Determinants of neonatal jaundice among neonates admitted to five referral hospitals in Amhara region, Northern Ethiopia: an unmatched case-control study
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SUBMITTER: Bizuneh A
PROVIDER: S-EPMC7511639 | biostudies-literature | 2020 Jan
REPOSITORIES: biostudies-literature
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Project description:ObjectiveThis study aimed to assess the morbidity and mortality patterns of preterm neonates with low birth weight admitted in the Amhara region referral hospitals in Ethiopia.DesignHospital-based retrospective follow-up study.SettingAmhara region referral hospitals, Ethiopia.ParticipantsA total of 291 preterm neonates low birth weight that were admitted to referral hospitals in the Amhara region between 1 January 2017 and 30 December 2018 were reviewed. Data were entered into Epi-data V.4.4.2.1 and exported to STATA V.14 for analysis, and variables with a p value of <0.05 at 95% confidence level in multivariable logistic regression model analysis were declared as statistically significant associated factors of mortality.Primary outcomeMorbidity and mortality patterns in preterm low birthweight neonates.ResultsThis study revealed that 37.8% (95% CI 32.4% to 43.5%) of preterm low birthweight neonates died. The most common morbidities found were 219 (75.26%) hypothermia, followed by 201 (69.07%), 145 (49.83%), 39 (13.4%) and 24 (8.25%) with sepsis, respiratory distress, jaundice and congenital anomalies, respectively. Sepsis (AOR: 2.0; 95% CI 1.03 to 3.89), respiratory distress (AOR: 4.6; 95% CI 2.51 to 8.40), hypoglycaemia (AOR 3.91; 95% CI 1.09 to 10.52), APGAR score at fifth minute <7 (AOR 0.39; 95% CI (0.18 to 0.82) and duration of hospital stay below mean (<9.82 days) (AOR 0.17; 95% CI 0.09 to 0.33) were associated with mortality.ConclusionThe mortality rate of preterm low birthweight neonates was high, indicating that this is a public health issue. Hypothermia, sepsis, respiratory distress, jaundice and congenital anomalies were the common morbidities. Sepsis, respiratory distress, hypoglycaemia, Apgar score at fifth minute <7 and duration of hospital stay below the mean were independent factors of mortality. However, these need to be further investigated in future research and appropriately addressed using prospective follow-up.
| S-EPMC9272098 | biostudies-literature
Project description:BackgroundApplying evidence-based practice during care provision is essential because it improves the quality of care, reduces health care costs, and increases patient and family satisfaction. However, information on evidence-based nursing practice and associated factors were not well studied and documented in the study area. Hence, this study aimed to assess utilization and associated factors of evidence-based practice among nurses working in Amhara Region Referral Hospitals, Ethiopia.MethodsAn institution-based cross-sectional study was conducted from March 18 to April 16, 2019, in Amhara Region Referral Hospitals. A simple random sampling technique was used to select 684 respondents. Data were collected using a pretested and self-administered questionnaire. Data were entered into Epi Info version 7.1.2.0 and exported to SPSS version 22.0 for analysis. The bivariable analysis was used primarily and variables with p-value < 0.2 were further examined using a multivariable logistic regression model to control con-founders. Then, variables' p-value < 0.05 with 95% CI was used to determine associated factors.ResultsFrom 684 proposed nurses, 671 of them completed the questionnaire giving 98.1% response rate. Of these, 55% (95% CI: 51.2, 58.9) of them had good evidence-based practice utilization. Variables including single (AOR = 1.662: 95% CI: 1.089-2.536), fewer work experience (AOR = 1.849: 95% CI: 1.049-3.257), good knowledge (AOR = 2.044: 95% CI: 1.406-2.972), effective communication skill (AOR = 2.537: 95% CI: 1.744-3.689), EBP training (AOR = 3.224 95% CI: 1.957-5.311), internet access (AOR = 1.655: 95% CI: 1.119-2.448) and evidence-based guideline availability (AOR = 1.827: 95% CI: 1.249-2.673) were found to be predictors of evidence-based practice utilization.ConclusionsThe study revealed that evidence-based practice utilization among nurses is low. Availing evidence-based guidelines in the work area, improving facilities' internet access, and building nurses' evidence-based practice competencies through either by giving separate training or incorporating as part of the curriculum would improve its utilization.
