scholarly journals Ectopic Pregnancy in Tigray, Ethiopia: A Cross-Sectional Survey of Prevalence, Management Outcomes, and Associated Factors

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Elsa Tesfa Berhe ◽  
Kalayu Kiros ◽  
Merhawit Gebremeskel Hagos ◽  
Hailay Abrha Gesesew ◽  
Paul R. Ward ◽  
...  

Background. Ectopic pregnancy is a neglected and challenging gynecologic problem in developing countries including Ethiopia. Objective. The present study is aimed at assessing the prevalence of ectopic pregnancy, its management outcomes, and factors associated with management outcomes in Tigray, North Ethiopia. Methods. We employed a four-year retrospective cross-sectional study from September 2015 to August 2019. We extracted data about all pregnant mothers who were admitted and managed for EPs in Axum, Tigray. Ectopic pregnancy and its outcomes (favorable and unfavorable) were the dependent variables, and age, residence, ethnicity, religion, parity, history of abortion, history of EP, pelvic infections, history of surgical procedures, and use contraceptives were the independent variables. We employed descriptive statistics and bivariate and multivariate logistic regression analyses using SPSS. Ethical clearance was obtained from Axum University, Tigray, Ethiopia. Results. The overall prevalence of ectopic pregnancy was 0.52% of total deliveries, which equates to 1 : 193 deliveries. Surgery for ectopic pregnancy accounts for 7.6% of all gynecological surgeries. Most participants were in the age group 26–30 years and lived in rural areas. Among the different EP implantation sites, most cases (92.4%) occurred in the fallopian tube, followed by 5.1% in the ovary and 2.5% in abdominal EPs. Surgical management (laparotomy) was undertaken for all the 79 women diagnosed with EPs, including laparotomy (100%), salpingo-oophorectomy (17.7%), salpingectomy (73.9%), oophorectomy (3.4%), cornual resection (2.5%), and removal of concepts tissue 2.5. The record reports that intraoperative procedure was correctly managed for 47 (59.5%) women but the condition of EP procedure was ruptured for about two-thirds (63.3%) of the women. Thirty (38%) patients had developed some complications after surgery including anemia ( hemoglobin < 10.5 ) ( n = 12 ), fever ( n = 10 ), wound infection ( n = 2 ), and pneumonia ( n = 2 ). Women who were from urban ( AOR = 11.2 , 95% CI: 2.65-47.2) and who had normal hemoglobin at presentation ( AOR = 9.94 , 95% CI: 2.03-48.7) were associated with favorable maternal outcomes. Conclusions. More than one-third of women with ectopic pregnancies had an unfavorable maternal outcome, which was higher among rural residents and anemic mothers. Women living in rural areas and anemia during pregnancy should seek special attention in the management of EPs. We also recommend improving the data management of hospitals in Ethiopia.

Author(s):  
Musaab Elzain ◽  
Ahmed Bashir ◽  
Noreen Moloney ◽  
Colum P. Dunne ◽  
Brendan D. Kelly ◽  
...  

Objectives: To investigate the frequency, characteristics and impact of death threats by patients towards psychiatrists. Methods: A cross-sectional survey of psychiatrists (n = 60) was undertaken to investigate the frequency, characteristics and impact of death threats by patients in one Irish healthcare region serving a mixed urban–rural population of 470,000. Results: Forty-nine responses (82%) were received. Thirty-one per cent of respondents experienced death threats by patients during their careers. Victims were more likely to be male and in a consultant role. Patients making the threats were more likely to be males aged 30–60 with a history of violence and diagnosis of personality disorder and/or substance misuse. A majority of threats occurred in outpatient settings and identified a specific method of killing, usually by stabbing. Prosecution of the perpetrator was uncommon. Of the victimised psychiatrists, 53% reported that such threats affected their personal lives, and 67% believed their professional lives were impacted. In half of the incidents, there were adverse incidents subsequent to the threats, involving either the patient or the clinician. Conclusions: Death threats by patients have significant psychological and professional impacts on psychiatrists. Early liaison with employers and police and transferring the care of the patient to another clinician may be useful measures.


2005 ◽  
Vol 37 (6) ◽  
pp. 761-771 ◽  
Author(s):  
JOSEPH KEATING ◽  
KATE MACINTYRE ◽  
CHARLES M. MBOGO ◽  
JOHN I. GITHURE ◽  
JOHN C. BEIER

A geographically stratified cross-sectional survey was conducted in 2002 to investigate household-level factors associated with use of mosquito control measures and self-reported malaria in Malindi, Kenya. A total of 629 households were surveyed. Logistic regressions were used to analyse the data. Half of all households (51%) reported all occupants using an insecticide-treated bed net and at least one additional mosquito control measure such as insecticides or removal of standing water. Forty-nine per cent reported a history of malaria in the household. Of the thirteen household factors analysed, low (OR=0·23, CI 0·11, 0·48) and medium (OR=0·50, CI 0·29, 0·86) education, mud–wood–coral (OR=0·0·39, CI 0·24, 0·66) and mud block–plaster (OR=0·47, CI 0·25, 0·87) wall types, farming (OR=1·38, CI 1·01, 1·90) and travel to rural areas (OR=0·48, CI 0·26, 0·91) were significantly associated with the use of mosquito control, while controlling for other covariates in the model. History of reported malaria was not associated with the use of mosquito control (OR=1·22, CI 0·79, 1·88). Of the thirteen covariates analysed in the second model, only two household factors were associated with history of malaria: being located in the well-drained stratum (OR=0·49, CI 0·26, 0·96) and being bitten while in the house (OR=1·22, CI 0·19, 0·49). These results suggest that high socioeconomic status is associated with increased household-level mosquito control use, although household-level control may not be enough, as many people are exposed to biting mosquitoes while away from the house and in areas that are more likely to harbour mosquitoes.


