Sex differences in prevalence and determinants of hypertension among adults: a cross-sectional survey of one rural village in Bangladesh

ObjectivePrevention of mortality due to cardiovascular disease (CVD) through control of hypertension is a public health priority in Bangladesh. Our objective was to assess sex differences in prevalence and determinants of hypertension among adults in one rural area of Bangladesh.Study designCross-sectional.Setting and participantsFrom January 2014 to December 2015, we conducted a cross-sectional study of 2600 men and women aged ≥18 years located in one rural district of Bangladesh. We collected data on demographics, behavioural factors, physical measurements and health history.Primary outcome measuresOur primary outcome was hypertension (systolic blood pressure ≥140 or diastolic blood pressure ≥90 mm Hg).ResultsThe average age of participants was 41.6 years and 53.7% were women. Hypertension prevalence was 6.9% (95% CI 5.9 to 7.9), and was significantly higher among women (8.9%) than men (4.5%). The highest prevalence of hypertension was observed among women aged ≥60 years at 21.3% (95% CI 16.6 to 26.7). A higher proportion of men with hypertension were aware of their condition (72.2%) compared with women (52.4%). Determinants of hypertension included older age, higher education, current tobacco use, increasing body mass index, and hyperglycaemia.ConclusionOur research suggests that hypertension prevalence is higher among women than men in rural Bangladesh. Sex-specific interventions should be developed to inform adults of the necessary lifestyle changes that may reduce the risk of hypertension and subsequent CVDs.

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P3424Gender differences in the implementation of CVD prevention In patients with coronary disease: Results from the EUROASPIRE V Survey

European Heart Journal ◽

10.1093/eurheartj/ehz745.0298 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K Kotseva ◽

G De Backer ◽

D De Bacquer ◽

D Grobbee ◽

A Hoes ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Coronary Disease ◽

Central Obesity ◽

Ldl Cholesterol ◽

Lifestyle Changes ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Risk Factor Management ◽

Coronary Syndrome

Abstract Introduction EUROASPIRE V was a cross-sectional survey carried out by the European Society of Cardiology, EURObservational Research Programme in 2016–2017 in 27 European countries Purpose To describe gender differences in lifestyle and risk factor management, and the use of cardioprotective drug therapies in patients with coronary heart disease in Europe. Methods Patients <80 years with coronary disease (CABG, PCI or an acute coronary syndrome) were identified from the hospital medical records and interviewed and examined by trained staff ≥6 months and ≤2 years later using standardized methods including central laboratory measurements. Results A total of 8,261 (25.8% females), mean age 63.6 (SD 9.6) were interviewed, with a median time between the index event and interview 1.12 years (IR 0.82–1.56). Women were older (mean age 65.4 years [SD 9.2] vs 63.0 [9.7] and had a lower level of education than men.Comparing women with men, the prevalence of the risk factors were as follows: current smoking 12.8% vs 20.7%,obesity (BMI ≥30 kg/m2) 45.7% vs 34.9%, central obesity (waist circumference ≥102 cm in men or ≥88 cm in women) 78.0% vs 51.8%, raised blood pressure (BP ≥140/90 mmHg, ≥140/80 mmHg in patients with diabetes) 47.1% vs 46.0%, elevated LDL-cholesterol (≥1.8 mmol/l) 77.9% vs 68.5% and self reported diabetes 33.1% vs 28.0%. Reported use of prophylactic drug therapies for the same comparison was: antiplatelets 91.8% vs. 92.8%; beta-blockers 81.8% vs. 80.8%; ACE inhibitors/ARBs 75.0% vs. 75.3%; and statins 76.8% vs. 82.2%. The therapeutic control of blood pressure, LDL-cholesterol and diabetes (HbA1c <7 mmol/L) was: 48.2% vs 49.9%; 25.7% vs 34.1% and 48.5% vs 56.7%, respectively. Conclusions The results show that women with coronary disease have higher prevalence of obesity, central obesity, elevated LDL-cholesterol and self-reported diabetes than men. There were no differences in terms of blood pressure management. All coronary patients require professional support to make lifestyle changes and manage risk factors more effectivelyin order to reduce their risk of recurrent cardiovascular events. Acknowledgement/Funding ESC-EORP supported by Amgen, Eli Lilly, Pfizer, Sanofi, Ferrer and Novo Nordisk

