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Prevalence and predictors of uterine rupture among Ethiopian women: A systematic review and meta-analysis.

ABSTRACT: BACKGROUND:Uterine rupture has a significant public health importance, contributing to 13% of maternal mortality and 74%-92% of perinatal mortality in Sub-Saharan Africa, and 36% of maternal mortality in Ethiopia. The prevalence and predictors of uterine rupture were highly variable and inconclusive across studies in the country. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and predictor of uterine rupture in Ethiopia. METHODS:This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 checklist. PubMed, Cochrane Library, Google Scholar, and African Journals Online databases were searched. The Newcastle- Ottawa quality assessment tool was used for critical appraisal. I2 statistic and Egger's tests were used to assess the heterogeneity and publication bias, respectively. The random-effects model was used to estimate the pooled prevalence and odds ratios with a 95% confidence interval. RESULTS:Sixteen studies were included, with a total of 91,784 women in the meta-analysis. The pooled prevalence of uterine rupture was 2% (95% CI: 1.99, 3.01). The highest prevalence was observed in the Amhara regional state (5%) and the lowest was in Tigray region (1%). Previous cesarean delivery (OR = 9.95, 95% CI: 3.09, 32.0), lack of antenatal care visit (OR = 8.40, 95% CI: 4.5, 15.7), rural residence (OR = 4.75, 95% CI: 1.17, 19.3), grand multiparity (OR = 4.49, 95% CI: 2.83, 7.11) and obstructed labor (OR = 6.75, 95%CI: 1.92, 23.8) were predictors of uterine rupture. CONCLUSION:Uterine rupture is still high in Ethiopia. Therefore, proper auditing on the appropriateness of cesarean section and proper labor monitoring, improving antenatal care visit, and birth preparedness and complication readiness plan are needed. Moreover, early referral and family planning utilization are the recommended interventions to reduce the burden of uterine rupture among Ethiopia women.

SUBMITTER: Desta M

PROVIDER: S-EPMC7605683 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Prevalence and predictors of uterine rupture among Ethiopian women: A systematic review and meta-analysis.

Desta Melaku M Amha Haile H Anteneh Bishaw Keralem K Adane Fentahun F Assemie Moges Agazhe MA Kibret Getiye Dejenu GD Yimer Nigus Bililign NB

PloS one 20201102 11

<h4>Background</h4>Uterine rupture has a significant public health importance, contributing to 13% of maternal mortality and 74%-92% of perinatal mortality in Sub-Saharan Africa, and 36% of maternal mortality in Ethiopia. The prevalence and predictors of uterine rupture were highly variable and inconclusive across studies in the country. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and predictor of uterine rupture in Ethiopia.<h4>Methods</h4>This sy ...[more]

PMID: 33137135

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Project description:Uterine rupture is a serious public health concern that causes high maternal and perinatal morbidity and mortality in the developing world. Few of the studies conducted in Ethiopia show a high discrepancy in the prevalence of uterine rupture, which ranges between 1.6 and 16.7%. There also lacks a national study on this issue in Ethiopia. This systematic and meta-analysis, therefore, was conducted to assess the prevalence and determinants of uterine rupture in Ethiopia. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic review and meta-analysis of studies. All observational published studies were retrieved using relevant search terms in Google scholar, African Journals Online, CINHAL, HINARI, Science Direct, Cochrane Library, EMBASE and PubMed (Medline) databases. Newcastle-Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The I2 test statistics were used to assess heterogeneity among included studies, and publication bias was assessed using Begg's and Egger's tests. Odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots. A total of twelve studies were included in this study. The pooled prevalence of uterine rupture was 3.98% (95% CI 3.02, 4.95). The highest (7.82%) and lowest (1.53%) prevalence were identified in Amhara and Southern Nations, Nationality and Peoples Region (SNNPR), respectively. Determinants of uterine rupture were urban residence (OR?=?0.15 (95% CI 0.09, 0.23)), primipara (OR?=?0.12 (95% CI 0.06, 0.27)), previous cesarean section (OR?=?3.23 (95% CI 2.12, 4.92)), obstructed labor(OR?=?12.21 (95% CI 6.01, 24.82)), and partograph utilization (OR?=?0.12 (95% CI 0.09, 0.17)). Almost one in twenty-five mothers had uterine rupture in Ethiopia. Urban residence, primiparity, previous cesarean section, obstructed labor and partograph utilization were significantly associated with uterine rupture. Therefore, intervention programs should address the identified factors to reduce the prevalence of uterine rupture.

