Prevalence of preterm premature rupture of membrane and associated factors among pregnant women admitted in hiwot fana comprehensive specialized university hospital, eastern ethiopia

BACKGROUND: Preterm premature rupture of membrane (PPROM) affects approximately 3% of all pregnancies and is responsible for one-third of all preterm births. Despite its contribution to maternal and neonatal mortality and morbidity, evidence on the burden of PPROM and its associated factors in the study area is scarce. Therefore, this study was aimed to assess the prevalence and associated factors of PPROM among preterm pregnancies managed from May 2019 to September 2020 at Hiwot Fana Comprehensive Specialized University Hospital University Hospital, Eastern Ethiopia. METHODS: A hospital-based retrospective cross-sectional study was conducted among 449 preterm pregnancies selected by systematic random sampling technique. Data related to socio-demographic variables, obstetric and reproductive health conditions, and labor and related pregnancy outcomes were extracted from their medical records using a structured checklist. Factors associated with PPROM were identified using bivariable and multivariable logistic regression. Association was presented using an adjusted odds ratio (AOR) along with 95% confidence interval (CI). P-value &lt;0.05 in the final model was considered as statistically significant.RESULTS: Of 449 preterm pregnant women included in the study, 64 (14.3%; 95% CI:11.1% -17.5%) had PPROM. Preterm PROM was significantly associated with urinary tract infections (AOR=6.33; 95% CI:3.26-12.29), vaginal bleeding (AOR=2.62; 95% CI:1.23-5.57), history of abortion (AOR= 3.07; 95% CI:1.33-7.06) and mid upper arm circumference &lt;23 (AOR=7.06; 95% CI: 4.02-12.43). A total of 3 (4.3%) stillbirth and 16 (22.9%) early neonatal deaths occurred corresponding with a gross perinatal mortality rate of 271 per 1000 births.CONCLUSION: This study showed that one in seven preterm pregnancies in eastern Ethiopia had PPROM. Urinary tract infection, vaginal bleeding, previous history of abortion, and undernutrition were associated with PPROM. Early screening and treatment of urinary tract infections and nutritional assessments are essential to reduce the risk of PPROM.</p

Prevalence of preterm premature rupture of membrane and associated factors among pregnant women admitted in hiwot fana comprehensive specialized university hospital, eastern ethiopia

BACKGROUND: Preterm premature rupture of membrane (PPROM) affects approximately 3% of all pregnancies and is responsible for one-third of all preterm births. Despite its contribution to maternal and neonatal mortality and morbidity, evidence on the burden of PPROM and its associated factors in the study area is scarce. Therefore, this study was aimed to assess the prevalence and associated factors of PPROM among preterm pregnancies managed from May 2019 to September 2020 at Hiwot Fana Comprehensive Specialized University Hospital University Hospital, Eastern Ethiopia. METHODS: A hospital-based retrospective cross-sectional study was conducted among 449 preterm pregnancies selected by systematic random sampling technique. Data related to socio-demographic variables, obstetric and reproductive health conditions, and labor and related pregnancy outcomes were extracted from their medical records using a structured checklist. Factors associated with PPROM were identified using bivariable and multivariable logistic regression. Association was presented using an adjusted odds ratio (AOR) along with 95% confidence interval (CI). P-value &lt;0.05 in the final model was considered as statistically significant.RESULTS: Of 449 preterm pregnant women included in the study, 64 (14.3%; 95% CI:11.1% -17.5%) had PPROM. Preterm PROM was significantly associated with urinary tract infections (AOR=6.33; 95% CI:3.26-12.29), vaginal bleeding (AOR=2.62; 95% CI:1.23-5.57), history of abortion (AOR= 3.07; 95% CI:1.33-7.06) and mid upper arm circumference &lt;23 (AOR=7.06; 95% CI: 4.02-12.43). A total of 3 (4.3%) stillbirth and 16 (22.9%) early neonatal deaths occurred corresponding with a gross perinatal mortality rate of 271 per 1000 births.CONCLUSION: This study showed that one in seven preterm pregnancies in eastern Ethiopia had PPROM. Urinary tract infection, vaginal bleeding, previous history of abortion, and undernutrition were associated with PPROM. Early screening and treatment of urinary tract infections and nutritional assessments are essential to reduce the risk of PPROM.</p

Prevalence of preterm premature rupture of membrane and associated factors among pregnant women admitted in hiwot fana comprehensive specialized university hospital, eastern ethiopia

