scholarly journals Validation of Maternal Recall of Iron Folic Supplementation During Antenatal Care in Rural Southern Nepal

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 722-722
Author(s):  
Emily Bryce ◽  
Joanne Katz ◽  
Melinda K Munos ◽  
Tsering Lama ◽  
Subarna Khatry ◽  
...  

Abstract Objectives This study's primary objective is to examine the validity of maternal recall of iron folate supplementation during antenatal care and factors associated with accuracy of maternal recall. Methods A longitudinal cohort design was employed for the validation study. The direct observation of all iron folate supplementation (IFA) received during all antenatal care visits at the five study health posts served as the “gold standard” to the maternal report of IFA received collected during a postpartum interview. Individual-level validity was assessed by calculating indicator sensitivity, specificity and area under the receiver operating curve (AUC). The inflation factor (IF) measured population-level bias, comparing the true coverage to the survey measure (maternal report) coverage of IFA. A multivariable log-binomial model was used to assess factors associated with accurate recall. Results The majority (95.8%) of women were observed receiving IFA during pregnancy. Women overreported the number IFA tablets received compared to what was observed during ANC visits. On average the reported number of tablets received was 45 tablets greater than the number observed. Individual-level accuracy of maternal report of any IFA receipt was moderate (AUC = 0.60) and population bias was low (IF = 1.01). However, the individual-level validity was poor across the seven IFA tablet count categories; the AUC for categories ranged from 0.47 to 0.58, indicating a performance that at best was slightly better than a random guess and at worst, misleading. Driven by the trend of maternal overreport, the inflation factor indicated that the survey measure drastically underestimated the prevalence of lower tablet categories and overestimated the prevalence of higher tablet counts. Accuracy of maternal report was not associated with months since last ANC observation nor any maternal characteristics. Conclusions Maternal report of the amount IFA supplementation received during pregnancy produced extremely biased population prevalence and performed comparably to or worse than a random guess for individual level validity. It's imperative to improve this indicator for future use, as it is included in global frameworks, initiatives and national program planning. Funding Sources This research was funded by the Bill and Melinda Gates Foundation.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Negeso Gebeyehu Gejo ◽  
Melaku Tesfaye W/mariam ◽  
Biruk Assefa Kebede ◽  
Ritbano Ahmed Abdo ◽  
Abebe Alemu Anshebo ◽  
...  

Abstract Background Preterm birth is defined as the birth of a baby before 37 completed weeks of gestation. Worldwide, prematurity is the second foremost cause of death in children under the age of 5 years. Preterm birth also gives rise to short and long term complications. Therefore, the primary aim of this study was to identify the factors associated with preterm birth in Wachemo University Nigist Eleni Mohammed Memorial referral hospital, Hadiya Zone, Southern Ethiopia. Methods An institution-based unmatched case-control study was conducted from July 01, 2018 to June 30, 2019 among mothers who gave birth in Wachemo University Nigest Eleni Mohammed Memorial referral hospital. A retrospective one-year data was retrieved from medical records of mothers with their index neonates. Simple random sampling technique was employed to recruit study participants. SPSS version 20 software was used for data entry and computing statistical analysis. Both bivariable and multivariable logistic regression analyses were used to determine the association of each independent variable with the dependent variable. Odds ratio with their 95% confidence intervals was computed to identify the presence and strength of association, and statistical significance was affirmed if p < 0.05. Result The current study evaluated 213 medical records of mothers with index neonates (71 cases and 142 controls). Urban residency [AOR = 0.48; 95% Cl; 0.239, 0.962], antenatal care follow up [AOR = 0.08; 95 Cl; 0.008, 0.694], premature rupture of membranes [AOR = 3.78; 95% Cl; 1.467, 9.749], pregnancy induced hypertension [AOR = 3.77; 95% Cl; 1.408, 10.147] and multiple pregnancies [AOR = 5.53; 95% Cl; 2.467, 12.412] were the factors associated with preterm birth. More than one-third (36.6%) preterm neonates died in the present study. Conclusions The present study found that urban residency, antenatal care follow up, premature rupture of membranes, pregnancy induced hypertension and multiple pregnancies were factors associated with preterm birth. The mortality among preterm neonates is high. Enhancing antenatal care follow up and early detection and treatment of disorders among pregnant women during antenatal care and undertaking every effort to improve outcomes of preterm birth and reduce neonatal mortality associated with prematurity is decisive.


