Association of age and colostrum discarding with breast-feeding practice in Ethiopia:Systematic review and meta-analyses

OBJECTIVE: To investigate whether maternal/caregiver's age, infant age (0-6 months) and discarding colostrum affects timely initiation of breast-feeding (TIBF) and exclusive breast-feeding (EBF) in Ethiopia. DESIGN: A systematic search of PubMed, SCOPUS, EMBASE, CINHAL, Web of Science and WHO Global Health Library electronic databases was done for all articles published in English from 2000 to January 2018. Two reviewers independently screened, extracted and graded the quality of studies using Newcastle-Ottawa Scale. A weighted inverse-variance random-effects model meta-analysis, cumulative meta-analysis and mixed-effects meta-regression analysis were done. SETTING: All observational studies conducted in Ethiopia.ParticipantsMothers of children aged less than 2 years.ResultA total of forty articles (fourteen studies on TIBF and twenty-six on EBF) were included. TIBF was associated with colostrum discarding (OR=0·38; 95 % CI 0·21, 0·68) but not with maternal/caregiver's age (OR=0·98; 95 % CI 0·83, 1·15). In addition, colostrum discarding (OR=0·53; 95 % CI 0·36, 0·78) and infant age (OR=1·77; 95 % CI 1·38, 2·27) were significantly associated with EBF but not maternal/caregiver's age (OR=1·09; 95 % CI 0·84, 1·41). CONCLUSIONS: There was no association between maternal/caregiver's age and breast-feeding practice (EBF and TIBF). Colostrum discarding was associated with both EBF and TIBF. This evidence could be helpful to counsel all mothers of reproductive age and who discard colostrum

Mother's knowledge on prevention of mother-to-child transmission of HIV, Ethiopia:A cross sectional study

Objective To identify proportion of and factors for comprehensive knowledge on prevention of mother-to-child transmission of HIV in pregnant women attending antenatal care in Northern Ethiopia. Methods A total of 416 pregnant women were interviewed between October 2012 and May 2013. Logistic regression analysis was used to identify factors for comprehensive knowledge on prevention of mother-to-child transmission of HIV. Results The proportion of pregnant women, who have comprehensive knowledge on prevention of mother-to-child transmission of HIV, was 52%. The odds of having comprehensive knowledge on prevention of mother-to-child transmission of HIV were higher among pregnant women who were younger (16 to 24 years old) (Adjusted Odds Ratio (AOR) = 2.95; 95%Cl: 1.20, 7.26), urban residents (AOR = 2.45; 95%CI: 1.39, 4.32), attending secondary education and above (AOR = 4.43; 95%CI: 2.40, 8.20), employed (AOR = 4.99;95%CI: 2.45, 10.16), have five children or more (AOR = 9.34; 95%CI:3.78, 23.07), have favored attitude towards HIV positive living (AOR = 2.53; 95%CI: 1.43, 4.44) and have perceived susceptibility to HIV (AOR = 10.72; 95%CI: 3.90, 29.39). Conclusion The proportion of women who have comprehensive knowledge on prevention of mother-to-child transmission of HIV in this study setting was low. Measures which will escalate mother's knowledge on prevention of mother-to-child transmission of HIV should be emphasized. Efforts to improve mother's knowledge on prevention of mother-to-child transmission of HIV should target women who were older age (> = 35years), rural residents, unemployed, not 16 attending formal education, primigravids, have no favored attitude towards HIV positive living and have not perceived susceptibility to HIV

Common mental disorder and its association with academic performance among Debre Berhan University students, Ethiopia