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Prevalence and associated risk factors of hypertension among persons aged 15–49 in India: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-029714 ◽

2019 ◽

Vol 9 (12) ◽

pp. e029714 ◽

Cited By ~ 3

Author(s):

Soumitra Ghosh ◽

Manish Kumar

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Family Health ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Effective Interventions ◽

Life Style Changes ◽

Associated Risk Factors

ObjectivesThis is the first attempt to provide estimates on the prevalence of hypertension at the national, state and district level, a prerequisite for designing effective interventions. Besides, the study aims to identify the risk factors of hypertension.DesignWe analysed cross-sectional survey data from the fourth round (2015–2016) of National Family Health Survey (NFHS). NFHS was conducted between January 2015 and December 2016, gathering information on a range of indicators including blood pressure. The age adjusted prevalence of hypertension was calculated for state comparison, while multilevel logistic regression analysis was done to assess the correlates of hypertension.Setting and participantsIndia (2015–2016; n=811 917) aged 15–49.Primary and secondary outcome measuresThe primary outcome is hypertension, which has been defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg.ResultsThe age-adjusted prevalence of hypertension in India was 11.3% (95% CI 11.16% to 11.43%) among persons aged between 15 and 49 and was four percentage points higher among males 13.8% (95% CI 13.46% to 14.19%) than among females 10.9% (95% CI 10.79% to 11.06%). Persons in the urban location (12.5%, 95% CI 12.25% to 12.80%) had a marginally higher prevalence than persons in rural location (10.6%, 95% CI 10.50% to 10.78%). The proportion of population suffering from hypertension varied greatly between states, with a prevalence of 8.2% (95% CI 7.58% to 8.85%) in Kerala to 20.3% (95% CI 18.81% to 21.77%) in Sikkim. Advancing age, obesity/overweight, male sex, socioeconomic status and consumption of alcohol were found to be the major predictors of hypertension.ConclusionsHypertension prevalence is now becoming more concentrated among the poor. Policy measures should be taken to improve the hazardous working conditions and growing social pressures of survival responsible for ‘life-style’ changes such as consumption of high calorie food and alcohol.

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Triggers of defensive medical behaviours: a cross-sectional study among physicians in the Netherlands

BMJ Open ◽

10.1136/bmjopen-2018-025108 ◽

2019 ◽

Vol 9 (6) ◽

pp. e025108 ◽

Cited By ~ 1

Author(s):

Erik Renkema ◽

Kees Ahaus ◽

Manda Broekhuis ◽

Maria Tims

Keyword(s):

Primary Outcome ◽

Response Rate ◽

Cross Sectional Study ◽

Avoidance Behaviour ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Self Blame ◽

Prescribe Medicine ◽

Risk Patients ◽

Defensive Behaviours

ObjectivesThis study investigated whether the attitudes of physicians towards justified and unjustified litigation, and their perception of patient pressure in demanding care, influence their use of defensive medical behaviours.DesignCross-sectional survey using exploratory factor analysis was conducted to determine litigation attitude and perceived patient pressure factors. Regression analyses were used to regress these factors on to the ordering of extra tests or procedures (defensive assurance behaviour) or the avoidance of high-risk patients or procedures (defensive avoidance behaviour).SettingData were collected from eight Dutch hospitals.ParticipantsRespondents were 160 physicians and 54 residents (response rate 25%) of the hospital departments of (1) anaesthesiology, (2) colon, stomach and liver diseases, (3) gynaecology, (4) internal medicine, (5) neurology and (6) surgery.Primary outcome measuresRespondents’ application of defensive assurance and avoidance behaviours.Results‘Disapproval of justified litigation’ and ‘Concerns about unjustified litigation’ were positively related to both assurance (β=0.21, p<0.01, and β=0.28, p<0.001, respectively) and avoidance (β=0.16, p<0.05, and β=0.18, p<0.05, respectively) behaviours. ‘Self-blame for justified litigation’ was not significantly related to both defensive behaviours. Perceived patient pressures to refer (β=0.18, p<0.05) and to prescribe medicine (β=0.23, p<0.01) had direct positive relationships with assurance behaviour, whereas perceived patient pressure to prescribe medicine was also positively related to avoidance behaviour (β=0.14, p<0.05). No difference was found between physicians and residents in their defensive medical behaviour.ConclusionsPhysicians adopted more defensive medical behaviours if they had stronger thoughts and emotions towards (un)justified litigation. Further, physicians should be aware that perceived patient pressure for care can lead to them adopting defensive behaviours that negatively affects the quality and safety of patient care.