| S-EPMC7978364 | biostudies-literature
Project description:BackgroundGlycemic control is the level of glucose in diabetes patient. Evidence regarding glycemic control is scarce in resource-limited settings, and this study was conducted to generate information regarding the prevalence and predictors of glycemic control among diabetes mellitus patients attending their care from the referral hospitals of the Amhara region, Ethiopia.MethodsA cross-sectional study design was implemented. A simple random sampling technique was used. Data were collected from March 2018 to January 2020. The data were collected using interviews, chart review, and blood samples. Hemoglobin A1c was measured using high-performance liquid chromatography. Data were entered into Epi-info software and analyzed by SPSS software. Descriptive statistics were used to estimate the prevalence of glycemic control; linear regression was used to identify the predictors of HbA1c.ResultsA total of 2554 diabetes patients were included giving for the response rate of 95.83%. The mean age of the study participants was 54.08 years [SD (standard deviation) ± 8.38 years]. The mean HbA1c of the study participants was 7.31% [SD ± 0.94%]. Glycemic control was poor in 55.32% [95% CI: 53.4%-57.25%] of diabetes patients. The glycemic control of diabetes patients was determined by BMI (β 0.1; [95% CI: 0.09-0.1]), type 2 diabetes (β -0.14; [95% CI: -0.11-0.16]), age (β 0.22; [95% CI: 0.02-0.024]), duration of the disease (β 0.04; [95% CI: 0.037-0.042]), the presence of hypertension (β 0.12; [95% CI:0.09-0.16]), regular physical exercise (β -0.06; [95% CI: -0.03-0.09]), medication adherence (β -0.16; [95% CI: -0.14-0.18]), and male (β 0.34; [95% CI: 0.31-.037]).ConclusionThe glycemic control of diabetes patients was poor, and it needs the attention of decision-makers.
| S-EPMC7834781 | biostudies-literature
Project description:BackgroundInduction of labor is an artificial initiation of uterine contractions after fetal viability with the aim of vaginal delivery prior to the onset of spontaneous labor. Prevalence of induction of labor is increasing worldwide with subsequent increase in failure rate. However, there is limited evidence on labor induction in Ethiopia. Therefore, this study was aimed at assessing the prevalence and associated factors of failed induction of labor among women undergoing induction of labor at referral hospitals of Amhara national regional state, Ethiopia, 2016.MethodA multicenter cross-sectional study was conducted at referral hospitals found in Amhara national regional state from February 01 to September 30, 2016. Multistage sampling technique was employed to select a total of 484 women who underwent labor induction. Pre-tested structured questionnaires and checklists were used to collect the data. Data were entered into EPI info version 7 and analyzed using SPSS version 20 software. Stepwise Binary Logistic regression model was fitted to identify factors associated with failed induction of labor. The level of significance was determined based on the adjusted odds ratio with 95% confidence interval at the p-value of ≤0.05.ResultThe prevalence of failed induction of labor among women undergoing induction of labor was 31.4% (95% CI: 27.0, 36.0). Failed induction of labor was independently predicted by a Bishop score of ≤5 (AOR = 2.1; 95% CI: 1.3, 3.6), prolonged latent first stage of labor (AOR = 2.0; 95% CI: 1.2, 3.5), induction with oxytocin alone (AOR = 4.2; 95% CI: 2.2, 8.1), nulliparity (ARO = 1.9; 95% CI: 1.2, 2.9), post term pregnancy (AOR = 4.1; 95% CI: 1.8, 9.3) and hypertensive disorder of pregnancy (AOR = 2.4; 95% CI: 1.5, 5.1).ConclusionFailed induction of labor was high in the study area compared to the reports of previous studies done in Ethiopia. The majority of the determinants of failed induction of labor were connected with unjustifiable and inconsistent indication of induction of labor. Thus, preparing standardized practical guidelines and preventing unjustifiable case selection may help reduce the current high failure rates.
