to assess publication bias.ResultsA total of 976 research articles were identified. Seven studies that fulfilled eligibility criteria were included in this systematic review and meta-analysis. The pooled prevalence of homebirth preference in Ethiopia was 39.62% (95% CI 27.98, 51.26). The current meta-analysis revealed that average monthly income <1800 ETB (OR = 2.66, 95% CI 1.44, 4.90) lack of ANC follow-up (OR = 2.57, 95%CI 1.32, 5.01), being multipara (OR = 1.77, 95%CI 1.39, 2.25), poor knowledge about obstetric danger sign (OR = 5.75, 95%CI 1.o2, 32.42), and not discussing the place of delivery with a partner (OR = 5.89 (95%CI 1.1, 31.63) were significantly associated with homebirth preference.ConclusionThis systematic review and meta-analysis examined the substantial prevalence of homebirth preference in Ethiopia which may contribute maternal and child health crisis. The homebirth preference was associated with low average monthly income (<1800 ETB), lack of ANC follow-up, multipara, poor knowledge about obstetric danger signs, and not discussing with their partner the place of delivery. Improving knowledge of pregnant women about the benefit of health facility delivery and obstetric danger signs is necessary to decrease the prevalence of homebirth preference; for these can reduce negative outcomes occurred during delivery.

Project description:BackgroundSyphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Previously, studies showed inconsistent results and failed to show the actual picture of the diseases in Ethiopia. Thus, the aim of this meta-analysis was, first, to determine the updated pooled prevalence of syphilis among pregnant women in Ethiopia and, second, to assess its associated factors.MethodsA comprehensive search was made on PubMed, Google scholar, Science Direct, and African Journals Online databases to identify relevant articles. A random effects model was used to estimate pooled syphilis prevalence and odds ratio (OR) with the respective 95% confidence intervals (CIs) using STATA 14 statistical software. I2 statistics and Egger's regression test in conjunction with funnel plot was used to determine heterogeneity and publication bias among included studies respectively.ResultWe identified 13 suitable studies in this analysis. Accordingly, the pooled prevalence of syphilis among pregnant women in Ethiopia was 2.32% (95% CI, 1.68-2.97). Specifically, syphilis prevalence was 2.53% (95% CI, 1.92-3.14%) and 1.90% (95% CI, 0.40-3.40%) as per the treponemal and non-ytreponemal diagnostic test, respectively. On the other hand, regional analysis indicated that 4.06% (95% CI, 2.86-5.26) in Southern Nations Nationalities and Peoples (SNNP), 2.16% (95% CI, 1.57-2.75) in Amhara and 1.46% (95% CI, 0.69-2.23) in Oromia region. Being married (OR, 0.37 (95% CI, 0.12-0.91%)) was less likely to develop syphilis. On the other hand, women with history of multiple sexual partner (OR, 2.98 (95% CI, 1.15-7.70)) and women with history of previous sexually transmitted infection (STI) (OR, 4.88 (95% CI, 1.35-17.62)) have higher risk to develop syphilis. Besides, the pooled syphilis-HIV coinfection was 0.80% (95% CI, 0.60-1.01%).ConclusionThis study provides evidence of relatively high prevalence of syphilis among pregnant women in Ethiopia. Therefore, it is recommended to further ramping up of current intervention measures to prevent future generations.Systematic review registrationPROSPERO CRD42020211650.

Project description:BackgroundIn Ethiopia limited information is available regarding the prevalence and predictors of anemia in pregnancy. This systematic review and meta-analysis estimated the pooled prevalence of anemia among pregnant women in Ethiopia and also identified its predictors.Materials and methodsThe published primary studies were searched in the following electronic databases; PubMed/Medline, Google scholars, AJOL, and EMBASE. All primary studies published from 01/01/2010 to 30/05/2020 and written in English language were included without restriction on study setting and design. Critical appraisal of all available articles was done and extracted data was analyzed using STATA software version 14. The pooled prevalence of anemia was presented using a forest plot. The I2 statistical test for heterogeneity, and the Egger's and Begg's tests for publication bias were used. The relative risk was used to assess the association of predictor variables with anemia.ResultAfter screening 274 articles, sixty studies were included in the analysis. The pooled prevalence of anemia among pregnant women was 26.4(95% CI: 23.1, 29.6). Sub-group analysis showed higher pooled prevalence from community-based studies than institutional-based studies. Factors that were protective against maternal anemia included urban residence, formal education and smaller family size. Short birth interval and not having antenatal care (ANC) are associated with a higher risk of maternal anemia. Women with low dietary diversity [RR: 2.61(95% CI, 1.85, 3.68)], mid-upper arm circumference (MUAC) less than 23 cm [RR: 2.35(95% CI, 1.53, 3.68)] and those not taking iron-folic acid [RR: 1.53(95% CI: 1.30, 1.81)] also had a higher risk of anemia.ConclusionAlmost one in four pregnant women in Ethiopia had anemia. Being literate, living in urban areas with small family size and adequate birth spacing, as well as good dietary diversity are associated with a lower risk of anemia in pregnancy.Registration number(ID: CRD42020211054).