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Gender- and Age-Specific Differences in the Association of Hyperuricemia and Hypertension: A Cross-Sectional Study

International Journal of Endocrinology ◽

10.1155/2019/7545137 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Xiaoyun Lin ◽

Xiqian Wang ◽

Xin Li ◽

Lili Song ◽

Zhaowei Meng ◽

...

Keyword(s):

Blood Pressure ◽

Cross Sectional Study ◽

Multivariate Logistic Regression ◽

Middle Aged ◽

Cross Sectional ◽

Hypertension Prevalence ◽

Increased Risk ◽

Gender And Age ◽

Increasing Trends ◽

Increased Susceptibility

Objective. Both hyperuricemia and hypertension have important clinical implications, but their relationship in terms of gender and age is still a matter of debate. In this study, we aimed to explore gender- and age-specific differences in this association between hyperuricemia and hypertension in a Chinese population. Methods. A total of 78596 ostensibly healthy subjects (47781 men and 30815 women) were recruited. The association between hyperuricemia and hypertension was analyzed by multivariate logistic regression, and the analyses were stratified by gender and age. Results. Overall prevalence of hypertension and hyperuricemia was significantly higher in males than in females. Increasing trends of hypertension prevalence in both genders as well as hyperuricemia prevalence in females were found along with aging. However, males showed a reduced trend in hyperuricemia prevalence with aging. Higher hypertension and hyperuricemia prevalence was found in young and middle-aged men than in women, but not in elderly people older than 70 years. Significantly increased risk of hypertension from hyperuricemia was found only in men with an adjusted odds ratio of 1.131 (P<0.01), especially in the middle-aged male participants. However, such significant results were not found in women. Similarly, hyperuricemia was also an independent risk factor of increased systolic blood pressure and diastolic blood pressure in males, but not in females. Conclusion. We observed significantly higher overall prevalence of hyperuricemia and hypertension in men than in women. Men with hyperuricemia (particularly in middle age) had a significantly increased susceptibility of hypertension, while this significant association was not observed in women.

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Health Status and Predictors of Hypertension, Blood Pressure, and Pulse Rate of Jamaicans During the Covid-19 Pandemic

10.47363/jmhc/2021(3)140 ◽

2019 ◽

pp. 1-12

Author(s):

Paul Andrew Bourne ◽

◽

Vincent M.S. Peterkin ◽

Keyword(s):

Public Health ◽

Blood Pressure ◽

Health Status ◽

Research Design ◽

Pulse Rate ◽

Cross Sectional Study ◽

Least Square ◽

Unhealthy Lifestyle ◽

Cross Sectional Survey ◽

Cross Sectional

The objectives of the current research are to examine Jamaicans’ health status, pulse rate, body mass index (BMI), hypertension, and factors influencing 1) hypertension, 2) blood pressure, and 3) pulse rate, during COVID-19. A cross-sectional survey using associational research design by way of convenience sampling was used to conduct this research. This study examined correlation of age, gender, BMI, hypertension, and blood pressure among Jamaicans age ranging from 15 to 85 and above. Cross–sectional study and associational research design were used to collect data for the period of June to August 2020. The study demonstrated that hypertension is significantly predicted by gender, age, and pulse rate one─Omnibus tests of model (χ2(4) =138.947, P < 0.0001, -2Ll=2098.67) and Wald statistic being 90.161, P < 0.0001, and the variance in model 10.8% (Nagelkerke R2). Furthermore, ordinary least square (OLS) regression can be used to model pulse rate (bpm) for Jamaicans (F [4, 1676] =17.236, P < 0.0001), with the model explaining 4.0% of the variance in pulse rate of Jamaicans. Gender, BMI and Hypertensive emerged as the factors that determine the pulse rate of Jamaicans. Diastolic & systolic blood pressure were determined by age, weight, and pulse rate, with age being the most significant predictor. The risk of hypertension was higher among population groups who were overweight and obese. Gender was found to correlate with blood pressure and hypertension; female participants were more likely to be hypertensive than the male participants. BMI measurement should be recommended as a simple and effective predictor of hypertension in public health strategies. There is empirical evidence that can be used to establish that Jamaicans health status has worsen since March 10, 2020, and that Covid-19 has brought with it unhealthy lifestyle practices, which are pending public health challenges come 2021 and beyond.

