scholarly journals High susceptibility to varicella among urban and rural pregnant women in South India: a brief report

2021 ◽  
Vol 149 ◽  
Author(s):  
Leeberk Raja Inbaraj ◽  
Sindhulina Chandrasingh ◽  
Nalini Arun Kumar ◽  
Jothi Suchitra ◽  
Abi Manesh
Keyword(s):  
Pregnant Women ◽  
South India ◽  
Significant Proportion ◽  
Prevalence Ratio ◽  
Epidemiological Studies ◽  
Lethal Outcome ◽  
Factors Associated ◽  
Rural And Urban ◽  
History Of ◽  
Secondary Hospital

Abstract Varicella infection during pregnancy has serious and/or difficult implications and in some cases lethal outcome. Though epidemiological studies in developing countries reveal that a significant proportion of patients may remain susceptible during pregnancy, such an estimate of susceptible women is not known in India. We designed this study to study the prevalence and factors associated with susceptibility to varicella among rural and urban pregnant women in South India. We prospectively recruited 430 pregnant women and analysed their serum varicella IgG antibodies as surrogates for protection. We estimated seroprevalence, the validity of self-reported history of chickenpox and factors associated with varicella susceptibility. We found 23 (95% CI 19.1–27.3) of women were susceptible. Nearly a quarter (22.2%) of the susceptible women had a history of exposure to chickenpox anytime in the past or during the current pregnancy. Self-reported history of varicella had a positive predictive value of 82.4%. Negative history of chickenpox (adjusted prevalence ratio (PR) 1.85, 95% CI 1.15–3.0) and receiving antenatal care from a rural secondary hospital (adjusted PR 4.08, 95% CI 2.1–7.65) were significantly associated with susceptibility. We conclude that high varicella susceptibility rates during pregnancy were noted and self-reported history of varicella may not be a reliable surrogate for protection.

scholarly journals Perineal trauma after vaginal delivery in healthy pregnant women

2014 ◽  
Vol 132 (4) ◽  
pp. 231-238 ◽  
Author(s):  
Larissa Santos Oliveira ◽  
Luiz Gustavo Oliveira Brito ◽  
Silvana Maria Quintana ◽  
Geraldo Duarte ◽  
Alessandra Cristina Marcolin
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Standing Position ◽  
Professional Activity ◽  
Factors Associated ◽  
Perineal Injury ◽  
Secondary Hospital ◽  
Perineal Injuries

CONTEXT AND OBJECTIVE:Despite all the medical care provided during delivery labor, perineal injury is still prevalent and may lead to diverse pelvic floor disorders. The aim here was to investigate the prevalence of obstetric and anal sphincter injuries (OASIS) in healthy pregnant women after vaginal delivery.DESIGN AND SETTING:Cross-sectional study involving 3,034 patients with singletons in a secondary hospital for low-risk cases.METHODS:A standardized questionnaire was prepared and applied to medical files that had been completely filled out (classification of the Royal College of Obstetricians and Gynecologists, RCOG) in order to identify OASIS and analyze risk factors associated with mild and severe perineal lacerations.RESULTS:The women's mean age was 25 years; more than half (54.4%) were primiparae. Almost 38% of the participants had perineal lacerations; these were severe in 0.9% of the cases. Previous vaginal delivery (odds ratio, OR: 1.64 [1.33-2.04]) and forceps delivery (OR: 2.04 [1.39-2.97]) were risk factors associated with mild perineal injuries (1st and 2nd OASIS classifications). Only remaining standing for prolonged periods during professional activity (OR: 2.85 [1.34-6.09]) was associated with severe perineal injuries.CONCLUSION:The prevalence of severe perineal injuries was concordant with data in the literature. The variable of standing position was considered to be a risk factor for severe perineal injury and should be further investigated.

scholarly journals Magnitude and factors associated with anemia among pregnant women attending antenatal care at St. Paul's Hospital Millennium Medical College, Addis ababa, Ethiopia - a cross sectional type of study

2020 ◽  
Author(s):  
Desta Samuel Umuro ◽  
Yared Lasebew Asres ◽  
Gezahegn Mamo Muluneh
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Addis Ababa ◽  
Antenatal Clinic ◽  
Parasitic Infestation ◽  
Cross Sectional ◽  
Care Clinic ◽  
Factors Associated ◽  
Medical College ◽  
History Of

