The Role of Intraoperative Fluid Optimization Using the Esophageal Doppler in Advanced Gynecological Cancer: Early Postoperative Recovery and Fitness for Discharge

ObjectiveTo determine the effect of fluid optimization using esophageal Doppler monitoring (EDM) when compared to standard fluid management in women who undergo major gynecological cancer surgery and whether its use is associated with reduced postoperative morbidity.MethodsFrom January 2009 to December 2010, women undergoing laparotomy for pelvic masses or uterine cancer had either fluid optimization using intraoperative EDM or standard fluid replacement without using EDM. Cases were selected from 2 surgeons to control for variability in surgical practice. Demographic and surgical details were collected prospectively. Univariate and multivariate analyses were performed to quantify the association between the use of EDM with “early postoperative recovery” and “early fitness for discharge.”ResultsA total of 198 women were operated by the 2 prespecified surgeons; 79 women had fluid optimization with EDM, whereas 119 women had standard anesthetic care. The use of ODM was associated with earlier postoperative recovery (adjusted odds ratio, 2.83; 95% confidence interval, 1.20–6.68; P = 0.02) and earlier fitness for discharge (adjusted odds ratio, 2.81; 95% confidence interval, 1.01–7.78; P = 0.05). Women with advanced-stage disease in the “EDM” group resumed oral diet earlier than women in the “no EDM” group (median, 1 day vs 2 days; P = 0.02). These benefits with EDM did not extend to women with early-stage disease/benign/borderline tumors. No significant difference in postoperative complications was noted.ConclusionsIntraoperative fluid optimization with EDM in women with advanced gynecological cancer may be associated with improved postoperative recovery and early fitness for discharge. Studies with adequate power are needed to investigate its role in reducing postoperative complications.

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Sex modulates the association of radial artery augmentation index with renal function decline in individuals without chronic kidney disease

International Urology and Nephrology ◽

10.1007/s11255-020-02776-5 ◽

2021 ◽

Author(s):

Qiao Qin ◽

Fangfang Fan ◽

Jia Jia ◽

Yan Zhang ◽

Bo Zheng

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Arterial Stiffness ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Augmentation Index ◽

Renal Function Decline

Abstract Purpose An increase in arterial stiffness is associated with rapid renal function decline (RFD) in patients with chronic kidney disease (CKD). The aim of this study was to investigate whether the radial augmentation index (rAI), a surrogate marker of arterial stiffness, affects RFD in individuals without CKD. Methods A total of 3165 Chinese participants from an atherosclerosis cohort with estimated glomerular filtration rates (eGFR) of ≥ 60 mL/min/1.73 m2 were included in this study. The baseline rAI normalized to a heart rate of 75 beats/min (rAIp75) was obtained using an arterial applanation tonometry probe. The eGFRs at both baseline and follow-up were calculated using the equation derived from the Chronic Kidney Disease Epidemiology Collaboration. The association of the rAIp75 with RFD (defined as a drop in the eGFR category accompanied by a ≥ 25% drop in eGFR from baseline or a sustained decline in eGFR of > 5 mL/min/1.73 m2/year) was evaluated using the multivariate regression model. Results During the 2.35-year follow-up, the incidence of RFD was 7.30%. The rAIp75 had no statistically independent association with RFD after adjustment for possible confounders (adjusted odds ratio = 1.12, 95% confidence interval: 0.99–1.27, p = 0.074). When stratified according to sex, the rAIp75 was significantly associated with RFD in women, but not in men (adjusted odds ratio and 95% confidence interval: 1.23[1.06–1.43], p = 0.007 for women, 0.94[0.76–1.16], p = 0.542 for men; p for interaction = 0.038). Conclusion The rAI might help screen for those at high risk of early rapid RFD in women without CKD.

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Pulmonary restriction predicts long-term pulmonary impairment in people with HIV and tuberculosis

BMC Pulmonary Medicine ◽

10.1186/s12890-020-01368-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara C. Auld ◽

Hardy Kornfeld ◽

Pholo Maenetje ◽

Mandla Mlotshwa ◽

William Chase ◽

...