| S-EPMC8095340 | biostudies-literature
Project description:BackgroundGlobally, epilepsy is the commonest neurological disorder in adults. It has significant health and economic consequences to the affected individuals and the family. There is ample evidence that epileptic patients are at increased risk of poor sleep quality than the general population. However, there is limited evidence on sleep quality among epileptic patients and associated factors in Ethiopia. Therefore, this study investigated the prevalence of poor sleep quality and associated factors among adult patients with epilepsy.MethodInstitutional based cross-sectional study was conducted among adult epileptic patients attending follow-up care at referral hospitals in the Amhara region. A total of 575 epileptic patients were recruited using a stratified systematic random sampling technique. An interviewer-administered semi-structured questionnaire and record review were used for data collection. To assess sleep quality the pretested Pittsburgh Sleep Quality Index (PSQI) tool was used. A binary logistic regression model was used to assess factors associated with poor sleep quality. Variables with a p-value less than 0.2 in the bivariable binary logistic regression analysis were considered for the multivariable binary logistic regression analysis. In the multivariable binary logistic regression analysis, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) were reported to declare the statistical significance and strength of association. Model fitness was assessed using the Hosmer-Lemeshow test and was adequate (p>0.05). Multicollinearity of the independent variables was assessed using the Variance Inflation Factor (VIF) and the mean VIF was less than 10.ResultsA total of 565 participants were enrolled in the study with a response rate of 98.3%. The prevalence of poor sleep quality among adult epileptic patients was 68.8% [95% CI: 64.8%, 72.5%]. In the multivariable binary logistic regression, being unable to read and write [AOR = 3.16, 95%CI: 1.53, 6.51], taking polytherapy treatment [AOR = 2.10, 95% CI: 1.37, 3.21], poor medication adherence [AOR = 2.53, 95%CI: 1.02, 6.23] and having poor support [AOR = 2.72, 95%CI: 1.53, 4.82] and moderate social support [AOR = 1.89, 95%CI: 1.05, 3.41] were significantly associated with higher odds of poor sleep quality.Conclusion and recommendationPoor sleep quality is a major public health concern in Ethiopia. The patient's level of education, number of medication use, medication adherence, and social support were found significant predictors of poor sleep quality. These findings highlight improving medication adherence and social support are effective strategies to improve the sleep quality of epileptic patients. Besides, it is better to give special emphasis to those epileptic patients with a low level of education and taking polytherapy to enhance sleep quality.
| S-EPMC8664217 | biostudies-literature
Project description:BackgroundDiabetes Mellitus (DM) is a metabolic disorder associated with acute and chronic complications. Diabetic ketoacidosis (DKA) is the most serious diabetic emergency in patients with type one and type two diabetes mellitus. It is the leading cause of mortality in children and young adults. Even though the burden of DKA has increased, no research has been conducted on the determinants of Diabetes ketoacidosis in Ethiopia, particularly in the Amhara region. Thus, this study aimed to identify the determinants of diabetes Ketoacidosis among Diabetes Mellitus patients at North Wollo and Waghimra Zone public Hospitals.MethodsAn institution-based unmatched case-control study design was employed among 408 patients at North Wollo and Waghimra Zone Public Hospitals from March 1st to April 30th, 2020. A consecutive sampling method was used to select study participants. The data were collected using structured interviewer-administered questioners and reviewing of patient charts. The analysis was done using a binary logistic regression model. Then, P-value < 0.05 was considered statistically significant.ResultThe mean (±SD) age of the study participants was 46.96 (± 15.175 SD) years. Irregular follow-up in diabetes clinic (AOR:4.19, 95% CI: 2.28-7.71), not received diabetic education (AOR: 2.87, 95% CI:1.44-5.72), alcohol drinking (AOR:2.99, 95% CI: 1.46-6.12), discontinuation of medications (AOR: 4.31, 95% CI:1.92-9.68), presence of comorbidity (AOR:2.57, 95% CI: 1.37-4.84), and being type one of diabetes mellitus (AOR: 2.01, 95% CI:1.11-3.63) were determinant factors of diabetic ketoacidosis .ConclusionsThis study showed that the behavioral and clinical characteristics of diabetic patients were determinant factors of DKA. Follow-up in the diabetic clinic, diabetic education, discontinuation of medications, alcohol drinking, presence of comorbidities, and type of diabetes mellitus were independent determinants of diabetic ketoacidosis.