Abstract Background This study aimed to assess magnitude and factors associated with anemia among pregnant women attending antenatal clinic at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods Institution based cross sectional study design was conducted from December 1–30, 2018 on 405 pregnant women attending antenatal clinic. All pregnant women visiting the Antenatal care clinic during the study period and who fulfilled the eligibility criteria were included in the study. Secondary data was collected from clients register and personal files on hemoglobin, HIV, stool, and other variables. Descriptive statistics was used to analysis some variables by using SPSS. Logistic regression was carried out to identify factors associated with anemia in pregnancy. Adjusted odds ratio with their 95% of confidence interval and p < 0.05 are consider to have significant association. Results The magnitude of Anemia in pregnant women in this study was 19.8%, (95% CI 16.00-23.70). HIV infection (AOR = 6.12(95% CI 2.19, 17.08) parasitic infestation (AOR = 11.88 (95% CI 5.60, 25.20) and history of not taking fruit after meal during pregnancy (AOR = 3.12(95% CI 1.72, 5.67) were the major determinants of anemia. Conclusion This study showed that the magnitude of anemia among pregnant women was high especially at third trimester. Living with HIV /AIDS, parasitic infestation and no history of taking fruits after meal were the main factors.

Non-performance of urinalysis among pregnant women in Brazil

2019 ◽  
Vol 32 (1) ◽  
pp. 224-232
Author(s):  
Juraci A. Cesar ◽  
Luana P. Marmitt ◽  
Alessandra C. Dziekaniak ◽  
Sabrina S. Leite ◽  
Otávio A. Leão ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Design Methodology ◽  
Prevalence Ratio ◽  
Urine Test ◽  
Content Type ◽  
Factors Associated ◽  
Robust Variance ◽  
Effect Measure ◽  
South Of Brazil ◽  
Prenatal Visits

Purpose The purpose of this paper is to measure the prevalence, evaluate the trend and identify the factors associated with the non-performance of qualitative urine test (QUT) among pregnant women living in the extreme south of Brazil between 2007 and 2016. Design/methodology/approach All births occurred in the local maternity wards from January 1 to December 31 of 2007, 2010, 2013 and 2016. Mothers were interviewed within 48h after delivery. The outcome was the non-performance of QUT during pregnancy. χ2 test was used to compare proportions and Poisson regression with robust variance adjustment for the multivariate analysis. The effect measure used was the prevalence ratio. Findings Of the 10,331 new mothers identified, 10,004 (96.8 percent) performed at least one prenatal visit. The prevalence of non-performance of QUT was 3.3 percent (95% CI 2.9–3.7 percent), ranging from 1.5 percent in 2007 to 5.3 percent in 2016 (p<0.001). The analysis showed that not living with a companion, having under four years of schooling, living with seven or more people in the household, having five or more children, having had one to three prenatal visits and not having been supplemented with ferrous sulfate during pregnancy showed a significantly higher prevalence rate to the non-performance of QUT. Originality/value The rate of non-performance of this test among pregnant women has clearly increased. Mothers at higher risk of unfavorable outcomes in pregnancy were the ones with the highest probability of not performing QUT. Increasing the number of prenatal visits is a high-impact measure toward the performance of this test.

scholarly journals Sociodemographic, obstetric and psychological determinants of obesity among women in early to mid-pregnancy in South India

2019 ◽  
Vol 4 ◽  
pp. 2
Author(s):  
Shubhashree Venkatesh ◽  
Anita Nath ◽  
Sheeba Balan ◽  
Vindhya J ◽  
Chandra S. Metgud ◽  
...  
Keyword(s):  
Pregnant Women ◽  
South India ◽  
Maternal Obesity ◽  
Past History ◽  
Child Outcomes ◽  
The Body ◽  
Health Concern ◽  
Psychological Determinants ◽  
Prevalence Of Obesity ◽  
History Of

Background: Worldwide, the occurrence of obesity has markedly increased over the past decades with serious public health consequences. Obese pregnant women are more likely to develop hypertension, pre-eclampsia and gestational diabetes, resulting in obstetric complications which in turn may contribute to an increase in adverse child outcomes and maternal mortality. The present study was done to determine the prevalence of obesity and its association with socio-demographic variables, obstetric history and mental health. Methods: This study was nested within an ongoing cohort study, CASCADE, in a public hospital in Bangalore. The study participants comprised of 280 pregnant women who were 18 years of age and above, with a gestational age of less than 24 weeks, enrolled between a period of August 1st, 2017 until April 30th, 2018. Weight and height were measured using calibrated devices to calculate the body mass index. Results: The prevalence of obesity was observed to be 33.9% among the pregnant mothers. Obesity was found to be significantly associated with age, history of abortion, gravidity on multivariate logistic regression. No association was found with depression and anxiety. Conclusions: Obesity is an important health concern among urban pregnant women in the region of South India. The prevalence is much higher than that reported in other studies. Increasing age, multigravidity and past history of abortion were significantly associated with maternal obesity.

