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Determinants of neonatal jaundice among neonates admitted to five referral hospitals in Amhara region, Northern Ethiopia: an unmatched case-control study

ABSTRACT: Background Neonatal jaundice is associated with a significant risk of neonatal morbidity and mortality. It is a major cause of hospital neonatal intensive care unit admission and readmissions during the neonatal period. Hence, the study aimed to identify the determinant factors of neonatal jaundice among neonates admitted at five referral hospitals in Amhara region, Northern Ethiopia. Method A hospital-based unmatched case-control study design was employed, on 447 neonates (149 cases and 298 controls) at referral hospitals in Amhara region, Northern Ethiopia, from 1 March to 30 July 2019. Consecutive sampling method was used to select both the cases and controls. The collected data were entered into Epi data V.4.2 and then exported into SPSS window V.24 for analysis. Bivariable and multivariable analysis were carried out by using binary logistic regression. A p value of <0.05 was considered as significant difference between cases and controls for the exposure variable of interest. Results The median (±IQR) age of neonate at the time of admission and gestational age were 3±2 days and 38 (±3) weeks, respectively. Prolonged duration of labour (adjusted OR (AOR)=2.45, 95%?CI 1.34 to 4.47), being male sex (AOR=3.54, 95% CI 1.99 to 6.29), low birth weight (AOR=5.06, 95%?CI 2.61 to 9.82), birth asphyxia (AOR=2.88, 95% CI 1.38 to 5.99), sepsis (AOR=2.49, 95%?CI 1.22 to 5.11) and hypothermia (AOR=2.88, 95% CI 2.63 to 14.02) were the determinant factors for neonatal jaundice. Conclusions Prolonged duration of labour, hypothermia, sepsis, birth asphyxia, low birth weight and sex of neonate were independent determinants of neonatal jaundice. Early recognition and management of identified modifiable determinants are the recommended interventions.

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.

Project description:BackgroundPelvic organ prolapse is a common disorder, with up to 40% of women worldwide having some form of anatomical prolapse, and it is a significant public health problem in developing countries including Ethiopia. The prevalence of pelvic organ prolapse in Ethiopia is 13% in Benchi Maji. This study is designed to provide information about the determinants of pelvic organ prolapse among gynecologic patients attending public referral hospitals in the Amhara region, 2020.MethodInstitution-based unmatched case-control study design was conducted from March to June 2020 among randomly selected 348 mothers (116 cases and 232 controls). A convenient sampling technique was used to select cases, and controls were selected by systematic random sampling technique. A pre-tested and structured interviewer-administered questionnaire was used to collect the data. Data were coded and entered into Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. Finally, adjusted odds ratio and 95% confidence intervals were used to declare statistical significance.ResultThe result showed that being unable to read and write (illiterate) (adjusted odds ratio = 3.91; 95% confidence interval = 1.06-14.39), age of women >= 40 (adjusted odds ratio = 2.91; 95% confidence interval = 1.255-6.736), giving first birth before age of 20 (adjusted odds ratio = 5.72; 95% confidence interval = 1.73-18.94), carrying heavy objects (adjusted odds ratio = 2.296; 95% confidence interval = 1.102-4.785), parity ⩾ 4 (adjusted odds ratio = 7.02; 95% confidence interval = 1.16-42.45), and family history of pelvic organ prolapse (adjusted odds ratio = 3.09; 95% confidence interval = 1.24-7.71) were significantly associated with pelvic organ prolapse.ConclusionThis study concluded that being unable to read and write, age ⩾ 40, multiparity, family history of pelvic organ prolapse, early childbirth, and carrying heavy objects were the risk factors of pelvic organ prolapse. Providing health education on planning the number of children, and the impact of carrying heavy loads on pelvic organs, preventing early childbirth, and encouraging women to pursue their education at least up to primary school level is recommended.