BACKGROUND: Preterm premature rupture of membrane (PPROM) affects approximately 3% of all pregnancies and is responsible for one-third of all preterm births. Despite its contribution to maternal and neonatal mortality and morbidity, evidence on the burden of PPROM and its associated factors in the study area is scarce. Therefore, this study was aimed to assess the prevalence and associated factors of PPROM among preterm pregnancies managed from May 2019 to September 2020 at Hiwot Fana Comprehensive Specialized University Hospital University Hospital, Eastern Ethiopia. METHODS: A hospital-based retrospective cross-sectional study was conducted among 449 preterm pregnancies selected by systematic random sampling technique. Data related to socio-demographic variables, obstetric and reproductive health conditions, and labor and related pregnancy outcomes were extracted from their medical records using a structured checklist. Factors associated with PPROM were identified using bivariable and multivariable logistic regression. Association was presented using an adjusted odds ratio (AOR) along with 95% confidence interval (CI). P-value &lt;0.05 in the final model was considered as statistically significant.RESULTS: Of 449 preterm pregnant women included in the study, 64 (14.3%; 95% CI:11.1% -17.5%) had PPROM. Preterm PROM was significantly associated with urinary tract infections (AOR=6.33; 95% CI:3.26-12.29), vaginal bleeding (AOR=2.62; 95% CI:1.23-5.57), history of abortion (AOR= 3.07; 95% CI:1.33-7.06) and mid upper arm circumference &lt;23 (AOR=7.06; 95% CI: 4.02-12.43). A total of 3 (4.3%) stillbirth and 16 (22.9%) early neonatal deaths occurred corresponding with a gross perinatal mortality rate of 271 per 1000 births.CONCLUSION: This study showed that one in seven preterm pregnancies in eastern Ethiopia had PPROM. Urinary tract infection, vaginal bleeding, previous history of abortion, and undernutrition were associated with PPROM. Early screening and treatment of urinary tract infections and nutritional assessments are essential to reduce the risk of PPROM.</p

Prevalence of preterm premature rupture of membrane and associated factors among pregnant women admitted in hiwot fana comprehensive specialized university hospital, eastern ethiopia

BACKGROUND: Preterm premature rupture of membrane (PPROM) affects approximately 3% of all pregnancies and is responsible for one-third of all preterm births. Despite its contribution to maternal and neonatal mortality and morbidity, evidence on the burden of PPROM and its associated factors in the study area is scarce. Therefore, this study was aimed to assess the prevalence and associated factors of PPROM among preterm pregnancies managed from May 2019 to September 2020 at Hiwot Fana Comprehensive Specialized University Hospital University Hospital, Eastern Ethiopia. METHODS: A hospital-based retrospective cross-sectional study was conducted among 449 preterm pregnancies selected by systematic random sampling technique. Data related to socio-demographic variables, obstetric and reproductive health conditions, and labor and related pregnancy outcomes were extracted from their medical records using a structured checklist. Factors associated with PPROM were identified using bivariable and multivariable logistic regression. Association was presented using an adjusted odds ratio (AOR) along with 95% confidence interval (CI). P-value &lt;0.05 in the final model was considered as statistically significant.RESULTS: Of 449 preterm pregnant women included in the study, 64 (14.3%; 95% CI:11.1% -17.5%) had PPROM. Preterm PROM was significantly associated with urinary tract infections (AOR=6.33; 95% CI:3.26-12.29), vaginal bleeding (AOR=2.62; 95% CI:1.23-5.57), history of abortion (AOR= 3.07; 95% CI:1.33-7.06) and mid upper arm circumference &lt;23 (AOR=7.06; 95% CI: 4.02-12.43). A total of 3 (4.3%) stillbirth and 16 (22.9%) early neonatal deaths occurred corresponding with a gross perinatal mortality rate of 271 per 1000 births.CONCLUSION: This study showed that one in seven preterm pregnancies in eastern Ethiopia had PPROM. Urinary tract infection, vaginal bleeding, previous history of abortion, and undernutrition were associated with PPROM. Early screening and treatment of urinary tract infections and nutritional assessments are essential to reduce the risk of PPROM.</p

Tuberculosis treatment outcome and associated factors among tuberculosis patients at Wolayta Sodo Teaching and Referral Hospital, Southern Ethiopia: a retrospective study