scholarly journals Prevalence and factors associated with multidrug-resistant tuberculosis in South India

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Smita S. Shivekar ◽  
Venkatesh Kaliaperumal ◽  
Usharani Brammacharry ◽  
Anbazhagi Sakkaravarthy ◽  
C. K. Vidya Raj ◽  
...  
Keyword(s):  
Treatment Failure ◽  
South India ◽  
Previous History ◽  
Treatment Compliance ◽  
Positive Association ◽  
Rifampicin Resistance ◽  
Factors Associated ◽  
Tb Treatment ◽  
Mdr Tb ◽  
History Of

Abstract India accounts for about one-fourth of the global burden of MDR-TB. This study aims to assess  the prevalence and factors associated with tuberculosis drug resistance among patients from South India. MTBDRplus assay and MGIT liquid culture performed on 20,245 sputum specimens obtained from presumptive MDR-TB cases during a six-year period from 2013 to 2018 were analyzed retrospectively. Univariate and multivariate logistic regression analysis was carried out to evaluate factors associated with MDR, Rifampicin mono-resistance, and Isoniazid mono-resistance. MDR, Rifampicin mono- resistant and Isoniazid mono-resistant TB were  found in 5.4%, 2.5%, and 11.4% cases of presumptive MDR-TB, respectively. Based on the rpoB gene, true resistance, hetero-resistance, and inferred resistance to Rifampicin was found in 38%, 29.3%, and 32.7% of the 1582 MDR cases, respectively. S450L (MUT3) was the most common rpoB mutation present in 59.4% of the Rifampicin resistant cases. Of the 3390 Isoniazid resistant cases, 72.5% had mutations in the katG gene, and 27.5% had mutations in the inhA gene. True resistance, heteroresistance, and inferred resistance accounted for 42.9%, 22.2%, and 17.3% of the 2459 katG resistant cases, respectively. True resistance, heteroresistance, and inferred resistance for the inhA gene were found in 54.5%, 40.7%, and 4.7% cases, respectively. MDR-contact (AOR 3.171 95% CI: 1.747–5.754, p-0.000) treatment failure (AOR 2.17595% CI: 1.703–2.777, p-0.000) and female gender (AOR 1.315 95% CI: 1.117–1.548, p-0.001), were positively associated with MDR-TB. Previous TB treatment did not show a significant positive association with MDR (AOR 1.113 95% CI: 0.801–1.546, p-0.523). Old age (AOR 0.994 95% CI: 0.990–0.999, p-0.023) and HIV seropositivity (AOR 0.580 95% CI: 0.369–0.911, p-0.018) were negatively associated with MDR-TB. Although Rifampicin mono-resistance had a positive association with treatment failure (AOR 2.509 95% CI: 1.804–3.490, p < .001), it did not show any association with previous TB treatment (AOR 1.286 95% CI: 0.765–2.164, p-0.342) or with history of contact with MDR-TB (AOR 1.813 95% CI: 0.591–5.560, p-0.298). However, INH mono-resistance showed a small positive association with the previous history of treatment for TB (AOR 1.303 95% CI: 1.021–1.662, p-0.033). It was also positively associated (AOR 2.094 95% CI: 1.236–3.548, p-0.006) with MDR-TB contacts. Thus INH resistance may develop during treatment if compliance has not adhered too and may be easily passed on to the contacts while Rifampicin resistance is probably due to factors other than treatment compliance. MDR-TB, i.e. resistance to both Rifampicin and Isoniazid, is strongly correlated with treatment failure, spread through contact, and not to treatment compliance. The temporal trend in this region shows a decrease in MDR prevalence from 8.4% in 2015 to 1.3% in 2018. A similar trend is observed for Rifampicin mono-resistance and Isoniazid mono-resistance, pointing to the effectiveness of the TB control program. The higher proportion of inferred resistance observed for Rifampicin compared with INH may indicate a surfeit of mechanisms that enable rifampicin resistance. Association of MDR-TB with age, gender, and HIV status suggest the role of the immune system in the emergence of the MDR phenotype.