Keyword(s):

Lung Function ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Logistic Regression Models ◽

Pulmonary Impairment ◽

Mixed Pattern

Abstract Background While tuberculosis is considered a risk factor for chronic obstructive pulmonary disease, a restrictive pattern of pulmonary impairment may actually be more common among tuberculosis survivors. We aimed to determine the nature of pulmonary impairment before and after treatment among people with HIV and tuberculosis and identify risk factors for long-term impairment. Methods In this prospective cohort study conducted in South Africa, we enrolled adults newly diagnosed with HIV and tuberculosis who were initiating antiretroviral therapy and tuberculosis treatment. We measured lung function and symptoms at baseline, 6, and 12 months. We compared participants with and without pulmonary impairment and constructed logistic regression models to identify characteristics associated with pulmonary impairment. Results Among 134 participants with a median CD4 count of 110 cells/μl, 112 (83%) completed baseline spirometry at which time 32 (29%) had restriction, 13 (12%) had obstruction, and 9 (7%) had a mixed pattern. Lung function was dynamic over time and 30 (33%) participants had impaired lung function at 12 months. Baseline restriction was associated with greater symptoms and with long-term pulmonary impairment (adjusted odds ratio 5.44, 95% confidence interval 1.16–25.45), while baseline obstruction was not (adjusted odds ratio 1.95, 95% confidence interval 0.28–13.78). Conclusions In this cohort of people with HIV and tuberculosis, restriction was the most common, symptomatic, and persistent pattern of pulmonary impairment. These data can help to raise awareness among clinicians about the heterogeneity of post-tuberculosis pulmonary impairment, and highlight the need for further research into mediators of lung injury in this vulnerable population.

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Māori health outcomes in an intensive care unit in Aotearoa New Zealand

Anaesthesia and Intensive Care ◽

10.1177/0310057x21989715 ◽

2021 ◽

pp. 0310057X2198971

Author(s):

M Atif Mohd Slim ◽

Hamish M Lala ◽

Nicholas Barnes ◽

Robert A Martynoga

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

New Zealand ◽

Renal Replacement Therapy ◽

Confidence Interval ◽

Health Outcomes ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

One Year ◽

Maori Health

Māori are the indigenous people of New Zealand, and suffer disparate health outcomes compared to non-Māori. Waikato District Health Board provides level III intensive care unit services to New Zealand’s Midland region. In 2016, our institution formalised a corporate strategy to eliminate health inequities for Māori. Our study aimed to describe Māori health outcomes in our intensive care unit and identify inequities. We performed a retrospective audit of prospectively entered data in the Australian and New Zealand Intensive Care Society database for all general intensive care unit admissions over 15 years of age to Waikato Hospital from 2014 to 2018 ( n = 3009). Primary outcomes were in–intensive care unit and in-hospital mortality. The secondary outcome was one-year mortality. In our study, Māori were over-represented relative to the general population. Compared to non-Māori, Māori patients were younger (51 versus 61 years, P < 0.001), and were more likely to reside outside of the Waikato region (37.2% versus 28.0%, P < 0.001) and in areas of higher deprivation ( P < 0.001). Māori had higher admission rates for trauma and sepsis ( P < 0.001 overall) and required more renal replacement therapy ( P < 0.001). There was no difference in crude and adjusted mortality in–intensive care unit (16.8% versus 16.5%, P = 0.853; adjusted odds ratio 0.98 (95% confidence interval 0.68 to 1.40)) or in-hospital (23.7% versus 25.7%, P = 0.269; adjusted odds ratio 0.84 (95% confidence interval 0.60 to 1.18)). One-year mortality was similar (26.1% versus 27.1%, P=0.6823). Our study found significant ethnic inequity in the intensive care unit for Māori, who require more renal replacement therapy and are over-represented in admissions, especially for trauma and sepsis. These findings suggest upstream factors increasing Māori risk for critical illness. There was no difference in mortality outcomes.