Project description:There is little available evidence that quantifies the determinats of NNM in Ethiopia despite an increasing magnitude of neonatal mortality. Therefore, this study was designed to provide concrte evidence about the determinats of NNMS among neonates admitted to Guji and Borena Zones Public Hospitals, Southern Ethiopia, 2021. A facility based unmatched case control study design was conducted on 402 (134 cases and 268 controls) selected neonates admitted to Bule Hora, Adola and Yabelo General Hospitals from February 1-March 31, 2021. Cases were consecutively selected. Whereas for each case, two controls were selected by systematic random sampling technique. The data collection included a pretested and structured face-to-face interviewer administered questionnaire with a supplementation of maternal and neonatal medical records with checklists. Then the data were coded and entered in to Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. The descriptive statistics run and the results of the data were presented using frequencies, and tables. Bivariable and multi variable logistic regression was used for the analsysis of the data. Finally, Adjusted Odds Ratio together with 95% Confidence Intervals and p value <0.05 was used to declare the significance of all statistic. A total of 134 cases (neonatal near misses) and 268 controls (normal neonate) were participated in this study to make a response rate of 100% for both cases, and controls. In this study rural residence (AOR = 0.51, 95% CI: 0.27, 0.96), previous history of neonatal death (AOR = 4.85, 95%CI: 2.24,10.49), birth interval ≤ 2 years (AOR = 1.83, 95% CI: 1.04, 3.11) and history of abortion (both induced and miscarriage) (AOR = 1.97, 95%CI: 1.17, 3.31) were found to be statistically significant at a p-value of <0.05. History of prior abortion history of prior neonatal death and short birth interval (≤ 2 years) were identified to be the determinats of NNMs. High quality antenatal and intrapartum continuum of care should be provided for women and neonates. Additionally, contraceptive utilization should be encouraged for a women to space the births of their children.

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.

Project description:BackgroundThe coexistence of diabetes mellitus and hypertension is a worldwide public health problem causing significant morbidity, mortality, and decreased quality of life. Despite the increasing burden of hypertension among patients with DM, data on determinants of hypertension among patients with DM in the Amhara region of Ethiopia is scarce. Hence, this study identified determinants of hypertension among people with diabetes attending chronic disease follow-up clinics in the Amhara region of comprehensive specialized hospitals in Ethiopia.Method and materialsAn institutional-based unmatched case-control study was conducted among 470 individuals with diabetes in the Amhara region's comprehensive specialized hospitals (Debre Berhan, Felege Hiwot, and Dessie Comprehensive specialized hospital). A multistage sampling technique was used to select participants for this study. We collected the data using standard questionnaires (short form of international physical activity questionnaire, Morisky medication adherence scale, patient health questionnaire, perceived dietary adherence scale, Oslo social support questionnaire, and alcohol use disorder identification test), physical measurements, and data extraction checklists. A multivariable binary logistic regression was fitted to identify determinants of hypertension, and we presented the findings using an adjusted odds ratio (AOR) with a 95% confidence interval (CI).Results235 cases and 235 controls participated in this study. The median (IQR) age for the cases was 60 (52-66 = 14), and the mean age (± SD) for the controls was 51.72 (± 12.51). The significant determinants of hypertension with AOR [95% CI] were a lower level of physical activity: 1.82 [1.00, 3.31], depression: 2.00 [1.24, 3.21], family history of hypertension: 2.13 [1.34, 3.37], not having diabetic health education: 1.87 [1.18, 2.96], a longer duration of diabetes: 1.99 [1.05, 3.79], and poor glycemic control: 1.57 [1.01, 2.45].ConclusionIn this study, determinants that increase the risk of hypertension among people with diabetes mellitus were older age, physical inactivity, depression, family history of hypertension, not having diabetic health education, a longer duration of diabetes, and poor glycemic control.