scholarly journals Thyrotoxic Atrial Fibrillation: Factors Associated with Persistence and Risk of Ischemic Stroke

2017 ◽  
Vol 2017 ◽  
pp. 1-11
Author(s):  
Cheuk-Lik Wong ◽  
Ho-Kee Vicki Tam ◽  
Chun-Kit Vincent Fok ◽  
Pong-Kai Ellen Lam ◽  
Lai-Ming Fung
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Significant Proportion ◽  
Persistent Atrial Fibrillation ◽  
High Rate ◽  
Factors Associated ◽  
History Of ◽  
Reduce Risk ◽  
Free Thyroxine Level

Background. Atrial fibrillation (AF) is one of the commonest cardiovascular manifestations of thyrotoxicosis. A significant proportion of patients have persistent AF which may have long term consequences, for example, ischemic stroke. Methods. We performed a retrospective cohort study in a regional hospital from January 2004 to June 2016 to examine the clinical characteristics and outcomes of thyrotoxic patients who presented with atrial fibrillation and to investigate possible factors associated with persistent atrial fibrillation and ischemic stoke. Results. Among 1918 patients who had a diagnosis of thyrotoxicosis, 133 (6.9%) patients presented with AF. Spontaneous sinus conversion occurred in 89 (66.9%) patients in which 85 (94%) patients developed sinus conversion before or within 6 months after having achieved euthyroidism. The remaining 44 (33.1%) had persistent AF. The rate of ischemic stroke was numerically higher among patients who had persistent AF than those with spontaneous sinus conversion (15.9% versus 10.1%; log-rank 0.442, p=0.506). Patients who sustained an ischemic stroke were older (71 ± 11 years versus 62 ± 16 years, p=0.023) and had a trend towards higher CHA2DS2-VASc score (2.9 ± 1.7 versus 2.3 ± 1.7, p=0.153). History of smoking (adjusted odds ratio 4.9, 95% CI [1.8,14.0], p=0.002), a larger left atrial diameter (adjusted odd ratio 2.6, 95% CI [1.2,5.5], p=0.014), and a relatively lower free thyroxine level at diagnosis (adjusted odd ratio 2.1, 95% CI [1.2,3.5], p=0.008) were associated with persistence of AF on multivariate analysis. Conclusion. Persistence of thyrotoxic AF occurred in one-third of patients and spontaneous sinus conversion was unlikely after six months of euthyroidism. High rate of ischemic stroke was observed among patients with persistent thyrotoxic AF and older age. Patients with factors associated with persistent AF, especially older people, should be closely monitored beyond 6 months so that anticoagulation can be initiated in a timely manner to reduce risk of ischemic stroke.

scholarly journals Factors associated with HIV and syphilis screenings among pregnant women at first antenatal visit in Lusaka, Zambia

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Rindcy Davis ◽  
Xu Xiong ◽  
Fernando Althabe ◽  
John Lefante ◽  
Maria Luisa Cafferata ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Older Women ◽  
Prevalence Ratio ◽  
Married Women ◽  
Antenatal Visit ◽  
Hiv Screening ◽  
Previous Pregnancy ◽  
Younger Women ◽  
Factors Associated ◽  
Syphilis Screening

Abstract Objectives To identify characteristics associated with obtaining HIV and syphilis screenings of pregnant women attending a first antenatal visit in Lusaka, Zambia. Results Among 18,231 participants from April 2015 to January 2016, 95% obtained HIV screening, 29% obtained syphilis screening, and 4% did not obtain antenatal HIV or syphilis screenings. Divorced/separated women were associated with a moderate decrease in prevalence of obtaining HIV (adjusted prevalence ratio (aPR) 0.88, 95% confidence interval (95% CI) 0.82, 0.95) and syphilis (aPR 0.51, 95% CI 0.27, 0.96) screenings compared to married women. Women with previous pregnancies were associated with a slight decrease in prevalence of obtaining HIV screening (aPR 0.97, 95% CI 0.95, 0.99) compared to women without previous pregnancy. Older women ≥ 35 years were associated with a slight decrease in prevalence of obtaining HIV screening (aPR 0.96, 95% CI 0.92, 0.99) compared to younger women. The statistically significant differences were not of clinical relevance as defined by a proportional difference of 10 percent. Findings of this study show that a vast majority of pregnant women are obtaining HIV screenings but not syphilis screenings during first antenatal visit. Provision of antenatal HIV and syphilis screening at first visit is only weakly related to patient level factors.

