Quality of Perioperative Informations Provided and its Associated Factors Among Adult Patients Who Undergone Surgery in Public Hospitals of Gamo &Gofa Zones: A Mixed Design Study, Southern Ethiopia, 2019

Background: Surgery is one of biggest health related decisions done in one’s life with an outcome ranging in both extremes. It do have three phases. Preoperative, Intraoperative and Postoperative  phases. All the phases are interlinked and affect one another. Surgical outcomes are   found to be    affected by range of factors. Some of the factors could be social, financial, medical, immunological, and etc. Surgery as a professional procedure, is bound with multiples of concerns including clinical, professional, moral, Ethical and legal aspects. Appropriate health informations are an indispensable component of health care as well as surgery. Noting is known about the quality of perioperative informations provided in Public Hospitals of Gamo and Gofa Zones. Therefore, the purpose of this study will be to assess the quality of perioperative informations provided and its associated factors among adult patients who undergone surgery in public hospitals of Gamo and Gofa Zones. Method and materials: A facility based mixed design study was conducted from March-April 2019 in Arba minch, Chencha and Sawla Hospitals, Southern Ethiopia. A simple random sampling technique was employed to select 410 study participants among admitted adult patients who undergone surgery. Bivariate logistic regression analysis was done to identify candidates for multivariable logistic regression analysis. Explanatory variables with a p-value of less than 0.25 in the bivariate logistic regression analysis were included in the initial logistic model of multivariable logistic regression. Finally, statistically significant associations of variables were determined based on an Adjusted Odds ratio with 95% confidence interval and p-value <0.05. Result: the proportion of patients who received good quality perioperative informations are only 36.6%. In the multivariable analysis; Frequency of Hospital Visit  [AOR=2.604, 95% CI: 1.669-4.063],  Reasons for Hospital Visit [AOR = 2.370; 95% CI: 1.356-4.144], Previous Surgery [AOR = 2.370; 95% CI: 1.449-3.876], number of Previous Surgery [AOR = 1.808; 95% CI: 1.097-2.981], Place of Surgery[AOR =0.333; 95% CI:0.152-0.726], Surgical Professional [AOR =2.007; 95% CI:1.096-3.677] and Consenter [AOR =7.408; 95% CI:4.453-12.325] were significantly associated with the provision of good quality perioperative informations. Conclusion: According to this study, the proportion of patients who received good quality perioperative informations are only 36.6%.Therefore, all the concerned bodies must strive to improve the quality of informations to adult surgical patients

Incidence, Contributing Factors and Outcomes of Antepartum Hemorrhage in Jimma University Specialized Hospital, Southwest Ethiopia

Abstract Background: Antepartum haemorrhage complicates three to five percent of pregnancies contributing to perinatal and maternal morbidity and mortality. Timely access to quality obstetric services is the major determinant of both maternal and newborn outcomes after antepartum haemorrhage. In Ethiopia, the magnitude and consequences of antepartum haemorrhage are not well studied. The objective of this study was to determine the incidence, factors associated with and maternal and perinatal outcomes of antepartum haemorrhage in Jimma University Specialized Hospital. Methods: A hospital-based prospective cohort study was conducted in Jimma University Specialized Hospital, from January 1 to December 31, 2013. Data were collected by reviewing medical records and interviewing mothers. Cumulative incidence of antepartum hemorrhage among mothers who gave birth and odds of adverse outcomes among mothers with and without antepartum hemorrhage were calculated. Odds ratio was calculated to estimate the effect of antepartum hemorrhage on maternal and new born adverse outcomes. Results: Between January and December 2013, 3854 women gave birth in JUSH. The incidence of antepartum hemorrhage was 5.1% (n=195) in 2013. The major causes of antepartum hemorrhage were abruptio placentae and placenta previa occurring in 127(65.1%) and 52(26.7%) of cases, respectively. Six (3.1%) of the patients with antepartum hemorrhage died. Of the 206 babies born, 63 (30.6%) were stillborn and additional 13 (6.3%) newborns died during the first seven days of life making perinatal mortality rate of 36.9%. Conclusion: Antepartum hemorrhage is a common complication of pregnancy and cause of maternal and perinatal mortality in Jimma University Specialized Hospital. The risk of adverse outcomes is very high compared to other countries. Efforts to improve access and quality of comprehensive emergency obstetric care services are required

Determinants of pre‐eclampsia among pregnant women attending perinatal care in hospitals of the Omo district, Southern Ethiopia

Abstract Pre‐eclampsia is estimated to cause 70 000 maternal death globally every year, with the majority of deaths in low‐ and middle‐income countries. In Ethiopia, pre‐eclampsia causes 16% of direct maternal deaths. Despite the high burden of disease, pre‐eclampsia remains poorly studied in low and middle‐income countries. In this study, we aimed to identify risk factors for pre‐eclampsia in pregnant women attending hospitals in the Omo district of Southern Ethiopia. Data were collected via face‐to‐face interviews. Logistic regression analysis was computed to examine the relationship between the independent variable and pre‐eclampsia. An adjusted odds ratio (AOR) with the corresponding 95% confidence interval (CI) excluding 1 in the multivariable analysis was considered to identify factors associated with pre‐eclampsia at a p‐value of <0.05. A total of 167 cases and 352 controls were included. Factors that were found to have a statistically significant association with pre‐eclampsia were primary relatives who had a history of chronic hypertension (AOR 2.1, 95% CI: 1.06‐4.21), family history of diabetes mellitus (AOR 2.35; 95% CI: 1.07‐5.20), preterm gestation (AOR = 1.56, 95% CI: 1.05‐2.32), and pre‐conception smoking exposure (AOR = 4.16, 95% CI: 1.1‐15.4). The study identified that a family history of chronic illnesses and diabetes mellitus, preterm gestation, and smoking exposure before conception were the risk factors for pre‐eclampsia. Presumably, addressing the identified risk factors may give further insight into where interventions and resources should be focused, as well as having an understanding of the burden of disease

Individual and Obstetric Risk Factors of Preeclampsia among Singleton Pregnancy in Hospitals of Southern Ethiopia

Background. Preeclampsia is the second most common problem that causes maternal morbidity and complication in low-income countries. In contrast to death due to other direct causes, preeclampsia-related death is appeared to be connected with multiple factors; yet, factors have paucity and are limited. Considering the clinical significance, this study aimed to identify that individual and obstetric factors of preeclampsia can be an input for disease identification involving clinicians in southern Ethiopia. Methods. A case-control study was conducted among mothers with a singleton pregnancy who attended perinatal care in all six public hospitals in the provinces around the Omo stream. A sample size of 487 women with a singleton pregnancy (163 cases and 326 controls) was involved in the study. All cases were enrolled, while controls were selected consecutively using a random sampling technique. Data were gathered using a structured questionnaire and data extraction sheet. Descriptive data were presented using percentages and numbers. Multivariable logistic regression analysis was carried out to identify factors at a p value of less than 0.05. Results. There was a statistically significant association between the family history of hypertension (AOR = 2.42, 95% CI: 1.16–5.05), no pregnancy interval (AOR = 1.62; 95% CI: 1.03–2.55), and normal body mass index (AOR = 0.42, 95% CI: 0.21–0.87) and the occurrence of preeclampsia. Conclusion. Primary relatives with a history of chronic hypertension and no pregnancy interval were identified as risk factors of preeclampsia, while having a normal body mass index was found to be a protective factor of preeclampsia occurrence. To improve early detection and timely management of preeclampsia, the clinician should give attention to women who have no previous childbirth and whose close relatives had a history of chronic hypertension, as well as working on the protective factor is recommended