Project description:BackgroundKhat chewing has become a common practice among university students in developing countries like Ethiopia. It has a potential effect on physical, mental, social and cognitive aspects of student functioning. In Ethiopia, study findings regarding the prevalence of khat chewing were highly dispersed and inconsistent. Therefore, this systematic review and meta-analysis estimates the pooled prevalence of khat chewing and its predictors among Ethiopian university students.MethodA systematic review and meta-analysis was conducted to assess the prevalence and predictors of khat chewing among university students in Ethiopia. We searched literature from the databases of PubMed, Google Scholar, Science Direct, and the Cochrane Library. A total of 24 Ethiopian studies reporting the prevalence of khat chewing among university students were included. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistics and I2 test were used. Since the included studies exhibit high heterogeneity, a random effect meta-analysis model was computed to estimate the pooled prevalence of khat chewing. Moreover, the association between predictor variables, and khat chewing practice were examined.ResultsThe meta-analysis of 24 studies revealed that the pooled prevalence of khat chewing among university students in Ethiopia was 23.22% (95% CI: 19.5, 27.0). In the subgroup analysis, the highest prevalence was observed in Oromia region (31.6%; 95CI: 21.2, 41.9) whereas the lowest prevalence was observed in Amhara region (18.1%; 95%CI: 12.4, 23.8). Being male OR: 2.76 (95% CI 1.64, 4.63), family khat chewing practice OR: 2.91 (95% CI 1.06, 7.98), friend khat chewing habit OR: 4.74 (95% CI 3.48, 13.06), alcohol drinking OR: 7.06 (95% CI 5.65, 8.82) and cigarette smoking habit OR: 15.11 (95% CI 8.96, 25.51) were found to be predictors of khat chewing.ConclusionThe study found that the prevalence of khat chewing among university students was quite common, with slightly more than 1 in 5 students engaging in the use of this substance. Being male, family khat chewing practice, friend's khat chewing habit, alcohol drinking, and cigarette smoking were found to be predictors of khat chewing practice among university students.

Project description:BackgroundImplanon discontinuation before the recommended time is problematic, as it puts women at risk of unwanted pregnancies and unsafe abortions, along with negative maternal health outcomes. Although the magnitude and determinants of Implanon discontinuation have been studied in Ethiopia, the results were inconsistent, with significant variability. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of Implanon discontinuation and its determinants in Ethiopia.MethodsA comprehensive search of studies published before 18 February 2022 was done using electronic databases such as PubMed, Embase, Google Scholar, Scopus, Web of Science, Science Direct, and Cochrane Library. The relevant data were extracted using a Microsoft Excel 2013 and analyzed using STATA Version 16. A random-effect meta-analysis model was used to compute pooled prevalence and odds ratio. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A funnel plot, Begg's, and Egger's tests were used to check for the presence of publication bias.ResultsA total of 11 studies with 4320 study participants were included in this meta-analysis. The overall pooled prevalence of Implanon discontinuation in Ethiopia was found to be 32.62% (95% confidence interval = 24.10, 41.13). There was significant heterogeneity among the included studies (I2 = 97.4%, p < 0.001). However, there was no statistical evidence of publication bias (p = 0.533). Dissatisfied with service provision at the time of insertion (odds ratio = 3.92, 95% confidence interval = 1.54, 6.29), not having pre-insertion counseling (odds ratio = 2.98, 95% confidence interval = 1.91, 5.04), the absence of post-insertion follow-up (odds ratio = 4.03, 95% confidence interval = 2.17, 5.90), and the presence of side effects (odds ratio = 2.93, 95% confidence interval = 1.87, 3.98) were found to be determinants of Implanon discontinuation.ConclusionAccording to this systematic review and meta-analysis, one-third of Ethiopian women discontinued Implanon before the recommended time (3 years). Program managers and service providers should consider using more evidence-based and participatory counseling approaches to enhance client satisfaction. Furthermore, family planning service delivery points should be equipped to manage and reassure women who are experiencing side effects.