Background: Common mental disorder (CMD) is prevalent in industrialized and non-industrialized countries. The prevalence of CMD among university students was 28.8-44.7% and attributed to several risk factors, such as schooling. The aim of this study was to assess the prevalence and risk factors of CMD. In addition, the association between CMD and academic performance was tested. Methods: Institution based cross-sectional study was conducted with 422 students at Debre Berhan university from March to April 2015. CMD was the primary outcome variable whereas academic performance was the secondary outcome variable. Kessler psychological distress (K10) scale was used to assess CMD. Bivariate and multiple logistic regression analysis were performed for modeling the primary outcome variable; independent samples T test and linear regression analysis were carried out for modeling the secondary outcome variable. The strength of association was interpreted using odds ratio and regression coefficient (beta) and decision on statistical significance was made at a p value of 0.05. Data were entered using EPI-data version 3.1 software and analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.01 software. Results: The prevalence of CMD was 63.1%. Field of study (p = 0.008, OR = 0.2, 95% CI 0.04-0.61), worshiping (p = 0.04, OR = 1.8, 95% CI 1.02-3.35), insomnia (p <0.001, OR = 3.8, 95% CI 2.21-6.57), alcohol drinking (p = 0.006, OR = 2.7, 95% CI 1.33-5.66), and headache (p = 0.02, OR = 2.1, 95% CI 1.10-3.86) were identified risk factors for CMD. The mean cumulative grade point average of students with CMD was lower by 0.02 compared to those without CMD, but not statistically significant (p = 0.70, beta = -0.02, 95% CI -0.15 to 0.10). CMD explained only 0.8% (r(2) = 0.008) of the difference in academic performance between students. Conclusions: At least three out of five students fulfilled CMD diagnostic criteria. The statistically significant risk factors were field of study, worshiping, insomnia, alcohol drinking, and headache. Moreover, there was no statistically significant association between CMD and academic performance. Undertaking integrated evidence-based intervention focusing on students with poor sleep quality, poor physical health, and who drink alcohol is essential if the present finding confirmed by a longitudinal study

Mental and Reproductive Health Correlates of Academic Performance among Debre Berhan University Female Students, Ethiopia:The Case of Premenstrual Dysphoric Disorder

Background. Globally 3 to 8% of reproductive age women are suffering from premenstrual dysphoric disorder (PMDD). Several mental and reproductive health-related factors cause low academic achievement during university education. However, limited data exist in Ethiopia. The aim of the study was to investigate mental and reproductive health correlates of academic performance. Methods. Institution based cross-sectional study was conducted with 667 Debre Berhan University female students from April to June 2015. Academic performance was the outcome variable. Mental and reproductive health characteristics were explanatory variables. Two-way analysis of variance (ANOVA) test of association was applied to examine group difference in academic performance. Result. Among 529 students who participated, 49.3% reported mild premenstrual syndrome (PMS), 36.9% reported moderate/severe PMS, and 13.8% fulfilled PMDD diagnostic criteria. The ANOVA test of association revealed that there was no significant difference in academic performance between students with different level of PMS experience (F-statistic = 0.08, p value = 0.93). Nevertheless, there was a significant difference in academic performance between students with different length of menses (F-statistic = 5.15, p value = 0.006). Conclusion. There was no significant association between PMS experience and academic performance, but on the other hand, the length of menses significantly associated with academic performance

Insomnia and Its Temporal Association with Academic Performance among University Students:A Cross-Sectional Study

Introduction. Studies show that 9.4% to 38.2% of university students are suffering from insomnia. However, research data in developing countries is limited. Thus, the aim of the study was to assess insomnia and its temporal association with academic performance. Methods and Materials. Institution based cross-sectional study was conducted with 388 students at Debre Berhan University. Data were collected at the nine colleges. Logistic and linear regression analysis was performed for modeling insomnia and academic performance with a p value threshold of 0.05, respectively. Data were entered using EPI-data version 3.1 and analyzed using SPSS version 20. Results. The prevalence of insomnia was 61.6%. Field of study (p value = 0.01), worshiping frequency (p value = 0.048), marital status (p value = 0.03), and common mental disorder (p value < 0.001) were identified associated factors of insomnia. There was no significant association between insomnia and academic performance (p value = 0.53, β = −0.04). Insomnia explained 1.2% (r2 = 0.012) of the difference in academic performance between students. Conclusions. Nearly 3 out of 5 students had insomnia. We recommended that universities would endorse sleep quality and mental health illness screening programs for students

Sociodemographic Factors Predicting Exclusive Breastfeeding in Ethiopia:Evidence from a Meta-analysis of Studies Conducted in the Past 10 Years

OBJECTIVES: To investigate the association between EBF and educational status, household income, marital status, media exposure, and parity in Ethiopia.METHODS: PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases were searched using key terms for all studies published in English between September 2009 and March 2019. The methodological quality of studies was examined using the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. To obtain the pooled odds ratio (OR), extracted data were fitted in a random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2, and I2 statistics. In addition, Jackknife sensitivity analysis, cumulative meta-analysis, and meta-regression analysis were conducted.RESULTS: Out of 553 studies retrieved, 31 studies fulfilled our inclusion criteria. Almost all included studies were conducted among mothers with newborn less than 23 months old. Maternal primary school education (OR 1.39; 95% CI 1.03-1.89; I2 = 86.11%), medium household income (OR 1.27; 95% CI 1.05-1.55; I2 = 60.9%) and being married (OR 1.39; 95% CI 1.05-1.83; I2 = 76.96%) were found to be significantly associated with EBF. We also observed an inverse dose-response relationship of EBF with educational status and income. However, EBF was not significantly associated with parity, media exposure, and paternal educational status.CONCLUSIONS: In this meta-analysis, we showed the relevant effect of maternal education, income, and marital status on EBF. Therefore, multifaceted, effective, and evidence-based efforts are needed to increase the national level of exclusive breastfeeding in Ethiopia.</p