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Nonadherence to tuberculosis treatment and associated factors among patients using directly observed treatment short-course in north-west Nigeria: A cross-sectional study

SAGE Open Medicine ◽

10.1177/2050312121989497 ◽

2021 ◽

Vol 9 ◽

pp. 205031212198949

Author(s):

Cylia Nkechi Iweama ◽

Olaoluwa Samson Agbaje ◽

Prince Christian Ifeanachor Umoke ◽

Chima Charles Igbokwe ◽

Eyuche Lawretta Ozoemena ◽

...

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Medication Nonadherence ◽

Cross Sectional ◽

Tuberculosis Patients ◽

North West ◽

Short Course ◽

Directly Observed Treatment

Introduction: Tuberculosis is a public health problem in Nigeria. One of the most effective ways of controlling tuberculosis is the directly observed treatment short-course. However, some factors influence tuberculosis patients’ treatment nonadherence via directly observed treatment short-course. The study objective was to assess medication nonadherence and associated factors among tuberculosis patients in north-west Nigeria. Methods: A cross-sectional study enrolled tuberculosis patients using directly observed treatment short-course in public health facilities in Kano and Kaduna States from January 2015 to June 2016. The sample selection was conducted via a multistage sampling procedure. Data were collected using tuberculosis patients’ demographic and clinical characteristics forms, well-validated structured instruments, and medical records. SPSS version 20 was used for data analysis. Logistic and multivariable logistic regression analyses to determine factors of medication nonadherence ( P < 0.05) Results: Complete responses from 390 patients out of the 460 patients recruited for the study were used for data analyses. The mean age was 51.5 (standard deviation = ±13.8) years. The mean tuberculosis medication adherence questionnaire score was 4.35 ± 1.12. The prevalence of nonadherence to tuberculosis medication was 30.5%. Multivariable logistic regression analysis showed that having a monthly income between #100,000 and #199, 000 (adjusted odds ratio = 0.01; 95% confidence interval: 0.00–0.13), being widowed (adjusted odds ratio = 26.74, 95% confidence interval: 2.92–232.9), being married (adjusted odds ratio = 120.49, 95% confidence interval: 5.38–271.1), having a distance <5 km to directly observed treatment short-course center from home (adjusted odds ratio = 0.06, 95% confidence interval: 0.00–0.01), having a tuberculosis/HIV co-infection (adjusted odds ratio = 0.01, 95% confidence interval: 0.12–0.35), use of antiretroviral treatment and cotrimoxazole prophylaxis therapy medications (adjusted odds ratio = 24.9, 95% confidence interval: 19.6–304.3) were associated with tuberculosis medication nonadherence. Conclusion: Tuberculosis medication nonadherence was high among the patients. Thus, patient-specific adherence education, attenuation of potential factors for tuberculosis medication nonadherence, and continual resource support for tuberculosis patients are needed to improve treatment outcomes.

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Factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda Northwest Ethiopia: A cross-sectional study

SAGE Open Medicine ◽

10.1177/2050312120978008 ◽

2020 ◽

Vol 8 ◽

pp. 205031212097800

Author(s):

Damtew Asrat ◽

Atsede Alle ◽

Bekalu Kebede ◽

Bekalu Dessie

Keyword(s):

Confidence Interval ◽

Traditional Medicine ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Medicine Use ◽

Community Based ◽

Cross Sectional ◽

Traditional Medicines ◽

Factors Associated

Background: Over the last 100 years, the development and mass production of chemically synthesized drugs have revolutionized health care in most parts of the world. However, large sections of the population in developing countries still depend on traditional medicines for their primary health care needs. More than 88% of Ethiopian parents use different forms of traditional medicine for their children. Therefore, this study aimed to determine factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda. Method: Community-based cross-sectional study was conducted from 1 to 30 March 2019 in Fagita Lekoma Woreda. Data collection tool was a structured interviewer-administered questionnaire. Both descriptive and inferential statistics were used to present the data. Odds ratio and binary and multiple logistic regression analysis were used to measure the relationship between dependent and independent variables. Results: Among 858 participants, 71% of parents had used traditional medicine for their children within the last 12 months. Parents who cannot read and write (adjusted odds ratio = 6.42, 95% confidence interval = 2.1–19.7), parents with low monthly income (adjusted odds ratio = 4.38, 95% confidence interval = 1.58–12.1), and those who had accesses to traditional medicine (adjusted odds ratio = 2.21, 95% confidence interval = 1.23–3.98) were more likely to use traditional medicine for their children. Urban residents (adjusted odds ratio = 0.20, 95% confidence interval = 0.11–0.38) and members of community-based health insurance (adjusted odds ratio = 0.421, 95% confidence interval = 0.211–0.84) were less likely to use traditional medicine for their children. Conclusions: Our study revealed that the prevalence of traditional medicine remains high. Educational status, monthly income, residence, accessibility to traditional medicine, and being a member of community-based health insurance were predictors of potential traditional medicine use. Therefore, the integration of traditional medicine with modern medicine should be strengthened. Community education and further study on efficacy and safety of traditional medicines should be also given great attention.

