Postpartum anemia and its determinant factors among postnatal women in two selected health institutes in Gondar, Northwest Ethiopia: A facility-based, cross-sectional study

BackgroundAnemia is highly prevalent globally and disproportionately affects postnatal women. It is a significant cause of maternal mortality and morbidity globally.ObjectiveThe main aim of this study was to determine the extent of postpartum anemia and associated factors among postnatal women in two selected health facilities in Gondar, Northwest Ethiopia.MethodsA facility-based, cross-sectional study was conducted among 282 postnatal women from March to May 2021. A systematic sampling technique was used to recruit study participants from each institute. Sociodemographic, obstetric, and clinical data were collected through a semi-structured questionnaire. A venous blood sample was collected to determine the red blood cell parameters. A thin blood smear preparation was performed to examine blood morphology. In addition, direct wet mount and formalin-ether sedimentation techniques were used for stool examination to identify intestinal parasites. Data were entered into EpiData and exported to Stata 14 for statistical analysis. Descriptive statistics were presented in text, tables, and figures. A binary logistic regression model was used to identify factors associated with postpartum anemia. A p-value <0.05 was considered statistically significant.ResultsThe proportion of postpartum anemia was 47.16%; 95% CI; 41.30–53.03 with moderate, mild, and severe anemia accounting for 45.11, 42.86, and 12.03%, respectively. The majority of the anemia (94%) was of the normocytic normochromic type. It was associated with postpartum hemorrhage (AOR = 2.23; 95% CI: 1.24–4.01), cesarean section (AOR = 4.10; 95% CI: 2.11–7.78), lack of iron and folate supplementation during pregnancy (AOR = 2.12; 95% CI: 1.17–4.02), and low diet diversity level (AOR = 1.83; 95% CI: 1.05–3.18).ConclusionThe prevalence of anemia was found to be a major public health concern. Iron and folate supplementation during pregnancy, improved management of PPH, an effective cesarean section with post-operative care, and taking a diversified diet will reduce the burden. Therefore, identified factors should be considered to prevent and control postpartum anemia

Forest plot of pooled estimated SMD using random effect model.

The size of the x-axis shows the SMD estimate of the studies. Hard line indicates no difference (SMD = 0). In the pooled point calculation, the dotted line represents the mean difference. The black dot in the middle of the gray box reflects the SMD estimate of each sample’s point and the line shows the 95% CI of the estimates. The gray boxes represent each study weight that contributes to the estimation of the pooled mean difference. I-squared illustrates the heterogeneity between the included studies.</p

The PRISMA (Preferred reporting items for systematic and meta-analysis) checklists.

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Forest plot of population based sub-group analysis.

The x-axis scale displays the estimation of the SMD in MPV. The hard line shows no difference. The dotted line represents the mean difference in the pooled point estimate of each study. In the center of the gray box, the black dot reflects the SMD estimate of each article’s point estimate and the line shows the 95% CI of the estimates. I-squared indicates the heterogeneity across the included studies, p indicating for statistical significance of heterogeneity.</p

Egger’s test statistics.

Egger’s test statistics.</p

Forest plot of pooled estimated MPV in IBD patients using random effect model.

The size of the x-axis shows the estimate pooled MPV of the studies. In the pooled point calculation, the dotted line represents the MPV. The black dot in the middle of the gray box reflects the estimate pooled MPV of each studies point and the line shows the 95% CI of the estimates. The gray boxes represent each study weight that contributes to the estimation of the pooled MPV. I-squared illustrates the heterogeneity between the included studies.</p

Summary characteristics of studies included in meta-analysis.

Summary characteristics of studies included in meta-analysis.</p

PRISMA flow chart describing screening protocols of studies for Meta-analysis.

NB; UC: Ulcerative Colitis; CD: Crohn’s Disease; IBD: Inflammatory Bowel Disease; AA: Acute Appendicitis; CFPIAP: Child Food Protein Induced Allergic Proctocolitis.</p

The methodological quality of the included studies using JBI critical appraising tool.

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Prevalence of biofilm producing Acinetobacter baumannii clinical isolates: A systematic review and meta-analysis.

BackgroundAcinetobacter baumannii, the first human pathogen to be designated as a "red-alert" pathogen, is on the critical priority list of pathogens requiring new antibiotics. Biofilm-associated diseases are the most common infections caused by the antibiotic-resistant bacteria A. baumannii. Multidrug-resistant strains are more easily transmitted around the world due to A. baumannii's ability to produce biofilms, which allows it to develop antibiotic resistance mechanisms and thrive in healthcare environments. As a result, A. baumannii infections are becoming increasingly common in hospital settings allover the world. As a result, a comprehensive systematic review and meta-analysis were carried out to determine the global prevalence of biofilm-producing A. baumannii clinical isolates.MethodsArticles were extensively searched in bibliographic databases and grey literatures using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported into STATA version 12 software for statistical analysis. A random-effects model was used to compute the pooled prevalence of biofilm-producing A. baumannii clinical isolates. The heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger's test. Sensitivity analysis was done to assess the impact of a single study on pooled effect size.ResultOf the 862 studies identified, 26 studies consisted of 2123 A.baumannii clinical isolates of which 1456 were biofilm-producing. The pooled prevalence of biofilm-producing A.baumannii clinical isolates was 65.63% (95% CI = 56.70%-74.56%). There was substantial heterogeneity with an I2 value of 98.1%. Moreover, 41.34%, 33.57%, and 27.63% of isolates of strong, mild, and weak producers of biofilm. Higher prevalence was found in studies published after 2014 (66.31%); Western Pacific region (76.17%); and Asia (66.22%) followed by the African continent (57.29%).ConclusionThe pooled prevalence of biofilm-producing A. baumannii clinical isolates has risen alarmingly, posing a public health risk. This indicates the burden of biofilm-producing A. baumannii infections urges routine screening and appropriate treatment for better management of hospitalized patients, as well as effective controlling of the emergence of drug resistance. Furthermore, this finding is an alert call for the stakeholders to develop strong infection prevention and antibiotics stewardship programs for the prevention and control of biofilm-producing bacterial infections