Background: Tuberculosis is a major public health problem throughout the world particularly in resource limited countries. Measuring and reporting of TB treatment outcomes and identifying associated factors are fundamental part of TB treatment. The aim of this study was to assess TB treatment outcome and associated factors among TB patients in Wolayta Sodo Teaching and Referral Hospital, Southern Ethiopia.Design and Methods: Facility based retrospective cohort study was conducted in Wolayta Sodo Teaching and Referral Hospital. All TB patients who registered during September 2014 to August 2019 and had known treatment outcome were included in the study. The data were collected using pretested structured data extraction format that included demographic, clinical and treatment outcome variables. SPSS Version 23 for Windows was used for data processing. Bivariate and multivariate analysis with 95% confidence interval (CI) was employed to infer associations between the independent and dependent variables.Results: Of total 232 TB patients included in the study, 54.3% were male,80.2% were urban residents, 65.9% were pulmonary TB (PTB). From the total 153 PTB cases,31.5% were smear positive, 17.2% were HIV co-infected and all of them were on antiretroviral treatment. Most, 97.0% of the TB cases were newly diagnosed and all were treated as first line treatment category. The overall treatment success rate was 82.5% (28% cured 54.3% completed), 11.2% loss to follow-up, 4.7% dead and 0.9% treatment failure. The treatment success rate of HIV co-infected TB patients was 77.5%. There was no significant association between TB treatment outcome and age, sex, residence, type of TB, category of patients and HIV status.Conclusions: The treatment success rate was low (82.5%) which is below the90% threshold defined standard with high proportion of patient’s lost to follow-up (11.2%). A higher number of transfer-out cases were recorded in this study. Thus, supervision and monitoring of DOTs implementation, improved counseling service, mechanisms for lost to follow-up patients should be strengthen. Establish efficient referral and contact tracing mechanisms for transferred-out cases and document their treatment outcomes of status is also fundamental

Prevalence of diarrheal disease and associated factors among under-five children in flood-prone settlements of Northwest Ethiopia: A cross-sectional community-based study

BackgroundDiarrheal illnesses are a long-standing public health problem in developing countries due to numerous sanitation issues and a lack of safe drinking water. Floods exacerbate public health issues by spreading water-borne infectious diseases such as diarrhea through the destruction of sanitation facilities and contamination of drinking water. There has been a shortage of studies regarding the magnitude of diarrheal disease in flood-prone areas. Therefore, this research aimed to evaluate the prevalence of diarrheal disease and its predictors among under-five children living in flood-prone localities in the south Gondar zone of Northwest Ethiopia.MethodA community-based cross-sectional research was carried out in flood-prone villages of the Fogera and Libokemkem districts from March 17 to March 30, 2021. Purposive and systematic sampling techniques were used to select six kebeles and 717 study units, respectively. Structured and pretested questionnaires were used to collect the data. A multivariable analysis was performed to determine the predictors of diarrheal disease, with P-value &lt;0.05 used as the cut-off point to declare the association.ResultThe prevalence of a diarrheal disease among under-five children was 29.0%. The regular cleaning of the compound [AOR: 2.13; 95% CI (1.25, 3.62)], source of drinking water [AOR: 2.36; 95% CI: (1.26, 4.41)], animal access to water storage site [AOR: 3.04; 95% CI: (1.76, 5.24)], vector around food storage sites [AOR: 9.13; 95% CI: (4.06, 20.52)], use of leftover food [AOR: 4.31; 95% CI: (2.64, 7.04)], and fecal contamination of water [AOR: 12.56; 95% CI: (6.83, 23.20)] remained to have a significant association with diarrheal diseases.ConclusionThe present study found that the prevalence of the diarrheal disease among under-five children was high. Routine compound cleaning, the source of drinking water, animal access to a water storage site, vectors near food storage sites, consumption of leftover food, and fecal contamination of water were significant predictors of diarrheal disease. Therefore, it is advised to provide improved water sources, encourage routine cleaning of the living area, and offer health education about water, hygiene, and sanitation

Zoonotic tuberculosis in a high bovine tuberculosis burden area of Ethiopia

BackgroundTuberculosis (TB) is a major cause of ill health and one of the leading causes of death worldwide, caused by species of the Mycobacterium tuberculosis complex (MTBC), with Mycobacterium tuberculosis being the dominant pathogen in humans and Mycobacterium bovis in cattle. Zoonotic transmission of TB (zTB) to humans is frequent particularly where TB prevalence is high in cattle. In this study, we explored the prevalence of zTB in central Ethiopia, an area highly affected by bovine TB (bTB) in cattle.MethodA convenient sample of 385 patients with pulmonary tuberculosis (PTB, N = 287) and tuberculous lymphadenitis (TBLN, N = 98) were included in this cross-sectional study in central Ethiopia. Sputum and fine needle aspirate (FNA) samples were obtained from patients with PTB and TBLN, respectively, and cultures were performed using BACTEC™ MGIT™ 960. All culture positive samples were subjected to quantitative PCR (qPCR) assays, targeting IS1081, RD9 and RD4 genomic regions for detection of MTBC, M. tuberculosis and M. bovis, respectively.ResultsTwo hundred and fifty-five out of 385 sampled patients were culture positive and all were isolates identified as MTBC by being positive for the IS1081 assay. Among them, 249 (97.6%) samples had also a positive RD9 result (intact RD9 locus) and were consequently classified as M. tuberculosis. The remaining six (2.4%) isolates were RD4 deficient and thereby classified as M. bovis. Five out of these six M. bovis strains originated from PTB patients whereas one was isolated from a TBLN patient. Occupational risk and the widespread consumption of raw animal products were identified as potential sources of M. bovis infection in humans, and the isolation of M. bovis from PTB patients suggests the possibility of human-to-human transmission, particularly in patients with no known contact history with animals.ConclusionThe detected proportion of culture positive cases of 2.4% being M. bovis from this region was higher zTB rate than previously reported for the general population of Ethiopia. Patients with M. bovis infection are more likely to get less efficient TB treatment because M. bovis is inherently resistant to pyrazinamide. MTBC species identification should be performed where M. bovis is common in cattle, especially in patients who have a history of recurrence or treatment failure