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Risk Factors for a Positive Hepatitis C Status in Fishermen in Kuantan Malaysia

Asia Pacific Journal of Public Health ◽

10.1177/1010539519841294 ◽

2019 ◽

Vol 31 (3) ◽

pp. 227-237

Author(s):

Priya Lall ◽

Rumana Saifi ◽

Diva Baggio ◽

Samantha Fitzsimmons Schoenberger ◽

Martin Choo ◽

...

Keyword(s):

Hepatitis C ◽

Confidence Interval ◽

Risk Taking ◽

Odds Ratio ◽

Large Scale ◽

Adjusted Odds Ratio ◽

Environmental Drivers ◽

Negative Effects ◽

Risk Taking Behaviors ◽

Risk Communities

Malaysia currently has an estimated hepatitis C virus (HCV) prevalence of 1.3% with an infected population of 384,000. Fishermen in Malaysia are at risk of HCV infection due to injection drug use and disproportionately high rates of incarceration. This study used quantitative data from Project WAVES, a large-scale mixed methods project charting environmental drivers of risk-taking behaviors among a respondent-driven sample of 406 fishermen in Malaysia. Over a quarter of participants (27.9%) reported injecting drugs in the past month; 49.8% of the sample tested positive for HCV. Respondents who had previously been arrested displayed increased odds of being HCV-positive (adjusted odds ratio = 4.79, confidence Interval = 2.46-9.35). Participants who reported being in lock-up displayed close to 6-fold odds of being HCV-infected (adjusted odds ratio = 5.49, confidence interval = 2.77-10.90, P < .001). These findings underscore the need for policies and structural interventions targeting the negative effects of aggressive incarceration contributing to the burden of HCV among high-risk communities.

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Regular STI testing amongst men who have sex with men and use social media is suboptimal – a cross-sectional study

International Journal of STD & AIDS ◽

10.1177/0956462416636780 ◽

2016 ◽

Vol 28 (6) ◽

pp. 573-583 ◽

Cited By ~ 6

Author(s):

Jamie Frankis ◽

Lisa Goodall ◽

Dan Clutterbuck ◽

Abdul-Razak Abubakari ◽

Paul Flowers

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Anal Intercourse ◽

Sex Partners ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Sti Testing ◽

Male Sex ◽

Sex With Men

Sexually transmitted infections (STIs) disproportionately affect men who have sex with men, with marked increases in most STIs in recent years. These are likely underpinned by coterminous increases in behavioural risks which have coincided with the development of Internet and geospatial sociosexual networking. Current guidelines advocate regular, annual sexually transmitted infection testing amongst sexually active men who have sex with men (MSM), as opposed to symptom-driven testing. This paper explores sexually transmitted infection testing regularity amongst MSM who use social and sociosexual media. Data were collected from 2668 men in Scotland, Wales, Northern Ireland and the Republic of Ireland, recruited via social and gay sociosexual media. Only one-third of participants report regular (yearly or more frequent) STI testing, despite relatively high levels of male sex partners, condomless anal intercourse and high-risk unprotected anal intercourse. The following variables were associated with regular STI testing; being more ‘out’ (adjusted odds ratio = 1.79; confidence interval = 1.20–2.68), HIV-positive (adjusted odds ratio = 14.11; confidence interval = 7.03–28.32); reporting ≥10 male sex partners (adjusted odds ratio = 2.15; confidence interval = 1.47–3.14) or regular HIV testing (adjusted odds ratio = 48.44; confidence interval = 28.27–83.01). Men reporting long-term sickness absence from work/carers (adjusted odds ratio = 0.03; confidence interval = 0.00–0.48) and men aged ≤25 years (adjusted odds ratio = 0.36; 95% confidence interval = 0.19–0.69) were less likely to test regularly for STIs. As such, we identify a complex interplay of social, health and behavioural factors that each contribute to men’s STI testing behaviours. In concert, these data suggest that the syndemics placing men at elevated risk may also mitigate against access to testing and prevention services. Moreover, successful reduction of STI transmission amongst MSM will necessitate a comprehensive range of approaches which address these multiple interrelated factors that underpin MSM's STI testing.