Project description:BackgroundPremature rupture of the membrane is a serious public health problem, especially in low- and middle-income countries with significant maternal and perinatal morbidity and mortality. Despite its substantial contributions to feto-maternal complications, the burden of premature rupture of the membrane was not systematically analyzed in Ethiopia. Hence, this review aimed to identify the burden of premature rupture of the membrane and associated factors among pregnant women in Ethiopia.MethodsPubMed/Medline, Scopus, and African journal online databases and Google Scholar were searched for articles published in the English language. Independent review authors selected and screened studies. Appraisal for methodological quality of studies was conducted using the Joanna Briggs Institute assessment checklist. RevMan 5.3 software was used for meta-analysis. The I 2 statistical significance and Egger's test were used to assess heterogeneity and publication bias, respectively.ResultsThe pooled prevalence of premature rupture of the membrane among pregnant women in Ethiopia was 9.2% (95% confidence interval = 5.0, 16.4). Factors significantly associated with premature rupture of the membrane were no antenatal care visit (odds ratio = 2.87, confidence interval = 1.34, 6.14), history of premature rupture of the membrane (odds ratio = 4.09, 95% confidence interval = 2.82, 5.91), history of abortion (odds ratio = 3.13, confidence interval = 1.63, 6.01), abnormal vaginal discharge (odds ratio = 6.78, confidence interval = 4.11, 11.16), and urinary tract infection (odds ratio = 3.04, confidence interval = 1.21, 7.63).ConclusionNearly one in ten pregnancies in Ethiopia encounters premature rupture of the membrane complications. The finding highlights improving antenatal care utilization, thus preventing or treating urinary and reproductive tract infections, and tailored interventions for pregnant women with a history of premature rupture of the membrane or abortion contribute to reduced premature rupture of the membrane.

Project description:BACKGROUND:Anemia during pregnancy is one of the most common indirect obstetric cause of maternal mortality in developing countries. It is responsible for poor maternal and fetal outcomes. A limited number of studies were conducted on anemia during pregnancy in Ethiopia, and they present inconsistent findings. Therefore, this review was undertaken to summarize the findings conducted in several parts of the country and present the national level of anemia among pregnant women in Ethiopia. METHODS:Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, and African Journals Online. Search terms used were; anemia, pregnancy related anemia and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 14 software. The pooled Meta logistic regression was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence interval (CI). RESULTS:Twenty studies were included in the meta-analysis with a total of 10, 281 pregnant women. The pooled prevalence of anemia among pregnant women in Ethiopia was 31.66% (95% CI (26.20, 37.11)). Based on the pooled prevalence of the subgroup analysis result, the lowest prevalence of anemia among pregnant women was observed in Amhara region, 15.89% (95% CI (8.82, 22.96)) and the highest prevalence was in Somali region, 56.80% (95% CI (52.76, 60.84)). Primigravid (RR: 0.61 (95% CI: 0.53, 0.71)) and urban women (RR: 0.73 (95% CI: 0.60, 0.88)) were less likely to develop anemia. On the other hand, mothers with short pregnancy interval (RR: 2.14 (95% CI: 1.67, 2.74)) and malaria infection during pregnancy (RR: 1.94 (95% CI: 1.33, 2.82)) had higher risk to develop anemia. CONCLUSIONS:Almost one-third of pregnant women in Ethiopia were anemic. Statistically significant association was observed between anemia during pregnancy and residence, gravidity, pregnancy interval, and malaria infection during pregnancy. Regions with higher anemia prevalence among pregnant women should be given due emphasis. The concerned body should intervene on the identified factors to reduce the high prevalence of anemia among pregnant women.

Project description:BackgroundsPregnancy related complications are major causes of maternal morbidity and mortality worldwide. Diversified food consumption is essential to produce hormones during pregnancy and it reduced complications. In Ethiopia, many researchers were investigated about the proportion of pregnant women with dietary diversity and its determinant factors. However, those studies are inconsistent and fragmented. Therefore, the aim of this study was to estimate the pooled proportion of pregnant women with dietary diversity practice and its associated factors in Ethiopia.MethodsWe conducted a systematic electronic web-based search of PubMed/ /MEDLINE, EMBASE, Web of Science, Google Scholar and Google online databases for identifying studies on proportion of pregnant women with dietary diversity practice and its associated factors in Ethiopia using pre-defined quality and inclusion criteria. STATA version 14 statistical software was used to analyze the data. We extracted relevant data and presented in tabular form. The I2 test was used to assess heterogeneity across studies. Funnel plot asymmetry and Begg's test were used to check for publication bias. The final effect size was determined by applying a random-effects model.ResultsOur search identified 170 studies. Of which, 23 were included in the final analysis stage. The pooled proportion of dietary diversity among pregnant women in Ethiopia was 41% (95% CI: 33, 49). Mothers can read and write (OR = 1.82 (95% CI: 1.25, 2.64)), maternal primary school and above educated (OR = 2.11 (95% CI: 1.10, 4.05)), nutritional information (OR = 4.1 (95% CI: 2.1, 7.99), dietary diversity knowledge (OR = 3.4 (95% CI: 2.73, 4.73)) and household had rich wealth index (OR = 3.45 (95% CI: 1.19, 10.1)) were significantly associated with dietary diversity practice during pregnancy.ConclusionsIn this meta-analysis; we found that low proportion of pregnant women with adequate dietary diversity in Ethiopia (41%). Maternal education, nutritional information, dietary diversity knowledge and wealth index level of household were significantly associated factors of pregnant woman with dietary diversity practice. This finding implies that improving the awareness of woman about dietary diversity during pregnancy and empowering women economically would play a significant role to improve dietary diversity practice.