Foods ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 681
Author(s):  
Nora A. Althumiri ◽  
Mada H. Basyouni ◽  
Ali F. Duhaim ◽  
Norah AlMousa ◽  
Mohammed F. AlJuwaysim ◽  
...  

Background: Food waste and food insecurity may co-exist in various balances in developing and developed countries. This study aimed to explore the levels of food waste and food insecurity, the factors associated with them, and their relationships at the household and individual levels in Saudi Arabia. Methods: This study was a nationwide cross-sectional survey conducted via computer-assisted phone interviews in January 2021. Quota sampling was utilized to generate balanced distributions of participants by gender across all the administrative regions of Saudi Arabia. Data collection included household demographics, food waste and disposal, the Food Insecurity Experience Scale (FIES), and the Household Food Insecurity Access Scale (HFIAS). Results: Out of the 2807 potential participants contacted, 2454 (87.4%) completed the interview. The mean age was 31.4 (SD = 11.7; range = 18–99) and 50.1% were female. The weighted prevalence of uncooked food waste in the last four weeks was 63.6% and the cooked food waste was 74.4%. However, the food insecurity weighted prevalence at the individual level (FIES) was 6.8%. In terms of food insecurity at the household level (HFIAS), 13.3% were in the “severely food insecure” category. Moreover, this study found that “moderately food insecure” households were associated with an increased likelihood to waste uncooked food (relative risk (RR) = 1.25), and the “mildly food insecure” (RR = 1.21) and “moderately food insecure” (RR = 1.17) households were associated with an increased likelihood to waste cooked food. However, “food secure” households were associated with a decreased likelihood to waste cooked food (RR = 0.56). Finally, this study identified four household factors associated with food waste and three household factors that were associated with “severe food insecurity.” Conclusions: This first national coverage study to explore food waste and food insecurity at the individual level and household level, identified household factors associated with food waste and food insecurity and identified new associations between food waste and food insecurity in Saudi Arabia. The associations found between food waste and food insecurity are potential areas of intervention to reduce both food waste and food insecurity at the same time, toward achieving the Sustainable Development Goal (SDG) targets related to food waste and food security.


2020 ◽  
Vol 5 (12) ◽  
pp. e002169
Author(s):  
Ngatho Samuel Mugo ◽  
Kyaw Swa Mya ◽  
Camille Raynes-Greenow

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.


2021 ◽  
pp. 875512252110117
Author(s):  
Jesus Ruiz Ramos ◽  
Laura Gras-Martin ◽  
Ana María Juanes Borrego ◽  
Marta Blazquez-Andion ◽  
Mireia Puig Campmany ◽  
...  

Background: Drug-related problems (DRPs) are a frequent reason for emergency departments (EDs) visits. However, data about the risk factors associated with EDs revisits are limited. Objective: To develop and validate a predictive model indicating the risk factors associated with EDs revisit within 30 days of the first visit. Methods: A retrospective cohort study was conducted involving patients who attended an ED for DRPs related to cardiovascular drugs. A 30-day prediction model was created in a derivation cohort by logistic regression. An integer score proportional to the regression coefficient was assigned to the variables with P < .100 in the multivariate analysis. Results: 581 patients (mean age: 80.0 [12.6] years) were included, 133 (22.9%) revisited the ED within 30 days from discharge. Six factors (chronic kidney disease, chronic heart failure, visit to an ED in the preceding 3 months, high anticholinergic burden, DRPs associated with heparin, and safety-related DRPs) were identified as risk factors and combined into a final score, termed the DREAMER score. The model reached an area under the receiver operating curve values of 0.72 (95% confidence interval [CI] = 0.67-0.77) in the referral cohort and 0.71 (95% CI = 0.65-0.74) in the validation cohort ( P = .273). Three risk categories were generated, with the following scores and estimated risks: low risk (0-8 points): 11.6%; intermediate risk (9-14 points): 21.3%; and high risk (>14 points): 41.2%. Conclusion and Relevance: The DREAMER score identifies patients at high risk for ED revisit within 30 days from the first visit for a DRPs, being a useful tool to prioritize interventions on discharge.