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Cross-sectional study of nutritional intake among patients undergoing tuberculosis treatment along the Myanmar–Thailand border

BMJ Open ◽

10.1136/bmjopen-2021-052981 ◽

2022 ◽

Vol 12 (1) ◽

pp. e052981

Author(s):

Karim Damji ◽

Ahmar H Hashmi ◽

Lin Lin Kyi ◽

Michele Vincenti-Delmas ◽

Win Pa Pa Htun ◽

...

Keyword(s):

Weight Gain ◽

Primary Outcome ◽

Cross Sectional Study ◽

Nutritional Intake ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Tb Treatment ◽

Micronutrient Intake ◽

Caloric Requirements

ObjectiveThis study summarises nutritional intake among patients with tuberculosis (TB) along the Myanmar–Thailand border according to the local diet.SettingTB clinic along the Myanmar–Thailand border.ParticipantsCross-sectional surveys of 24-hour food recall were conducted with participants receiving anti-TB treatment. Participants were purposively selected to reflect proportion of age, sex and HIV co-infection based on historical patient records. Out of a total of 28 participants, 20 (71.4%) were men and 5 (17.9%) were co-infected with HIV.Primary and secondary outcome measuresThe primary outcome compared actual recorded intake to recommended intake. Secondary outcomes compared weight gain and body mass index (BMI) from diagnosis to time of survey.ResultsThere were no significant differences in macronutrient or micronutrient intake by sex or for patients supplementing their rations. Mean treatment length at time of survey was 20.7 weeks (95% CI: 16.5 to 24.8). A significantly higher proportion of women (8/8, 100%) met caloric requirements compared with men (9/20, 45.0%, p=0.010), but few participants met other macronutrient or micronutrient requirements, with no significant differences by sex or for patients supplementing their rations. From diagnosis to the time of the survey, participants averaged significant weight gain of 6.48 kg (95% CI: 3.87 to 9.10) and increased BMI of 2.47 kg/m2 (95% CI: 1.45 to 3.49; p=0.0001 for both). However, 50% (14/28) still had mild or more severe forms of malnutrition.ConclusionsThis cross-sectional survey of nutritional intake in patients undergoing TB treatment in a sanatorium setting demonstrates the difficulty in sufficiently meeting nutritional demands, even when providing nutritional support.

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Hubungan Merokok dengan Kejadian Hipertensi pada Laki-Laki Usia 35-65 Tahun di Kota Padang

Jurnal Kesehatan Andalas ◽

10.25077/jka.v4i2.268 ◽

2015 ◽

Vol 4 (2) ◽

Author(s):

Yashinta Octavian Gita Setyanda ◽

Delmi Sulastri ◽

Yuniar Lestari

Keyword(s):