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An epidemiological investigation of the 2019 suspected pertussis outbreak in northwestern Nigeria

SAGE Open Medicine ◽

10.1177/20503121211008344 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110083

Author(s):

Omoleke Semeeh ◽

Biniam Getachew ◽

Yusuf Taofik ◽

Lukman Surajudeen ◽

Assad Hassan ◽

...

Keyword(s):

Confidence Interval ◽

Disease Transmission ◽

Attack Rate ◽

Odds Ratio ◽

Case Fatality Rate ◽

Adjusted Odds Ratio ◽

Case Fatality ◽

Immunization Coverage ◽

Fatality Rate ◽

Vaccine Preventable Diseases

Introduction: In 2019, we investigated the profile of the cases and controls and the determinants of pertussis transmission in Kebbi State, Northwestern Nigeria, to inform better immunization and surveillance strategies. Methods: Community-based unmatched case–control study and review of the 2019 pertussis routine surveillance data in the affected settlements in the state were conducted. A total of 52 suspected cases of pertussis and 107 control from two local government areas in Kebbi State were recruited. Data were analyzed using descriptive and inferential statistics. Results: The highest attack rate was observed among between 1- and 4-year age group followed by children less than 1-year old, and the least attack rate was among those above 15 years. The overall attack rate and the case fatality rate were 2.10% and 0.10%, respectively. A higher attack rate was observed among women, whereas the case fatality rate was more among males. From the community survey, we observed that the cases were less likely to have pertussis vaccination history (adjusted odds ratio = 0.28, 95% confidence interval = 0.11–0.74) compared with the controls. Knowing pertussis prevention methods were found protective for pertussis transmission (adjusted odds ratio = 0.14, 95% confidence interval = 0.04–0.45). Conclusion: This study showed the vulnerability of children under 5 years, especially under 1 year, to vaccine-preventable diseases in rural populations, where “real” immunization coverage is sub-optimal, and the dominant socio-demographic factors are supportive of disease transmission. We found immunization and knowledge of the preventive measures to be protective against pertussis outbreaks. Therefore, routine immunization services must be intensified to improve coverage and prevent future pertussis outbreak(s).

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Translational delivery of Cool Little Kids to prevent child internalising problems: Randomised controlled trial

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867417726582 ◽

2017 ◽

Vol 52 (2) ◽

pp. 181-191 ◽

Cited By ~ 14

Author(s):

Jordana K Bayer ◽

Ruth Beatson ◽

Lesley Bretherton ◽

Harriet Hiscock ◽

Melissa Wake ◽

...

Keyword(s):

Standard Deviation ◽

Confidence Interval ◽

Anxiety Disorders ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Controlled Trial ◽

