scholarly journals Competency of health workers in detecting and managing gestational hypertension, pre-eclampsia, severe pre-eclampsia and eclampsia during antenatal check-ups in primary care health facilities in Bangladesh: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046638
Author(s):  
Sk Masum Billah ◽  
Abdullah Nurus Salam Khan ◽  
S M Rokonuzzaman ◽  
Nafisa Lira Huq ◽  
Marufa Aziz Khan ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Workers ◽  
Gestational Hypertension ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cross Sectional ◽  
Hypertensive Disorders ◽  
Care Facilities

Study objectiveTo evaluate the competency of trained health workers in detecting and managing hypertensive disorders of pregnancy during routine antenatal check-ups (ANCs) at primary care facilities in Bangladesh.Study design and settingsCross-sectional study; conducted in 26 primary care facilities.Outcome measuresAccurate diagnosis of the hypertensive disorders of pregnancy.MethodIn total 1560 ANC consultations provided by primary health workers, known as Family Welfare Visitors (FWVs), were observed using a structured checklist between October 2017 and February 2018. All consultations were reassessed by study physicians for validation.ResultOf the ‘true’ cases of gestational hypertension (n=32), pre-eclampsia (n=29) and severe pre-eclampsia (n=16), only 3%, 7% and 25%, respectively, were correctly diagnosed by FWVs. Per cent agreement for the diagnosed cases of any hypertensive disorders of pregnancy was 9% and kappa statistics was 0.50 (p value 0.0125). For identification of any hypertensive disorders by FWVs, sensitivity and positive predictive values were 14% and 50%, respectively. There was a moderate positive correlation between the blood pressure measurements taken by FWVs and study physicians. Only 27% of those who had ‘some protein’ in urine were correctly identified by FWVs. Women diagnosed with any of the hypertensive disorders of pregnancy by FWVs were more likely to be counselled on at least one danger sign of pre-eclampsia (severe headache, blurring of vision and upper abdominal pain) than those without any such diagnosis (41% vs 19%, p value 0.008). All four cases of severe pre-eclampsia diagnosed by FWVs were given a loading dose of intramuscular magnesium sulphate and three among them were referred to a higher facility.ConclusionThe FWVs should be appropriately trained on risk assessment of pregnant women with particular emphasis on accurately assessing the diagnostic criteria of hypertensive disorders of pregnancy and its management.

Prevalence and Predictors of Gestational Hypertension: a Cross-Sectional Study among Moroccan Pregnant Women

2021 ◽  
Vol 13 (1) ◽  
pp. 1-9
Author(s):  
A. El Kardoudi ◽  
K. Kaoutar ◽  
A. Chetoui ◽  
K. Boutahar ◽  
S. Elmoussaoui ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Household Income ◽  
Gestational Hypertension ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Care Facilities ◽  
Primary Health Care Facilities

The objective of this study was to assess the prevalence of gestational hypertension, and to determine its predictors among pregnant women attending primary health care facilities in Beni Mellal city in Morocco. The prevalence of gestational hypertension was 18.7%. The low monthly household income (Adjusted Odds Ratio (AOR) = 7.874; IC 95% = [1.788–34.67]), gestational age less than 37 weeks (AOR = 6.860; IC 95% = [1.285–36.626]), limited knowledge on gestational hypertension (AOR = 12.719; IC 95% = [3.386–47.785]), and primigravidity (AOR = 9.047; IC 95% = [1.595–51.324]), were significantly associated with gestational hypertension.

Hospital and Domiciliary Services Outcome: A Cross-Sectional Study on Married Women of Peshawar Khyber Pakhtunkhwa

2020 ◽  
Keyword(s):  
Antenatal Care ◽  
Health Workers ◽  
Cross Sectional Study ◽  
P Value ◽  
Hospital Services ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Domiciliary Care ◽  
Safe Delivery

Background: Antenatal care and effective services are the hallmarks of effective pregnancy outcome. Thus, practices by community care providers throughout labor and childbirth might affect health outcomes of newborns. There is a need for proper antenatal checkups in hospital and domiciliary care by community health workers and importance of antenatal care on pregnancy outcomes. Since, every woman has a right to safe delivery that must include proper labor management protocols. Therefore, the purpose of this study was to compare and assess the antenatal care of hospital based and domiciliary services on the outcome of delivery. Methods: This cross-sectional study was conducted from November 2018-April 2019. A sample size of about 300 married females was selected from different towns of Peshawar through non-probability convenient sampling technique. Data was collected using semi structured questionnaire after taking informed consent from the women. Data were analyzed by using SPSS. Chi square test was applied for associations between hospital and domiciliary services and antenatal outcomes in both setups. p-value < 0.05 was considered significant. Results: The comparison of hospital and domiciliary services on the outcome of newborn and mother, showed better services of hospital. Domiciliary care services showed increased number of complications in females during delivery (p-value<0.05) and in newborn (p-value< 0.05) compared to hospital services. Conclusion: Hospital services provide antenatal care by trained person majority of deliveries were normal, while in cases of domiciliary-based services majority faced complications during pregnancy and delivery. Awareness of community is important step to improve mother and child health. Keywords: Antenatal Care; Domiciliary Service; Hospital Services.