Parasitology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Cleya da Silva Santana Cruz ◽  
David Soeiro Barbosa ◽  
Vinícius Cunha Oliveira ◽  
Diogo Tavares Cardoso ◽  
Nathália Sernizon Guimarães ◽  
...  

Abstract Visceral leishmaniasis (VL) is endemic in 70 countries and has been reported in 12 countries of Latin America, with over 90% of the cases reported in Brazil, where epidemics have occurred since 1980. The objective of this review is to describe the factors associated with the occurrence of VL epidemics in humans in urban areas. A systematic review was conducted according to the PRISMA-P guidelines. The databases PubMed (by Medline), Cochrane Library, Embase, Amed, LILACS and grey literature [Google Scholar and handsearch of the database of the Information System for Notifiable Diseases (SINAN) of Brazil's Unified Health System] were used. The protocol was registered under PROSPERO (CRD42019128998). Climatic, environmental factors and indicators of urban social structure were described as influencing the outbreaks in the North and Northeast regions. Gender and age characteristics were related to a greater chance of developing VL in the Central-West, Northeast and Southeast regions. Vector indicators showed a positive correlation with the incidence of VL in studies in the Northeast region. In the Southeast and Northeast regions, studies revealed the presence of dogs with positive correlation with VL. Knowledge gaps remain regarding the contribution to the increase in the risk factors described in ecological approaches, as no analysis was performed at the individual level, and it is still necessary to discuss the influence of other associated elements in epidemic episodes in the spread of VL.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsegaye Gebremedhin ◽  
Demiss Mulatu Geberu ◽  
Asmamaw Atnafu

Abstract Background The burden of low coverage of exclusive breastfeeding (EBF) has a significant impact on the health of a newborn and also on the family and social economy in the long term. Even though the prevalence of EBF practices in Ethiopia is low, the practices in the pastoral communities, in particular, are significantly low and affected by individual and community-level factors. Besides, its adverse outcomes are mostly unrecognised. Therefore, this study aimed to assess the individual and community-level factors of low coverage of EBF practices in the emerging regions of Ethiopia. Methods In this analysis, data from 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A two-stage stratified sampling technique was used to identify 1406 children aged 0 to 23 months in the emerging regions of Ethiopia. A multilevel mixed-effect binary logistic regression analysis was used to determine the individual and community level factors associated with exclusive breastfeeding practices. In the final model, variables with a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were found to be statistically significant factors that affect exclusive breastfeeding practices. Results Overall, 17.6% (95% CI: 15.6–19.6) of the children aged 0 to 23 months have received exclusive breastfeeding. Employed mothers (AOR: 0.33, 95% CI: 0.21–0.53), richer household wealth status (AOR: 0.39, 95% CI: 0.16–0.96), mothers undecided to have more children (AOR: 2.29, 95% CI: 1.21–4.29), a child with a history of diarrhoea (AOR: 0.31, 95% CI: 0.16–0.61) were the individual-level factors, whereas Benishangul region (AOR: 2.63, 95% CI: 1.44–4.82) was the community-level factors associated with the exclusive breastfeeding practices. Conclusions Less than one-fifth of the mothers have practised exclusive breastfeeding in the emerging regions of Ethiopia. The individual-level factors such as mother’s employment status, household wealth status, desire for more children, presence of diarrhoea and community-level factors such as region have contributed to the low coverage of exclusive breastfeeding. Therefore, the federal and regional health bureaus and other implementers should emphasise to those emerging regions by creating awareness and strengthening the existing community-based health extension program to enhance exclusive breastfeeding practices.


2019 ◽  
Vol 5 ◽  
pp. 237802311987979 ◽  
Author(s):  
George Wood ◽  
Daria Roithmayr ◽  
Andrew V. Papachristos

Conventional explanations of police misconduct generally adopt a microlevel focus on deviant officers or a macrolevel focus on the top-down organization of police departments. Between these levels are social networks of misconduct. This study recreates these networks using data on 16,503 complaints and 15,811 police officers over a six-year period in Chicago. We examine individual-level factors associated with receiving a complaint, the basic properties of these misconduct networks, and factors related to officer co-naming in complaints. We find that the incidence of police misconduct is associated with attributes including race, age, and tenure and that almost half of police officers are connected in misconduct ties in broader networks of misconduct. We also find that certain dyadic factors, especially seniority and race, strongly predict network ties and the incidence of group misconduct. Our results provide actionable information regarding possible ways to leverage the co-complaint network structure to reduce misconduct.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Justine B. Daly ◽  
Sarah Dowe ◽  
Belinda Tully ◽  
Flora Tzelepis ◽  
Christophe Lecathelinais ◽  
...  