Higher educational and economic status are key factors for the timely initiation of breastfeeding in Ethiopia:A review and meta-analysis

Aim: To investigate the association between initiation of breastfeeding within 1 hour after birth (TIBF) and maternal educational status, paternal educational status, household income, marital status, media exposure and parity in Ethiopia. Methods: We searched PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases. All studies were conducted in Ethiopia and published from 2000 to 2019 were included. To obtain the pooled odds ratio (OR), data were fitted in random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2 and I2 statistics. This meta-analytic review was reported in compliance with the PRISMA statement. Results: Out of 553 studies retrieved, 25 fulfilled our inclusion criteria. High maternal educational status (P <.001), paternal educational status (P =.001) and household income (P =.002), being married (P =.001) and multiparity (P =.01) were significantly associated with TIBF. There was no significant publication bias. Conclusions: Our meta-analysis showed that TIBF was associated with high educational and economic status, being married and multiparity. This suggests that the meta-analysis detected small associations that many previous studies in Ethiopia have not been able to show. Our findings can be useful for comparisons with other countries

How applicable is geospatial analysis in maternal and neonatal health in sub-Saharan Africa?:A systematic review

Background: Sub-Saharan Africa (SSA) has the world's highest maternal and neonatal morbidity and mortality and has shown the slowest progress in reducing them. In addition, there is substantial inequality in terms of maternal and neonatal morbidity and mortality in the region. Geospatial studies can help prioritize scarce resources by pinpointing priority areas for implementation. This systematic review was conducted to explore the application of geospatial analysis to maternal and neonatal morbidity and mortality in SSA. Methods: A systematic search of PubMed, SCOPUS, EMBASE, and Web of Science databases was performed. All observational and qualitative studies that reported on maternal or neonatal health outcomes were included if they used a spatial analysis technique and were conducted in a SSA country. After removing duplicates, two reviewers independently reviewed each study's abstract and full text for inclusion. Furthermore, the quality of the studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Finally, due to the heterogeneity of studies, narrative synthesis was used to summarize the main findings, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was strictly followed to report the review results. A total of 56 studies were included in the review. Results: We found that geospatial analysis was used to identify inequalities in maternal and neonatal morbidity, mortality, and health care utilization and to identify gaps in the availability and geographic accessibility of maternal health facilities. In addition, we identified a few studies that used geospatial analysis for modelling intervention areas. We also detected challenges and shortcomings, such as unrealistic assumptions used by geospatial models and a shortage of reliable, up-to-date, small-scale georeferenced data. Conclusions: The use of geospatial analysis for maternal and neonatal health in SSA is still limited, and more detailed spatial data are required to exploit the potential of geospatial technologies fully

Breast and complementary feeding in Ethiopia:New national evidence from systematic review and meta-analyses of studies in the past 10 years

PURPOSE: The aim of this systematic review and meta-analysis was to provide a national estimate of breast and complementary feeding practices and its predictors in Ethiopia.METHODS: PubMed, SCOPUS, EMBASE, CINHAL, Web of Science and WHO Global Health Library electronic databases were searched for all available literature published until April 2018. Observational studies including cross-sectional, case-control and cohort studies were included. Newcastle-Ottawa Scale was used to assess the quality of studies. Heterogeneity of studies was quantified using Cochran's Q χ2 statistic and Higgins's method (I2). A meta-analysis using a weighted inverse variance method was performed. Subgroup analysis was carried out based on region and study area.RESULTS: In total, 70 studies that involved &gt; 55,000 women from nine regions and two chartered cities in Ethiopia were included. The pooled national prevalence for timely initiation of breastfeeding (TIBF), exclusive breastfeeding (EBF) and timely initiation of complementary feeding was 66.5%, 60.1% and 62.5%, respectively. Guidance and counselling on breastfeeding, vaginal delivery and health institution delivery significantly increased the odds of TIBF and EBF. In addition, TIBF significantly associated with high EBF practice. Maternal occupational status significantly associated with low EBF practice, but not TIBF.CONCLUSIONS: Based on the WHO standard, the current breast and complementary feeding practice in Ethiopia is good and improving. Integrated intervention is still required for further improvement and minimizing the effect of occupational status.</p