Project description:IntroductionRespiratory distress syndrome is the major cause of neonatal death. However, data on the mortality and predictors related to respiratory distress syndrome were scarce. Hence, this study aimed to assess the incidence and predictors of death among neonates admitted with respiratory distress syndrome in West Oromia Referral Hospitals, Ethiopia, 2022.MethodsA retrospective follow-up study was conducted among 406 neonates admitted with respiratory distress syndrome at five referral hospitals from, 1 January 2019 to, 31 December 2021 in West Oromia, Ethiopia. The data were collected using a structured checklist and participants were selected using simple random sampling technique. The data were entered into Epi data version 4.6.0.2 and exported to STATA version 14 for cleaning, coding and analysis. The Kaplan-Meier curve was used to estimate survival time. The Weibull regression model was fitted to identify the predictors of mortality and variables with a P-value < 0.05 was taken as significant predictors of mortality.ResultFour hundred six neonates with respiratory distress syndrome were included in the analysis. The overall incidence of neonatal mortality was 59.87/1000 neonates-days observations (95%CI: 51.1-70.2) with a proportion of 152 (37.44%) (95% CI: 32.7-42.2). The median time of follow-up was 11 days (95% CI: 10-23). Very low birthweight (AHR = 4.5, 95%CI: 2.0-10.9) and low birth weight (AHR = 3.1, 95%CI: 1.4-6.6), perinatal asphyxia (AHR = 2.7, 95%CI: 1.8-4), Chorioamnionitis (AHR = 2.2, 95%CI: 1.4-3.5) and multiple pregnancies (AHR = 2.2, 95%CI: 1.4-3.4) increased the hazard of death, whereas, antenatal corticosteroid administration (AHR = 0.33, 95%CI: 0.2-0.7) was negatively associated with neonatal mortality.Conclusion and recommendationHigh mortality rate of neonates with respiratory distress syndrome was observed. Chorioamnionitis, perinatal asphyxia, low birth weight and multiple pregnancies increase the, mortality hazard while administering antenatal corticosteroids decreases it. Thus, administering corticosteroids- before giving birth and special emphasis on children with Chorioaminoitis, asphyxia, low birth weight and multiple pregnancies is important for reducing neonatal mortality.

Project description:IntroductionNowadays, the burden of colorectal cancer (CRC) has been increasing in the world, particularly in developing nations. This could be related to the poor prognosis of the disease due to late presentation at diagnosis and poor treatment outcomes. In Ethiopia, studies related to the stage of colorectal cancer at diagnosis and its determinants are limited. Therefore, the study was intended to assess advanced stage presentation and its associated factors among colorectal cancer patients in northwest Ethiopia.MethodsAn institution-based retrospective study was conducted among 367 CRC patients at two oncologic centers (the University of Gondar and Felege Hiwot comprehensive specialized hospitals) from January 1, 2017, to December 31, 2020. Data were entered into EPi-data 4.2.0.0 and transferred to STATA version 14 statistical software for analysis. Binary logistic regression was used to identify factors associated with the outcome variable. All variables with P-value < 0.2 during bi-variable analysis were considered for multivariable logistic regression. The level of statistical significance was declared at P-value <0.05.ResultsThe magnitude of advanced stage presentation of colorectal cancer was 83.1%. Being rural dwellers (Adjusted odds ratio (AOR) = 3.6; 95% CI: 1.8,7.2), not medically insured (AOR = 3.9; 95% CI: 1.9,7.8), patients delay (AOR = 6.5; 95% CI:3.2, 13.3), recurrence of the disease (AOR = 2.3; 95% CI: 1.1,4.7), and no comorbidity illness (AOR = 4.4; 95% CI: 2.1, 9.1) were predictors of advanced stage presentation of CRC.ConclusionThe current study revealed that the advanced-stage presentation of colorectal cancer patients was high. It is recommended that the community shall be aware of the signs and symptoms of the disease using different media, giving more emphasis to the rural community, expanding health insurance, and educating patients about the recurrence chance of the disease. Moreover, expansion of colorectal treatment centers and screening of colorectal cancer should be given emphasis.

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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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