| S-EPMC7890609 | biostudies-literature
Project description:BackgroundInformation in health care is rapidly expanding and is updated very regularly, especially with the increasing use of technology in the sector. Due to this, health care providers require timely access to the latest scientific evidence anywhere. Smartphone medical apps are tools to access the latest reputable scientific evidence in the discipline. In addition, smartphone medical apps could lead to improved decision making, reduced numbers of medical errors, and improved communication between hospital medical staff.ObjectiveThe aim of this study was to assess smartphone medical app use and associated factors among physicians working at referral hospitals of the Amhara region, Ethiopia.MethodsAn institution-based cross-sectional study design was conducted among physicians working at 5 referral hospitals in the Amhara region, Ethiopia, from February 5 to May 27, 2019. A simple random sampling method was used to select 423 physicians. A self-administered questionnaire was used to collect the data and analyzed using SPSS, version 21 (IBM Corp). Binary and multivariable logistic regression analysis was performed to assess factors associated with smartphone medical app use among physicians. A value of P<.05, corresponding to a 95% CI, was considered statistically significant. The validity of the questionnaire was determined based on the view of experts and the reliability of it obtained by calculating the value of Cronbach alpha (α=.78).ResultsIn this study, most of the 417 respondents (375, 89.9%) had medical apps installed on their smartphones. Of those 375 respondents, 264 (70.4%) had used medical apps during clinical practice. The medical apps most commonly used by the respondents were UpToDate, Medscape, MedCalc, and Doximity. According to multivariable logistic regression analysis, attitude (adjusted odds ratio [AOR] 1.64, 95% CI 1.05-2.55), internet access (AOR 2.82, 95% CI 1.75-4.54), computer training (AOR 1.71, 95% CI 1.09-2.67), perceived usefulness of the app (AOR 1.64, 95% CI 1.05-2.54), information technology support staff (AOR 2.363, 95% CI 1.5-3.08), and technical skill (AOR 2.52, 95% CI 1.50-4.25) were significantly associated with smartphone medical app use.ConclusionsMost respondents have a smartphone medical app and have used it in clinical practice. Attitude, internet access, computer training, perceived usefulness of the app, information technology support staff, and technical skill are the most notable factors that are associated with smartphone medical app use by physicians.
| S-EPMC8096376 | biostudies-literature
Project description:BackgroundNeonatal hypothermia is a worldwide problem and an important contributing factor for Neonatal morbidity and mortality especially in developing countries. High prevalence of hypothermia has been reported from countries with the highest burden of Neonatal mortality. So the aim of this study was to assess the prevalence of Neonatal hypothermia and associated factors among newborn admitted to Neonatal Intensive Care Unit of Public Hospitals in Addis Ababa.MethodsAn institutional based cross-sectional study was conducted from March 30 to April 30, 2016, in Public Hospitals in Addis Ababa and based on admission rate a total of 356 Neonates with their mother paired were enrolled for the study. Axillary temperate of the newborn was measured by a digital thermometer at the point of admission. Multivariate binary logistic regression, with 95% confidence interval and a p-value <?0.05 was used to identify variables which had a significant association.ResultsThe prevalence of Neonatal hypothermia in the study area was 64%. Preterm delivery (AOR?=?4.81, 95% CI: 2.67, 8.64), age of Neonate ?24 h old (AOR?=?2.26, 95% CI: 1.27, 4.03), no skin to skin contact with their mother immediately after delivery (AOR?=?4.39, 95% CI: 2.38, 8.11), delayed initiation of breastfeeding (AOR?=?3.72, 95% CI: 2.07, 6.65) and resuscitation at birth (AOR?=?3.65, 95%CI: 1.52, 8.78) were significantly associated with hypothermia.ConclusionsThe prevalence of Neonatal hypothermia in the study area was high. Preterm delivery, age???24 h old, no skin to skin contact immediately after delivery, delayed initiation of breastfeeding and resuscitation at birth were independent predictors of Neonatal hypothermia. Therefore attention is needed for thermal care of preterm newborn and use of low-cost thermal protection principles of warm chain especially on early initiation of breastfeeding, skin to skin contact immediately after delivery and warm resuscitation.
