scholarly journals 1344Interbirth interval and maternal anaemia in 21 sub-Saharan African countries: a multinational cross-sectional study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Kalayu Brhane Mruts ◽  
Gizachew Assefa Tessema ◽  
Amanuel Tesfay Gebremedhin ◽  
Jane Scott ◽  
Gavin Pereira

Abstract Background Anaemia is a global public health problem, which disproportionately affects women in sub-Saharan Africa (SSA). The causes of anaemia are multifactorial, and a short interbirth interval has been identified as a potentially modifiable risk factor. However, the current evidence for the association between interbirth interval and maternal anaemia remains inconclusive. Hence, this study aimed at examining the association between the interbirth interval and maternal anaemia in SSA. Methods We conducted a multinational cross-sectional study of interbirth interval (time between two singleton live births) and maternal anaemia for 21 SSA countries using the most recent nationally representative Demographic and Health Surveys, 2010-2017. Modified Poisson regression models were used to estimate the relative risk (RR) and 95% confidence intervals (CIs) after adjusting for confounding variables. Results There were 81,693 women included in the study (89.2% nonpregnant, 10.8% pregnant and 32.2% postpartum). Overall, 36.9% of women had anaemia (36.0% of non-pregnant, 44.3% pregnant, and 38.7% of postpartum women). Compared to a 24-35 months interbirth interval, maternal anaemia was not associated with short (<24 months) interbirth intervals (aRR 1.01, 95% CI; 0. 98, 1.04) or long (≥60 months) interbirth interval (aRR 1.00, 95% CI 0.96, 1. 04). Conclusions Our finding revealed insufficient evidence that both short and long birth intervals were associated with the risk of maternal anaemia in SSA. Key messages It is unlikely that the high prevalence of maternal anaemia in SSA can be reduced by avoiding short nor long interbirth intervals.

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045992
Author(s):  
Eugene Budu ◽  
Bright Opoku Ahinkorah ◽  
Richard Gyan Aboagye ◽  
Ebenezer Kwesi Armah-Ansah ◽  
Abdul-Aziz Seidu ◽  
...  

ObjectiveThe objective of the study was to examine the association between maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa.DesignOur study was a cross-sectional study that used pooled data from 29 countries in sub-Saharan Africa.ParticipantsA total of 60 964 mothers of children aged 11–23 months were included in the study.Outcome variablesThe main outcome variable was complete childhood vaccination. The explanatory variables were number of antenatal care (ANC) visits, assistance during delivery and postnatal care (PNC).ResultsThe average prevalence of complete childhood vaccination was 85.6%, ranging from 67.0% in Ethiopia to 98.5% in Namibia. Our adjusted model, children whose mothers had a maximum of three ANC visits were 56% less likely to have complete vaccination, compared with those who had at least four ANC visits (adjusted OR (aOR)=0.44, 95% CI 0.42 to 0.46). Children whose mothers were assisted by traditional birth attendant/other (aOR=0.43, 95% CI 0.41 to 0.56) had lower odds of complete vaccination. The odds of complete vaccination were lower among children whose mothers did not attend PNC clinics (aOR=0.26, 95% CI 0.24 to 0.29) as against those whose mothers attended.ConclusionThe study found significant variations in complete childhood vaccination across countries in sub-Saharan Africa. Maternal healthcare utilisation (ANC visits, skilled birth delivery, PNC attendance) had significant association with complete childhood vaccination. These findings suggest that programmes, interventions and strategies aimed at improving vaccination should incorporate interventions that can enhance maternal healthcare utilisation. Such interventions can include education and sensitisation, reducing cost of maternal healthcare and encouraging male involvement in maternal healthcare service utilisation.


PLoS ONE ◽  
2016 ◽  
Vol 11 (10) ◽  
pp. e0164052 ◽  
Author(s):  
Ibitola O. Asaolu ◽  
Jayleen K. Gunn ◽  
Katherine E. Center ◽  
Mary P. Koss ◽  
Juliet I. Iwelunmor ◽  
...  