Project description:Vitamin A plays an important role in the periods of rapid cellular growth and differentiation, especially during pregnancy, which is supplied by the mother to the fetus. The aim of this study is to assess the prevalence and potential influence factors of prenatal VAD of Chinese pregnant women.China National Nutrition and Health Survey 2010-2013(CHNNS2010-2013) is a nationally representative cross-sectional study. It involved the random selection of 150 districts (urban) or counties (rural). Each site randomly selected 30 pregnant women. Because volume of blood and incomplete data was taken into consideration,the final sample was formed by 1209 participants. Serum retinol concentrations were measured by high performance liquid chromatography. Characteristics of the pregnant women were collected by a questionnaire. Comparing retinol level across categories of independent variables was tested by the Mann-Whitney U test. Logistic and linear regression analyses were used to identify influence factors of Chinese pregnant women.The mean serum retinol level of the pregnant women was 1.63 μmol/L (95 % CI 1.60-1.67) and 64[5.3 % (95 % CI 4.03-6.56)] had VAD. The odds of VAD were significantly higher among the pregnant women in the poor rural areas and without college or university education and low- income. Pregnant women in the second and third trimester had 2.40 (95 % CI 1.05-5.46) and 2.82 (95 % CI 1.34-5.93) times increased odds of VAD compared with those in the first trimester respectively. Pregnant women of drinker had 3.10(1.65-5.81) times increased odds of VAD compared with those no drinker. Pregnant smokers had 5.68 (95 % CI 2.23-14.49) times higher odds of VAD compared with pregnant with non-smoker without passive smoking.VAD is of mild public-health issue in Chinese pregnant women. Such as : in the poor rural areas and without received college or university education and low- income and advanced gestational age and unhealthy lifestyles of pregnant women such as smoking and drinking. These were pertinent influence factors of VAD.

Project description:BackgroundVitamin A deficiency is a major nutritional concern in lower-income countries. The aim of this systematic review and meta-analysis was to show the magnitude of vitamin A deficiency among preschoolers in Ethiopia.ObjectiveThe present study was aimed at synthesizing qualitatively and quantitatively the existing literature on the prevalence of VAD in preschool children in Ethiopia.MethodsStudies were searched through the search engine of Google Scholar, Hinari, MEDLINE/PubMed, Cochrane Library, and Africa-Wide Information. Searching was made using the keywords/MeSH of vitamin A deficiency, xerophthalmia, night blindness, Bitot's spot, retinol, children, and Ethiopia. Data were analyzed and compared with the WHO threshold criteria to declare a public health problem. Heterogeneity among studies was assessed using a Cochran Q test and I 2 statistics. A random-effects model with 95% confidence interval was used for prevalence estimations.ResultsOf the 13 studies included in clinical analysis, 12 of them reported the prevalence of night blindness and/or Bitot's spot among preschool children in Ethiopia which was above WHO cutoff point for the public health problem 1% and 0.5%, respectively. The prevalence of night blindness significantly decreased from moderate public health problem 4.2% (95% CI: 2.8%-5.7%) in a period from 1990 to 2004 to mild public health problem 0.8% (95% CI: 0.6%-1.0%) in a period from 2005 to 2019. Furthermore, statistically insignificant reduction was observed in the prevalence of Bitot's spot in a period from 1990 to 2004, 2.2% (95% CI: 1.3%-3.2%) to 1.8% (95% CI: 1.2%-2.3%) in a period from 2005 to 2019. Among 8 studies on subclinical vitamin A deficiency, 7 of them indicated a severe public health problem (>20%). The prevalence of subclinical vitamin A deficiency decreased from 55.7% (95% CI: 39.8%-71.6%) in a period from 1990 to 2004 to 28.3% (95% CI: 9.8%-46.7%) in a period from 2005 to 2019, but not statistically significant.ConclusionsDespite the reduced proportion of night blindness and Bitot's spot, still both clinical and subclinical vitamin A deficiencies remain a public health problem in Ethiopia requiring strengthen intervention through the newly initiated health extension program.

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Prevalence and associated factors of zinc deficiency among pregnant women and children in Ethiopia: a systematic review and meta-analysis.

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Prevalence and associated factors of zinc deficiency among pregnant women and children in Ethiopia: a systematic review and meta-analysis.

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