Blood Pressure ◽

Random Sampling ◽

Smoking Habit ◽

Cross Sectional Study ◽

Lifestyle Changes ◽

Smoking Habits ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Multi Stage

AbstrakHipertensi merupakan salah satu penyebab kematian tertinggi pada masyarakat di dunia. Penyakit ini disebut juga the silent killer. Prevalensi hipertensi telah mencapai angka 31,7% dari semua penduduk. Peningkatan ini diakibatkan perubahan gaya hidup yang salah satunya merokok. Tujuan penelitian ini untuk mengetahui hubungan antara kebiasaan merokok termasuk lama merokok, jumlah rokok dan jenis rokok dengan hipertensi. Desain penelitian berupa cross-sectional study. Populasi adalah laki-laki yang berusia 35-65 tahun di empat kecamatan terpilih di kota Padang. Jumlah subjek sebanyak 92 orang yang diambil secara multi stage random sampling. Instrumen dalam penelitian ini ialah kuesioner untuk data responden dan karakteristik kebiasaan merokok, serta sphygmomanometer untuk mengukur tekanan darah. Data dianalisis dengan uji chi-square dengan p < 0,05 untuk signifikansi. Hasil penelitian didapatkan ada hubungan antara kebiasaan merokok dengan hipertensi (p=0,003) yaitu dipengaruhi oleh lama merokok (p=0,017) dan jenis rokok (p=0,017), tetapi tidak terdapat hubungan antara jumlah rokok dengan kejadian hipertensi (p=0,412). Oleh karena kebiasaan merokok meningkatkan risiko hipertensi, penyuluhan kesehatan tentang risiko peningkatan tekanan darah terhadap penderita hipertensi yang memiliki kebiasaan merokok harus dilakukan. Hal ini diperlukan agar terjadi penurunan angka kejadian hipertensi.Kata Kunci: hipertensi, kebiasaan merokok, lama merokok, jumlah rokok, jenis rokok AbstractHypertension is one of the major causes of death in the world. This disease is called silent killer. The prevalence of hypertension has reached 31.7% of the population. It increases because of lifestyle changes, one of them is smoking. The objective of this study was to determine the association between smoking habits including duration of smoking, number of cigarettes, and type of cigarettes with hypertension. The research design was cross-sectional study. The population was 35-65 years old men in four selected districts in Padang. There were 92 subjects who were taken by multi-stage random sampling. The instruments of this research were questionnaire for data of respondents and smoking habit characteristics, also sphygmomanometer for blood pressure measurements. Data were analyzed by chi-square test with p value < 0.05 for significance. The result of this study showed that there is association between smoking habit and hypertension (p=0.003) which is influenced by duration of smoking (p=0.017) and type of smoking (p=0.017), but there is no association between number of cigarettes with the incidence of hypertension (p=0.412). As smoking habits increase the risk of hypertension, health promotion about the risk of blood pressure increasing in the patient who has a smoking habit should be done. It is important in order to decrease the incidence of hypertension.Keywords: hypertension, duration of smoking, number of cigarettes, type of cigarettes

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Hypertension and its Determinants Among School Going Adolescents: A Cross Sectional Study in Nepal

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v39i2.25377 ◽

2019 ◽

Vol 39 (2) ◽

pp. 87-94

Author(s):

Sujata Shakya ◽

Shanti Bajracharya

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Blood Pressure Measurement ◽

Cross Sectional Study ◽

Lifestyle Changes ◽

Elevated Blood Pressure ◽

Bivariate Analysis ◽

Elevated Blood ◽

Sectional Study ◽

Cross Sectional

Introduction: Hypertension is a chronic life threatening non- communicable disease. It increases the risk for cardiovascular diseases even leading to premature death. Almost half of the adults with hypertension had elevated blood pressure during childhood. With globalisation and lifestyle changes, adolescents are exposed to various risk factors. However, diagnosis in this population is difficult due to absence of symptoms. Thus, regular blood pressure screening is essential in these groups. This study aimed to find out the prevalence of hypertension and its determinants among the school going adolescents of Kathmandu, Nepal. Methods: This was a descriptive cross sectional study which included five private secondary schools of Kathmandu, Nepal. The adolescent students studying in classes VIII, IX and X were the study subjects. Two stage cluster random sampling technique was used to select 356 participants. Data collection was done by doing anthropometric measurements, blood pressure measurement and through self administered questionnaire. Results: The study depicted that the prevalence of elevated blood pressure was 12.4%, stage 1 hypertension 32.3% and stage 2 hypertension 9.8%. Similarly, 13.8% were overweight and 1.4% were obese. Bivariate analysis depicted significant association of prevalence of hypertension with gender, religion and obesity (p < 0.05). The multivariate analysis shows that the significant predictors of elevated blood pressure and/or hypertension were gender and obesity. Males were six times more likely to have elevated blood pressure (AOR = 6.058, CI = 2.571 - 14.274) and 2.8 times more likely to be hypertensive (AOR = 2.838, CI = 1.688 - 4.773) compared to females. Similarly, compared to obese/ overweight students, thin and normally built ones have less likelihood of having elevated blood pressure and hypertension. Conclusions: Hypertension has been prevalent among adolescents, due to various behavioural risk factors. This is really challenging and of public health significance. Regular screening of adolescents is essential for early detection and management of hypertension.