| S-EPMC6090740 | biostudies-literature
Project description:BackgroundNeonatal mortality is a public health issue in, Ethiopia. Unfortunately, the issue is noticeably under-reported and underestimated, so the true gravity of the situation cannot be acknowledged in developing regions of the country. Regrettably, there is no single study to show the rates and predictors of neonatal mortality for Afar region. Thus, this study aims to assess neonatal mortality and associated factors in Afar region, Ethiopia.MethodsA health facility-based cross-sectional study was conducted on 403 neonates admitted to the neonatal intensive care units (NICUs) from January 2015 to December 2019. Maternal and neonatal medical records were reviewed and audited using structured data extraction checklist. The data was collected by four trained nurses and midwives. The medical records were selected using a systematic random sampling technique. Bivariate and multivariable logistic regression analyses were done. Adjusted odds ratio with the corresponding 95% confidence interval were used to assess the association between neonatal mortality and the associated factors. Finally, the statistical significance level was declared at a p-value of less than 0.05.ResultsIn this study, 391 medical records of newborns were included with the data complete rate of 97.02%. The prevalence of neonatal mortality was 57 (14.6%) [95% CI 11.0%-18.4%]. A multivariable logistic regression showed that lack of antenatal care (ANC) follow up [AOR = 4.69: 95%CI (1.77, 12.47)], giving birth through cesarean section [AOR 3.59, 95%CI (1.22, 10.55)], having admission temperature less than 36.5°C [AOR 10.75, 95%CI (3.75, 30.80)], birth asphyxia [AOR 7.16, 95%CI (2.22, 23.10)], and having a length of stay greater than five days in the hospital [AOR 0.23, 95%CI (0.08, 0.66)] were significantly associated with neonatal mortality.ConclusionThis study revealed that the rate of neonatal mortality is still high compared to the national data. Antenatal care, cesarean section delivery, length of stay in the hospital, low temperature at admission and birth asphyxia were factors associated with neonatal mortality. Thus, the health facilities should give due attention to improve antenatal care, intrapartum care and standardized care for admitted neonates. Furthermore, prospective studies are recommended.
| S-EPMC7968682 | biostudies-literature
Project description:ObjectiveThe aim of this study was to assess nurses' Knowledge, Attitude and Associated Factors towards end of life care in Amhara Referral Hospitals, Northwest Ethiopia, 2017.ResultsA total of 331 participants were included with a response rate of 93.2%. From these, 129 (39.0%) of them had good knowledge and 234 (70.7%) had favorable attitude towards end of life care. Being Bachelor of Science holder and above in nursing (AOR = 4.261, 95% CI 1.524-11.912), working in Emergency department (AOR = 4.911, 95% CI 1.796-13.426), having daily experience of caring for chronically ill patients (AOR = 2.764, 95% CI 1.366-5.591) and taking training on end of life care (AOR = 10.269, 95% CI 4.730-22.296) were significantly associated with good knowledge of nurses towards end of life care. On the other hand, having 6-10 years of working experience in nursing (AOR = 2.199, 95% CI 1.147-4.215), being trained in end of life care (AOR = 3.027, 95% CI 1.285-7.13), Bachelor of Science holder and above in nursing (AOR = 4.414, 95% CI 2.230-8.738) were found to be statistically significant with more positive attitude of nurses towards end of life care.
| S-EPMC6700991 | biostudies-literature