Anemia During Pregnancy

Anemia during pregnancy is a considerable health problem, with around two-fifths of pregnant women worldwide being anemic. Many gynecological and infectious diseases are predisposing factors for anemia during pregnancy. Anemia during pregnancy—especially the severe form—can lead to various maternal and perinatal adverse effects such as preterm labor, low birth weight, and intrauterine fetal death. It is one of the leading causes of maternal mortality. Therefore, preventive measures are needed if anemia and its adverse effects are to be prevented. Iron and folic acid supplements are the cornerstone for the prevention of anemia during pregnancy and one of the earliest preventive measures adopted in antenatal care. Other measures to prevent anemia during pregnancy include the fortification of principle foods with iron, increasing health and nutritional awareness, combating parasitic infections, and improvement in sanitation. There is a controversy concerning the benefit of other elements such as zinc, copper, and magnesium, so the use of these elements is not widely adopted for the prevention of anemia

Causes and risk factors of hospitalization among under-five children in kassala, eastern sudan

© 2020 Ahmed A. Hassan, Zainab Taha, Mohammed A. Abdulla, AbdelAziem A. Ali, Ishag Adam. BACKGROUND: According to the World Health Organization estimation, African Region deaths of all under-five deaths in 2015 were over 5 times higher in comparison to the European Region. AIM: The study aimed to estimate the prevalence, investigate the possible causes and risk factors associated with under-five children’s hospitalization in Kassala, Eastern Sudan. METHODS: A community-based cross-sectional study was conducted from December 2015 to March 2016. The data were collected by interviewing mothers. RESULTS: A total of 297 mother-child pairs participated in the study. The mean (SD) of maternal age and children’s age was 27.6 (5.9) years and 16 (11.3) months, respectively. One hundred and three children were hospitalized over the past 6 months. The most common mentioned causes for the last hospitalization were gastroenteritis 28.1% (29/103), respiratory tract infections 19.4% (20/103), malaria 9.7% (10/103), and trauma 3.8% (3/103). In multivariable analysis, a high birth order (adjusted odds ratio [AOR] 1.25, 95% Confidence Interval [CI] (1.06, 1.47), low paternal education (AOR 2.89, 95% 1.32, 6.30), and bottle feeding (AOR 2.26, 95% CI 1.30, 3.80) were associated with under-five children’s hospitalization. CONCLUSIONS: More than one-third of the children were hospitalized in Eastern Sudan. Urgent action is required to address children’s health issues (i.e., the above-mentioned causes and associated factors)

Causes and Risk Factors of Hospitalization among Under-five Children in Kassala, Eastern Sudan

BACKGROUND: According to the World Health Organization estimation, African Region deaths of all under-five deaths in 2015 were over 5 times higher in comparison to the European Region. AIM: The study aimed to estimate the prevalence, investigate the possible causes and risk factors associated with under-five children’s hospitalization in Kassala, Eastern Sudan. METHODS: A community-based cross-sectional study was conducted from December 2015 to March 2016. The data were collected by interviewing mothers. RESULTS: A total of 297 mother-child pairs participated in the study. The mean (SD) of maternal age and children’s age was 27.6 (5.9) years and 16 (11.3) months, respectively. One hundred and three children were hospitalized over the past 6 months. The most common mentioned causes for the last hospitalization were gastroenteritis 28.1% (29/103), respiratory tract infections 19.4% (20/103), malaria 9.7% (10/103), and trauma 3.8% (3/103). In multivariable analysis, a high birth order (adjusted odds ratio [AOR] 1.25, 95% Confidence Interval [CI] (1.06, 1.47), low paternal education (AOR 2.89, 95% 1.32, 6.30), and bottle feeding (AOR 2.26, 95% CI 1.30, 3.80) were associated with under-five children’s hospitalization. CONCLUSIONS: More than one-third of the children were hospitalized in Eastern Sudan. Urgent action is required to address children’s health issues (i.e., the above-mentioned causes and associated factors)

Severe anaemia is associated with a higher risk for preeclampsia and poor perinatal outcomes in Kassala hospital, eastern Sudan