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031322
Author(s):  
Agnès Esiéné ◽  
Paul Owono Etoundi ◽  
Joel Noutakdie Tochie ◽  
Junette Arlette Mbengono Metogo ◽  
Jacqueline Ze Minkande

IntroductionPulmonary embolism poses one of the most challenging diagnoses in medicine. Resolving these diagnostic difficulties is more crucial in emergency departments where fast and accurate decisions are needed for a life-saving purpose. Here, clinical pretest evaluation is an important step in the diagnostic algorithm of pulmonary embolism. Although clinical probability scores are widely used in emergency departments of sub-Saharan Africa, no study has cited their diagnostic performance in this resource-constrained environment. This study will seek to assess the performance of four routinely used clinical prediction models in Cameroonians presenting with suspicion of pulmonary embolism at the emergency department.Methods and analysisIt will be a cross-sectional study comparing the sensitivity, specificity, positive and negative predictive values and accuracy of the Wells, Simplified Wells, Revised Geneva and the Simplified Revised Geneva Scores to CT pulmonary angiography as gold standard in all consecutive consenting patients aged above 15 years admitted for clinical suspicion of pulmonary embolism to the emergency departments of seven major referral hospitals of Cameroon between 1 July 2019 and 31 December 2020. The area under the receiver operating curve, calibration plots, Hosmer and Lemeshow statistics, observed/expected event rates, net benefit and decision curve will be measured of each the clinical prediction test to ascertain the clinical score with the best diagnostic performance.Ethics and disseminationClearance has been obtained from the Institutional Review Board of the Faculty of medicine and biomedical sciences of the University of Yaounde I, Cameroon and the directorates of all participating hospitals to conduct this study. Also, informed consent will be sought from each patient or their legal next of kin and parents for minors, before enrolment into this study. The final study will be published in a peer-review journal and the findings presented to health authorities and healthcare providers.


2016 ◽  
Vol 194 (1) ◽  
pp. 67-76 ◽  
Author(s):  
Jamilah Meghji ◽  
Gilbert Nadeau ◽  
Kourtney J. Davis ◽  
Duolao Wang ◽  
Moffat J. Nyirenda ◽  
...  

2021 ◽  
Author(s):  
Jyoti Dalal ◽  
Isotta Triulzi ◽  
Ananthu James ◽  
Benedict Nguimbis ◽  
Gabriela Guizzo Dri ◽  
...  

Objective: To investigate differences of COVID-19 related mortality among women and men across sub-Saharan Africa (SSA) from the beginning of the pandemic. Design: A cross sectional study. Setting: Data from 20 member nations of the WHO African region until September 1, 2020. Participants: 69,580 cases of COVID-19, stratified by sex (men, n=43071; women, n=26509) and age (0-39 years, n=41682; 40-59 years, n=20757; 60+ years, n=7141). Main outcome measures: We computed the SSA- and country-specific case fatality rates (CFRs) and sex-specific CFR differences across various age groups, using a Bayesian approach. Results: A total of 1,656 (2.4% of total cases reported; 1656/69580) deaths were reported, with men accounting for 1168/1656 (70.5%) of total deaths. In SSA, women had a lower CFR than men (mean CFR<diff> = -0.9%; 95% credible intervals -1.1% to -0.6%). The mean CFR estimates increased with age, with the sex-specific CFR differences being significant among those aged 40 or more (40-59 age-group: mean CFR<diff> = -0.7%; 95% credible intervals -1.1% to -0.2%; 60+ age-group: mean CFR<diff> = -3.9%; 95% credible intervals -5.3% to -2.4%). At the country level, seven of the twenty SSA countries reported significantly lower CFRs among women than men overall. Moreover, corresponding to the age-specific datasets, significantly lower CFRs in women than men were observed in the 60+ age-group in seven countries and 40-59 age-group in one country. Conclusions: Sex and age are important predictors of COVID-19 mortality. Countries should prioritize the collection and use of sex-disaggregated data to understand the evolution of the pandemic. This is essential to design public health interventions and ensure that policies promote a gender sensitive public health response.


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