Project description:BackgroundWorkplace sexual violence is a significant public health problem in low and middle-income countries, including Ethiopia. However, except for individual studies with varying prevalence rates in different occupations, there are no national prevalence studies conducted in workplace settings in Ethiopia. Appropriate estimation of the problem is essential to formulate health service plans most fitted for workplaces. Hence, this review and meta-analysis intended to estimate the national pooled prevalence of workplace sexual violence in Ethiopia.MethodsThe databases used were; PubMed, Google Scholar, CINAHL, and African Journals Online. For a critical appraisal of the papers, we used the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument for cross-sectional studies. The meta-analysis was conducted using comprehensive meta-analysis and MetaXL software. Descriptive information of studies was presented in narrative form, and quantitative results were presented in forest plots. The Cochran Q test and I2 test statistics were employed to test heterogeneity across studies. A random-effect model computed the pooled estimate prevalence with 95% confidence intervals.ResultsThe pooled prevalence of workplace sexual violence was 22% (95% CI 17%, 28%). The pooled prevalence was 14.1% (95% CI 10.4%, 18.9%) for attempted rape, 8% (95% CI 5.7%, 11.1%) for rape, and 33.2% (95% CI 24.1%, 43.7%) for sexual harassment. The pooled prevalence was the highest among female university staffs 49% (95% CI 45%, 56%), and among commercial sex workers 28% (95% CI 3%, 59%).ConclusionsThis analysis revealed that the prevalence of sexual violence and sexual harassment in Ethiopian workplaces is high. It was also exceptionally high among female faculty staff, commercial sex workers, and workplaces in Tigray National regional state. Thus, concerned stakeholders must design and implement effective interventions to prevent workplace sexual violence in workplaces in Ethiopia and provide necessary support and care to the victims.

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:IntroductionCervical cancer is one of the leading causes of malignancies among women in Ethiopia. Knowing the disease could empower women to make an informed decision regarding participation with cervical cancer prevention strategies. There is scarcity of compiled data in the field. Therefore, this systematic review aimed to provide an overview of knowledge about cervical cancer among Ethiopian women.MethodsWe conducted a systematic review of peer-reviewed articles on the knowledge of cervical cancer. Articles were systematically searched using comprehensive search strings from PubMed/Medline, SCOPUS, and grey literature from Google Scholar. Two reviewers assessed study eligibility, extracted data, and the risk of bias independently. Meta-analysis was performed using STATA v 14 to pool the overall knowledge of the women about cervical cancer.ResultsWe included 26 articles published between 2013 and 2020 covering a total of 14,549 participants. All the included articles had good methodological quality. The proportion of participants who had heard of cervical cancer varied from 4.6 to 87.7% with the pooled estimate at 56% (95% CI: 47-66). Similarly, the proportion of participants who knew that HPV is the main cause of cervical cancer lied between 0 and 49.7% with the pooled result at 21% (95% CI: 13-30). Likewise, the pooled prevalence to identify at least one risk factor, one symptom of cervical cancer and ever heard of cervical cancer screening was gauged at 52% (95% CI: 39-64), 43% (95% CI: 26-60), and 39% (95% CI: 24-55), respectively. The overall pooled prevalence of good knowledge about cervical cancer was at 43% (95% CI: 33-53). On top of this, the prevalence of previous screening practice among the participants was at 14% (95% CI: 9-20).ConclusionsKnowledge about cervical cancer among Ethiopian women is quite poor. Therefore, health education to provide sufficient and unbiased information about HPV and cervical cancer in general is required to the public.

Project description:IntroductionPrecancerous lesions of the cervix are changes in cervical cells that make them more likely to develop into cancer. Understanding the prevalence and determinants of the precancerous lesions of the cervix among women helps to take an action like vaccination programs, improving screening coverage, and close management and follow-up which could decrease the morbidity and mortality caused by cervical cancer.Materials and methodsThe international databases, PubMed/MEDLINE, Web of Science, EMBASE, CINAHL, Google Scholar, Science Direct and Cochrane Library and unpublished reports were systematically searched. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 14 statistical software was employed to analyse the data. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity between the studies. A random-effect model was computed to estimate the pooled prevalence of precancerous lesions of the cervix in Ethiopia. Determinants of the precancerous lesion of cervix (early initiation of sexual intercourse, multiple sexual partners, and history of sexually transmitted infection) were analysed.ResultsThirteen studies fulfilled the inclusion criteria and included in the meta-analysis. The I2 test result showed high heterogeneity (I2, 93.2%, p = <0.001). Using the random effect analysis, the pooled prevalence of precancerous lesions of the cervix among women in Ethiopia was 14.21% (95% CI (10.49, 17.94). After adjusting of publication bias using trim-and-fill method, the pooled prevalence was 9.43% (95% CI (5.23, 13.62). Women who had multiple sexual partners in their lifetime (OR:2.67 CI: 1.49,4.79) and had a history of sexually transmitted infections (OR:6.22 CI: 2.99,12.92) were more likely to have a precancerous lesion of the cervix.ConclusionThe pooled prevalence of the precancerous lesions of the cervix among Ethiopian women was 9.43%. It was associated with having multiple sexual partners and a history of sexually transmitted infections.

Dataset Information

Prevalence and predictors of uterine rupture among Ethiopian women: A systematic review and meta-analysis.

Publications

Prevalence and predictors of uterine rupture among Ethiopian women: A systematic review and meta-analysis.

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