<p>Abstract</p> <p>Background</p> <p>Anaemia during pregnancy is major health problem. There is conflicting literature regarding the association between anaemia and its severity and maternal and perinatal outcomes.</p> <p>Methods</p> <p>This is a retrospective case-control study conducted at Kassala hospital, eastern Sudan. Medical files of pregnant women with severe anaemia (haemoglobin (Hb) < 7 g/dl, n = 303) who delivered from January 2008 to December 2010 were reviewed. Socio-demographic and obstetric data were analysed and compared with a similar number of women with mild/moderate anaemia (Hb = 7-10.9 g/dl, n = 303) and with no anaemia (Hb > 11 g/dl, n = 303). Logistic regression analysis was performed separately for each of the outcome measures: preeclampsia, eclampsia, preterm birth, low birth weight (LBW) and stillbirth.</p> <p>Results</p> <p>There were 9578 deliveries at Kassala hospital, 4012 (41.8%) women had anaemia and 303 (3.2%) had severe anaemia. The corrected risk for preeclampsia increased only in severe anaemia (OR = 3.6, 95% CI: 1.4-9.1, <it>P </it>= 0.007). Compared with women with no anaemia, the risk of LBW was 2.5 times higher in women with mild/moderate anaemia (95% CI: 1.1-5.7), and 8.0 times higher in women with severe anaemia (95% CI: 3.8-16.0). The risk of preterm delivery increased significantly with the severity of anaemia (OR = 3.2 for women with mild/moderate anaemia and OR = 6.6 for women with severe anaemia, compared with women with no anaemia). The corrected risk for stillbirth increased only in severe anaemia (OR = 4.3, 95% CI: 1.9-9.1, <it>P </it>< 0.001).</p> <p>Conclusions</p> <p>The greater the severity of the anaemia during pregnancy, the greater the risk of preeclampsia, preterm delivery, LBW and stillbirth. Preventive measures should be undertaken to decrease the prevalence of anaemia in pregnancy.</p

Recurrent urethral obstruction secondary to large vulval inclusion cyst: a remote complication of female genital mutilation: a case report

Abstract Background Female genital mutilation/cutting (FGM/C) is a major public health problem, particularly in developing countries. Case presentation The authors reported a case of 48-year old multiparous woman presented to Kassala Hospital, east Sudan, with recurrent urine retention resulting from urethral obstruction, which was caused by large vulval inclusion cyst. A traditional birth attendant circumcised her when she was 5 year old. Five years before her presentation the patient observed a painless swelling in her vulva, which was gradually increasing in size. She presented to the hospital with urine retention seeking medical care. Local examination showed a large cystic swelling originating in the circumcision line and covering the introitus. A diagnosis of inclusion cyst at the site of circumcision was made. The cyst was large enough causing bladder outlet obstruction and when the patient advised to tilt it away from the urethral orifice she passed urine without difficulties. The cyst was surgically removed by dissection along the lines of cleavage, which measured 10 × 9.2 cm and weighed 1.2 kg. Conclusion This case report indicates that FGM is a serious public health problem and there should an urgent intervention such as planned health education campaigns to end FGM practice

MATERNAL DEATH DUE TO APLASTIC ANEMIA – A CASE REPORT

Aplastic anaemia is characterized by a failure or suppression of multipotent myeloid stem cell resulting in pancytopenia (neutropenia, anaemia and thrombocytopenia). The cause can be inherited or acquired. The acquired causes mainly due to myelotoxic drugs and chemical, radiation and viral infection [1]. Aplastic anaemia in pegnancy is a rare disease with a major risk of materno-fetal morbidity and mortality, although the causal relationship is questioned [2]. &nbsp;Infections and bleeding remain the main cause of death in these patients [3]. ]. Pregnancy was suggested as a possible cause&nbsp; due to suppression of hematopoiesis by placental lactogens[4].&nbsp;This is supported by the clinical observation that the aplastic anaemia associated with pregnancy is frequently self-limited, ending with delivery,[5]. In places where nutritional anemia is prevalent, as in the tropics, aplastic anemia may be diagnosed late due to assumption that it is nutritional. We report a case of aplastic anaemia in pregnancy that lead to maternal deat

Provider-initiated HIV testing and counseling among tuberculosis patients in Kassala, Eastern Sudan

Summary: Because of the overlapping global incidence of tuberculosis (TB) and human immunodeficiency virus (HIV) infections, collaborative efforts are required for successful TB and HIV control programs. The current study was conducted at Kassala Hospital in Eastern Sudan and investigated the implementation of provider-initiated HIV testing and counseling (PITC) for patients infected with TB.Using a cross-sectional study design, patients who had been recently diagnosed with TB between January and December 2010 were consecutively enrolled. A total of 858 newly infected TB patients were enrolled in the study. Of these patients, 152 patients (17.7%) were given counseling, and 109 patients (12.7%) underwent HIV testing. The overall HIV infection rate among those tested was 18.3%. From a multivariate analysis, female sex (OR = 17.0, 95% CI = 8.7–33.1; P < 0.001), education level below secondary education (OR = 2.6, 95% CI = 1.6–4.1; P < 0.001), rural residency (OR = 1.7, 95% CI = 1.3–2.9; P = 0.001), and non-governmental employee status (OR = 10.4, 95% CI = 6.7–16.3; P < 0.001) were each associated with lower rates of PITC.Thus, in this setting, the frequency of PITC is low among TB-infected patients and is especially low for females, those of low educational status, and non-governmental employees. Keywords: Tuberculosis, HIV, PITC, Uptake, Suda