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Association of Serum Magnesium with Blood Pressure in Patients with Hypertensive Crises: A Retrospective Cross-Sectional Study

Nutrients ◽

10.3390/nu13124213 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4213

Author(s):

IfeanyiChukwu O. Onor ◽

Lashira M. Hill ◽

Modupe M. Famodimu ◽

Mallory R. Coleman ◽

Carolkim H. Huynh ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Primary Outcome ◽

Serum Magnesium ◽

Positive Association ◽

Cross Sectional Study ◽

Cross Sectional ◽

Hypertensive Crises

The role of magnesium in blood pressure has been studied among hypertensive patients; however, there is a dearth of studies exploring the role of magnesium in hypertensive crises. The primary objective of this study was to evaluate the relationship between serum magnesium and blood pressure in patients with hypertensive crises. This was a single-center, retrospective, chart review, cross-sectional study of patients with hypertensive crises. Patients were included if they were eighteen years of age or older, with an international classification disease ninth revision (ICD-9) code of 401.9 (hypertensive crises: emergency or urgency) and a documented magnesium level on their electronic medical record. The primary outcome of the study was the correlation between serum magnesium and blood pressure (systolic blood pressure and diastolic blood pressure) in patients with hypertensive crises. Two hundred and ninety-three patients were included in the study. The primary outcome result showed that serum magnesium was positively correlated with systolic blood pressure (r = 0.143, p = 0.014), but not diastolic blood pressure. Conclusion: This study found a significant positive association between magnesium and systolic blood pressure, but not diastolic blood pressure, among patients with hypertensive crises. This positive association of serum magnesium with systolic blood pressure was maintained after adjusting for covariates. This study’s findings suggest a potential role of magnesium in blood pressure among patients with hypertensive crises.

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Factors associated with the timely initiation of antenatal care: findings from a cross-sectional study in Northern Bangladesh

BMJ Open ◽

10.1136/bmjopen-2021-052886 ◽

2021 ◽

Vol 11 (12) ◽

pp. e052886

Author(s):

Bidhan Krishna Sarker ◽

Tawhidur Rahman ◽

Tanjina Rahman ◽

Musfikur Rahman

Keyword(s):

Antenatal Care ◽

Rural Women ◽

Primary Outcome ◽

Educational Status ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Timely Initiation ◽

To Receive

ObjectiveThis paper explored the factors that influence the timely initiation of antenatal care (ANC) in Bangladesh.DesignThis was a cross-sectional survey.SettingThis study conducted in two rural subdistricts and one urban area from three Northern districts of Bangladesh from August to November 2016.ParticipantsWomen who had a live birth in the last 1 year prior to data collection were enrolled for this study. In each study area, around 900 women were interviewed, and finally, we completed 2731 interviews.Primary outcome measuresThe primary outcome was timely first ANC from a Medically Trained Provider (MTP).ResultsAbout 43% of pregnancies were detected at their earliest time. The majority of participants (82%) received at least one ANC from an MTP. Only 11% received timely first ANC from an MTP as per the WHO FANC model. The women who detected pregnancy earlier were more likely (adj.OR 1.99, 95% CI 1.31 to 3.01) to receive the timely first ANC. The urban women were more likely (adj.OR 1.78, 95% CI 1.13 to 2.80) to receive the timely first ANC from an MTP than those of the rural women. Besides, their husbands’ educational status (adj.OR 1.61, 95% CI 1.0 to 2.60) was significantly associated with the timely first ANC.ConclusionApart from sociodemographic factors, early pregnancy detection was strongly associated with the timely first ANC visit. Timely initiation of ANC is an opportunity to adhere to all the WHO recommended timely ANC visits for a pregnant woman. The findings suggest maternal, neonatal, and child health programmes to focus on the early detection of pregnancy to ensure universal ANC coverage and its timeliness.

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