Secondary Outcomes ◽

Randomised Controlled ◽

Internalising Problems

Objective: To determine whether a population-delivered parenting programme assists in preventing internalising problems at school entry for preschool children at-risk with temperamental inhibition. Methods: Design: a randomised controlled trial was used. Setting: the setting was 307 preschool services across eight socioeconomically diverse government areas in Melbourne, Australia. Participants: a total of 545 parents of inhibited 4-year-old children: 498 retained at 1-year follow up. Early intervention: Cool Little Kids parenting group programme was implemented. Primary outcomes: the primary outcomes were child DSM-IV anxiety disorders (assessor blind) and internalising problems. Secondary outcomes: the secondary outcomes were parenting practices and parent mental health. Results: At 1-year follow up (mean (standard deviation) age = 5.8 (0.4) years), there was little difference in anxiety disorders between the intervention and control arms (44.2% vs 50.2%; adjusted odds ratio = 0.86, 95% confidence interval = [0.60, 1.25], p = 0.427). Internalising problems were reduced in the intervention arm (Strengths and Difficulties Questionnaire: abnormal – 24.2% vs 33.0%; adjusted odds ratio = 0.56, 95% confidence interval = [0.35, 0.89], p = 0.014; symptoms – mean (standard deviation) = 2.5 (2.0) vs 2.9 (2.2); adjusted mean difference = –0.47, 95% confidence interval = [–0.81, –0.13], p = 0.006). Parents’ participation in the intervention was modest (29.4% attended most groups, 20.5% used skills most of the time during the year). A priori interaction tests suggested that for children with anxious parents, the intervention reduced anxiety disorders and internalising symptoms after 1 year. Conclusion: Offering Cool Little Kids across the population for inhibited preschoolers does not impact population outcomes after 1 year. Effects may be emerging for inhibited children at highest risk with parent anxiety. Trial outcomes will continue into mid-childhood.

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Folic acid awareness and usage among females at Saudi Electronic University in Jeddah, Saudi Arabia

SAGE Open Medicine ◽

10.1177/20503121211059682 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110596

Author(s):

Mohammed AL-Mohaithef ◽

Hadeel Alaslani ◽

Nargis Begum Javed ◽

Sriram Chandramohan

Keyword(s):

Saudi Arabia ◽

Folic Acid ◽

Confidence Interval ◽

University Students ◽

Neural Tube ◽

Neural Tube Defects ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Health Sciences ◽

Folic Acid Deficiency

Objectives: This study evaluates awareness of folic acid and neural tube defects, use of folic acid and knowledge of folic acid usage among female university students in Saudi Arabia. Methods: An analytical cross-sectional survey was conducted in the Jeddah branch of Saudi Electronic University. A total of 400 female students in the 19–45 years age group were contacted to participate in the study using a convenience sampling method. Eighty-eight students refused to participate, so 312 students were included in the study. Demographic characteristics of participants and their awareness, usage and knowledge of folic acid are presented as frequencies and percentages. Logistic regression analysis was used to compute crude odds ratios to show the association between demographic factors and knowledge of folic acid supplementation. A further adjusted odds ratio was calculated to control for other cofactors. A p-value < 0.05 was considered significant. Results: Overall, 81.1% (253/312) of respondents had heard of folic acid, 30.4% knew about neural tube defects, and 47.1% of respondents reported using folic acid supplements. Marriage was found to be associated with awareness of folic acid (adjusted odds ratio (95% confidence interval) = 2.64 (1.01–6.91)). Health sciences specialization and experience of pregnancy were associated with the usage of folic acid (adjusted odds ratio (95% confidence interval) = 3.46 (1.73–6.91) and adjusted odds ratio (95% confidence interval) = 6.70 (3.09–14.53), respectively). A bachelor’s and above education level was found to be associated with knowledge of folic acid deficiency leading to neural tube defects (adjusted odds ratio (95% confidence interval) = 2.03 (1.17–3.52)), and health sciences specialization was found to be associated with knowledge of natural sources of folic acid (adjusted odds ratio (95% confidence interval) = 2.33 (1.25–4.36)). Similarly, marriage was found to be associated with knowledge of the correct dosage of folic acid and timing of folic acid to prevent neural tube defects (adjusted odds ratio (95% confidence interval) = 6.34 (3.50–11.48) and adjusted odds ratio (95% confidence interval) = 3.45 (1.93–6.16), respectively). Experience of pregnancy was found to be an associated with good total knowledge of folic acid (adjusted odds ratio (95% confidence interval) = 3.05 (1.65–5.63); p = 0.0001). Conclusion: The study findings highlight the lack of awareness among female university students about the importance of folic acid usage in the prevention of neural tube defects. There is a need for interventional programs in universities to create awareness.

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