Abstract Background Acceptance of smoking cessation support during antenatal care and associated quitting behaviours of pregnant Aboriginal women or women having an Aboriginal baby has not been investigated. This study aimed to determine, among pregnant women who smoke and attended AMIHS for their antenatal care: The acceptance of smoking cessation support, factors associated with acceptance and barriers to acceptance; The prevalence of quitting behaviours and factors associated with quitting behaviours. Methods A cross-sectional telephone survey of women who attended 11 AMIHSs for their antenatal care during a 12 month period in the Hunter New England Local Health District of New South Wales. Results One hundred women contacted consented to complete the survey (76%). Of those offered cessation support, 68% accepted NRT, 56% accepted follow-up support and 35% accepted a Quitline referral. Participants accepting NRT had greater odds of quitting smoking at least twice during the antenatal period [OR = 6.90 (CI: 1.59–29.7)] and those reporting using NRT for greater than eight weeks had six times the odds of quitting smoking for one day or more [OR = 6.07 (CI: 1.14–32.4)]. Conclusions Aboriginal women or women having an Aboriginal baby who smoke make multiple attempts to quit during pregnancy and most women accept smoking cessation support when offered by their antenatal care providers. Acceptance of care and quitting success may be improved with increased focus on culturally appropriate care and enhanced training of antenatal care providers to increase skills in treating nicotine addiction and supporting women to use NRT as recommended by treatment guidelines.


2020 ◽  
Vol 4 (3) ◽  
pp. 01-12
Author(s):  
Martin Malick

Background: Anemia in pregnancy is a major public health problem especially in Low and Middle-income countries (LMIC) including Ghana and is defined by the World Health Organization (WHO) as being present when the hemoglobin concentration in the peripheral blood is 11g/dl or less. In most African countries anemia in pregnancy occurs if the hemoglobin concentration falls below 10g/dl. Pregnant women are at a higher risk of developing anemia due to several factors such as hemodilution, nutritional factors, multiple gestation, socio-economic status and malaria infestation. Anemia in pregnancy is an important cause of maternal mortality and affects half of pregnant women worldwide; with 56% of West African pregnant women being anemic. The objective of this study is to assess the prevalence and identify the risk factors associated with anemia among pregnant women receiving antenatal care at the West Gonja Hospital (WGH) Methods: A cross-sectional was conducted with 136 pregnant women receiving antenatal care at the WGH between January 2017 to February 2018. Random sampling was used to select participants and data was collected using a structured questionnaire. Data was analyzed using the SPSS Version 24.0. Results: A total 71(52.2%) of the study population were anemic, while 65 (47.8%) were not anemic. 20(74.1%) of the 27 pregnant housewives were anemic, while 11(64.7%) of the pregnant farmers were anemic. 27 (96.4%) of the 28 pregnant women who took their iron/folate supplement only some few days were anemic. 12 (100%) of the 12 participants who took their iron/folate supplement a few times a week were anemic. 4 (80%) of the 5 participants who never took their iron/folate supplement were anemic. 21 (70%) of those who did not sleep under ITN were anemic. 33 (84.6%) of the 39 patients who were diagnosed with malaria were also anemic. 28 (87.5%) of the 32 participants who took only 2 meals a day were anemic. 27 (79.4%) of the 34 patients who took liver, beef, chicken and fish only twice weekly were anemic. 15 (88.2%) of the 17 patients who drank tea some days in a week were anemic. Conclusion: Although most of the pregnant women were adequately educated on the most relevant aspects of anemia in pregnancy, more than half of them were still anemic. Anemia was more prevalent among pregnant uneducated housewives with poor nutritional habits. All the pregnant sickle cell disease patients as well as those diagnosed with malaria were also anemic.


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