scholarly journals Risk Factors Associated with Gestational Diabetes among Pregnant Women in Owerri Municipal Council, Southeastern Nigeria

2013 ◽  
Vol 5 (1) ◽  
pp. 39-46 ◽  
Author(s):  
JC Nwaokoro ◽  
CO Emerole ◽  
SNO Ibe ◽  
AN Amadi ◽  
INS Dozie
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Significant Relationship ◽  
Previous History ◽  
Southeastern Nigeria ◽  
Family History Of Diabetes ◽  
Factors Associated ◽  
History Of

Background Gestational diabetes is emerging as a serious public health problem in Nigeria where the largest number of people with diabetes in Africa occurs. Current studies in Nigeria give an overall prevalence of gestational diabetes as 13.4% among pregnant women with unidentified risk factors. Aims and Objectives This study aimed at investigating the risk factors associated with gestational diabetes. Materials and Methods A cross-section analytical study design was adopted for this research and comprising a total of 100 pregnant women receiving ante-natal health care service at the Federal Medical Center, Owerri. A structured questionnaire including a set of detailed pre-determined questions was administered on the subjects. Data collected were analyzed statistically, using chi-square and T test. Results The results obtained suggest that there is a significant relationship (p<0.05) between previous macrosomic baby, parity, previous history of caesarean section, family history of diabetes and occurrence of gestational diabetes, respectively. However, there is no significant relationship (p>0.05) between history of miscarriages and stillbirth, socioeconomic status and occurrence of gestational diabetes. A family history of diabetes is independently and significantly associated with the development of gestational diabetes itself even after adjusting for other risk factors. Conclusion This study will be a working tool to guide obstetricians and midwives in counseling and advising women of their risk of developing GDM. DOI: http://dx.doi.org/10.3126/ajms.v5i1.8302 Asian Journal of Medical Science Vol.5(1) 2014 pp.39-46  

scholarly journals Do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? A cross-sectional study from Kampala, Uganda

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Angella Atukunda ◽  
Mwaka Amos Deogratius ◽  
Emmanuel Arinaitwe ◽  
Philip Orishaba ◽  
Moses R. Kamya ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Diagnostic Test ◽  
Clinical Management ◽  
Tertiary Education ◽  
Health Centre ◽  
Significant Proportion ◽  
Management Guidelines ◽  
Factors Associated ◽  
Diagnostic Practices ◽  
History Of

Abstract Background Uganda's clinical management guidelines recommend a malaria laboratory test in all patients presenting with fever (history of fever or an axillary temperature ≥ 37.5 °C), and only those with a positive test receive anti-malarial treatment. However, the current practice in areas with declining malaria transmission remains unknown. This study assessed the clinicians’ diagnostic practices, the factors associated with recommending a test, and the risk of missing a malaria case when a test is not recommended in patients presenting with fever in Kampala, an area of declining malaria transmission in Uganda. Methods Between January and March 2020, 383 participants aged ≥ 12 years and presenting to Kisenyi Health Centre IV in Kampala district with fever were enrolled in the study. A questionnaire was administered during exit interviews, routine diagnostic practices were recorded from participant clinical notes, and a research blood slide was obtained for later reading. Results Of the enrolled participants, 356 (93%) had a malaria diagnostic test recommended by the clinician. Factors associated with increasing prevalence of having a test recommended included; history of overnight travel (adjusted prevalence ratio [aPR] 1.07, 95% confidence interval [CI] 1.02–1.13, p = 0.011), being married (aPR = 1.07, 95% CI 1.01–1.13, p = 0.022), and having tertiary education (aPR = 1.09 95% CI 1.01–1.17, p = 0.031). Among the 27 participants where a malaria diagnostic test was not recommended, 4 (14.8%) had a positive study smear. Conclusion Despite having significant declines in malaria transmission in Kampala in the last decade, clinicians at the study health facility highly adhered to the clinical management guidelines, recommending a malaria test in almost all patients presenting with fever. However, a significant proportion of malaria cases was missed when a test was not recommended. These results highlight the importance of laboratory testing for malaria in all patients who present with fevers and live in endemic settings even when the transmission has significantly declined.

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