Global, regional, and national burden of meningitis and its aetiologies, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. Methods We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. Findings In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000–277 000) and 2·51 million (2·11–2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400–145 000) and 1·28 million incident cases (0·947–1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6–8·4) per 100 000 population in 1990 to 3·3 (2·8–3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1–19·2]), followed by N meningitidis (13·6% [12·7–14·4]) and K pneumoniae (12·2% [10·2–14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5–81·8]), followed by N meningitidis (72·3% [64·4–78·5]) and viruses (58·2% [47·1–67·3]). Interpretation Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment.publishedVersio

Routine health management information system data in Ethiopia: consistency, trends, and challenges.

Background: Ethiopia is investing in the routine Health Management Information System. Improved routine data are needed for decision-making in the health sector. Objective: To analyse the quality of the routine Health Management Information System data and triangulate with other sources, such as the Demographic and Health Surveys. Methods: We analysed national Health Management Information System data on 19 indicators of maternal health, neonatal survival, immunization, child nutrition, malaria, and tuberculosis over the 2012-2018 time period. The analyses were conducted by 38 analysts from the Ministry of Health, Ethiopia, and two government agencies who participated in the Operational Research and Coaching for Analysts (ORCA) project between June 2018 and June 2020. Using a World Health Organization Data Quality Review toolkit, we assessed indicator definitions, completeness, internal consistency over time and between related indicators, and external consistency compared with other data sources. Results: Several services reported coverage of above 100%. For many indicators, denominators were based on poor-quality population data estimates. Data on individual vaccinations had relatively good internal consistency. In contrast, there was low external consistency for data on fully vaccinated children, with the routine Health Management Information System showing 89% coverage but the Demographic and Health Survey estimate at 39%. Maternal health indicators displayed increasing coverage over time. Indicators on child nutrition, malaria, and tuberculosis were less consistent. Data on neonatal mortality were incomplete and operationalised as mortality on day 0-6. Our comparisons with survey and population projections indicated that one in eight early neonatal deaths were reported in the routine Health Management Information System. Data quality varied between regions. Conclusions: The quality of routine data gathered in the health system needs further attention. We suggest regular triangulation with data from other sources. We recommend addressing the denominator issues, reducing the complexity of indicators, and aligning indicators to international definitions

Trends in HIV/AIDS morbidity and mortality in Eastern 3 Mediterranean countries, 1990–2015: findings from the Global 4 Burden of Disease 2015 study

Objectives We used the results of the Global Burden of Disease 2015 study to estimate trends of HIV/AIDS burden in Eastern Mediterranean Region (EMR) countries between 1990 and 2015. Methods Tailored estimation methods were used to produce final estimates of mortality. Years of life lost (YLLs) were calculated by multiplying the mortality rate by population by age-specific life expectancy. Years lived with disability (YLDs) were computed as the prevalence of a sequela multiplied by its disability weight. Results In 2015, the rate of HIV/AIDS deaths in the EMR was 1.8 (1.4–2.5) per 100,000 population, a 43% increase from 1990 (0.3; 0.2–0.8). Consequently, the rate of YLLs due to HIV/AIDS increased from 15.3 (7.6–36.2) per 100,000 in 1990 to 81.9 (65.3–114.4) in 2015. The rate of YLDs increased from 1.3 (0.6–3.1) in 1990 to 4.4 (2.7–6.6) in 2015. Conclusions HIV/AIDS morbidity and mortality increased in the EMR since 1990. To reverse this trend and achieve epidemic control, EMR countries should strengthen HIV surveillance,and scale up HIV antiretroviral therapy and comprehensive prevention services