Faktor-Faktor Status Gizi Kurang Pada Anak Usia Prasekolah di Wilayah Kerja Puskesmas Guguk Panjang Kota Bukittinggi

2019 ◽  
Vol 4 (2) ◽  
pp. 359
Author(s):  
Vina Novela ◽  
Listiani Kartika
Keyword(s):  
Community Health ◽  
Health Center ◽  
Exclusive Breastfeeding ◽  
Health Workers ◽  
Community Health Center ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional

<p><em>Malnutrition in pre-school childrenstill found in Guguk Panjang Community Health Center. This data can be found from Bukittinggi Health Office in 2017 which stated that 800 under-fives children had less nutrition. In Guguk Panjang Community Health Centerin 2017, malnutrition cases were found in 162 people. This study aims to find out some factors related to malnutrition in the Guguk Panjang Community Health Center in 2018. The type of this research was descriptive analytic with a cross sectional study design.. </em><em>The population in this reseacrh as many 1.106 population and 92 samples preschool-aged mothers</em><em>. Then, the samples were taken from purposive sampling technique. The data were analyzed by univariate and bivariate by using Chi-Square statistical test. The results of this research showed that 54.3% of them had high level of knowledge. Then, 52.2% of themhad poor parenting. Next, the mothers did not provide exclusive breastfeeding were around 63.0%. Moreover, based on bivariate analysis there was a relationship between knowledge p value 0.008), parenting (p value 0.001) history of exclusive breastfeeding with malnutrition (p value 0.021). In short, it can be concluded that there were some factors related to malnutrition in preschool children. They were knowledge, parenting, and exclusive breastfeeding history. Then, it is expected that the health workers provide more information about nutrition and education about good parenting for children and also provide brochures or leaflets about nutrition.</em></p><p><em><br /></em></p><p><em><em>Kasus gizi kurang pada anak pra sekolah masih ditemukan diwilayah kerja puskemas guguk panjang. Hal ini terlihat data dari dinas kesehatan kota bukittinggi mencatat bahwa pada tahun 2017 balita dengan gizi kurang sebanyak 800 orang. Puskesmas guguk panjang pada tahun 2017 mempunyai gizi kurang sebanyak 162 orang. Tujuan penelitian, untuk mengetahui faktor-faktor yang berhubungan dengan gizi kurang pada anak prasekolah. Jenis penelitian ini adalah deskriptif analitik dengan desain cross sectional study. Populasi dalam penelitian sebanyak 1.106 orang dengan sampel 92 orang ibu anak prasekolah. Teknik pengambilan sampel porposive sampling. Pengolahan data dengan analisisunivariat dan bivariat  menggunakan uji statistik Chi - Square.Hasil penelitian menunjukkan terdapat 54,3% tingkat pengetahuan tinggi. Ibu yang pola asuh kurang baik sebanyak 52,2% . Ibu yang tidak memberikan ASI Ekslusif sebanyak 63,0%. Dari uji statistik didapatkan ada hubungan bermakna antara pengetahuan dengan gizi kurang (p value 0,008). Ada hubungan antara pola asuh dengan gizi kurang (p value 0,001) dan ada hubungan antara riwayat pemberian ASI Eksklusif dengan gizi kurang (p value,021).Disimpulkan bahwa faktor yang berhubungan dengan gizi kurang pada anak prasekolah adalah pengetahuan, pola asuh, dan riwayat pemberian ASI Eksklusif</em></em></p><p><strong> </strong></p>

scholarly journals Cross sectional study of the clinical characteristics of French primary care patients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paul Sebo ◽  
Benoit Tudrej ◽  
Julie Lourdaux ◽  
Clara Cuzin ◽  
Martin Floquet ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Identification ◽  
Clinical Characteristics ◽  
Diagnostic Performance ◽  
Cross Sectional Study ◽  
Positive Test ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Care Patients

AbstractThe early identification of patients suffering from SARS-CoV-2 infection in primary care is of outmost importance in the current pandemic. The objective of this study was to describe the clinical characteristics of primary care patients who tested positive for SARS-CoV-2. We conducted a cross-sectional study between March 24 and May 7, 2020, involving consecutive patients undergoing RT-PCR testing in two community-based laboratories in Lyon (France) for a suspicion of COVID-19. We examined the association between symptoms and a positive test using univariable and multivariable logistic regression, adjusted for clustering within laboratories, and calculated the diagnostic performance of these symptoms. Of the 1561 patients tested, 1543 patients (99%) agreed to participate. Among them, 253 were positive for SARS-CoV-2 (16%). The three most frequently reported ‘ear-nose-throat’ and non-‘ear-nose-throat’ symptoms in patients who tested positive were dry throat (42%), loss of smell (36%) and loss of taste (31%), respectively fever (58%), cough (52%) and headache (45%). In multivariable analyses, loss of taste (OR 3.8 [95% CI 3.3–4.4], p-value < 0.001), loss of smell (OR 3.0 [95% CI 1.9–4.8], p < 0.001), muscle pain (OR 1.6 [95% CI 1.2–2.0], p = 0.001) and dry nose (OR 1.3 [95% CI 1.1–1.6], p = 0.01) were significantly associated with a positive result. In contrast, sore throat (OR 0.6 [95% CI 0.4–0.8], p = 0.003), stuffy nose (OR 0.6 [95% CI 0.6–0.7], p < 0.001), diarrhea (OR 0.6 [95% CI 0.5–0.6], p < 0.001) and dyspnea (OR 0.5 [95% CI 0.3–0.7], p < 0.001) were inversely associated with a positive test. The combination of loss of taste or smell had the highest diagnostic performance (OR 6.7 [95% CI 5.9–7.5], sensitivity 44.7% [95% CI 38.4–51.0], specificity 90.8% [95% CI 89.1–92.3]). No other combination of symptoms had a higher performance. Our data could contribute to the triage and early identification of new clusters of cases.

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