2020 ◽  
Vol 33 (1) ◽  
pp. 49-53
Author(s):  
Nazia Islam

Background: Ectopic pregnancy is a common clinical condition. Diagnosis and managementof this condition is necessary in due to day practice. Methods: A cross sectional study on ectopic pregnancy was conducted in Sir SalimullahMedical College and Mitford Hospital (SSMC & MH) , Dhaka, with the objective to analyzethe risk factors and assess the results of management with respect to maternal morbidityand mortality of ectopic pregnancy during the last two years. Result: Fifty patients were admitted with ectopic pregnancy from 1st January 2008 to 31stDecember 2010.Frequency of ectopic pregnancy were 1.5% of total 3252 pregnancies. Riskfactors were found in 45% of cases. Surgical treatment were performed in total 43 patients.There was one heterotrophic pregnancy and one case of abdominal pregnancy. Four patientswere given intramuscular Methotrexate and two un-ruptured ectopics resolved spontaneouslyafter by expectant management. Conclusion: Conservative management was an option but surgical treatment was donemore often because of late referrals. Screening of high risk cases, early diagnosis and earlyintervention would reduce the morbidity in ectopic pregnancies. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 49-53


Author(s):  
Viral R. Dave ◽  
Bhavik M. Rana ◽  
Kantibhai N. Sonaliya ◽  
Suraj J. Chandwani ◽  
Samkit V. Sharma ◽  
...  

Background: Hypertension and gestational diabetes are among the leading causes of maternal and perinatal mortality, especially in rural areas of developing countries with meager health facilities. With early diagnosis and timely treatment, these adverse events can be decreased. The primary aim of this study was to implement a screening program for gestational diabetes and hypertension, and to assess risk factors associated with these conditions among antenatal women in the rural area of the Gujarat province in India.Methods: A cross–sectional study was conducted at one of the rural areas of Gujarat province in India. Following a random  cluster sampling procedure, the village of Davas was selected. A multistage random sampling method was utilized, resulting in a sample of 346 antenatal women. Screening guidelines from the American Diabetes Association were followed for gestational diabetes screening.Results: The majority of antenatal mothers (55.50%) were between 21-25 years of age. 242 antenatal women were multigravida, and among them, 85.96% had institutional delivery at their last pregnancy. Of the total 346 women, 17.60% were prehypertensive. The prevalence of systolic hypertension was 1.40%, diastolic hypertension was 0.90%, and gestational diabetes was 1.73%.Conclusion: Socioeconomically upper class, a family history of hypertension, and BMI ≥ 25 were strong risk factors for hypertension during pregnancy and gestational diabetes. Health education should be made readily available to antenatal mothers by paramedical workers regarding symptoms of hypertension and gestational diabetes mellitus for early self identification.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
S. M. Seck ◽  
D. G. Dia ◽  
D. Doupa ◽  
A. Diop-Dia ◽  
I. Thiam ◽  
...  

Diabetes represents a challenging global health issue in the 21st century. Data from sub-Saharan African populations are scarce and are usually restricted to urban settings. The objective of this study was to compare prevalence and risk factors of diabetes in rural and urban areas in Senegal.Methods.In a community-based survey between January and May 2012, we included 1027 adults aged≥18 years living in northern Senegal. Sociodemographic, clinical, and biological data were collected during household visits. Multivariate logistic regression was performed to identify factors associated with diabetes.Results.Mean age of participants was48.0±16.9years and 65.7% were female. Participants from urban area represented 55.7%. The age-standardized prevalence of diabetes was 7.6% (6.0% in men versus 9.0% in women). Prevalence of diabetes was higher in urban areas (8.1%) compared to rural areas (4.6%). Disease awareness rate was 43%. After multivariate analysis, age (OR = 1.63,p=0.001), familial history of diabetes (OR = 1.42,p=0.001), and abdominal obesity (OR = 1.17,p=0.05) were associated with diabetes.Conclusion.Diabetes is frequent in urban and rural areas in Senegal. Awareness rate is very low among populations. Age, family history of diabetes, and abdominal obesity are the main risk factors identified.


Heart ◽  
2019 ◽  
Vol 106 (8) ◽  
pp. 590-595 ◽  
Author(s):  
Liying Xing ◽  
Min Lin ◽  
Zhi Du ◽  
Li Jing ◽  
Yuanmeng Tian ◽  
...  

ObjectiveTo evaluate the epidemiology of atrial fibrillation (AF) in northeast China.MethodsThis cross-sectional survey using a multistage, stratified and cluster random sampling method was conducted in Liaoning Province between September 2017 and March 2019. A total of 18 796 participants (28.9% urban, 71.1% rural) aged ≥40 years were included. All participants completed a questionnaire and underwent a physical examination and ECG. AF was diagnosed according to history and ECG findings.ResultsThe overall AF prevalence was 1.1%; it increased steeply with age. AF was more prevalent in men than in women (1.5% vs 0.9%, p<0.001); however, the difference between urban and rural areas was not significant (1.3% vs 1.1%, p=0.228). Among the AF population, the overall AF awareness rate was 52.6%, higher in women than in men (61.5% vs 44.1%, p=0.011); however, the difference between areas was not statistically significant (60.0% vs 49.0%, p=0.129). According to the CHA2DS-VASc score, almost all (90.2%, 194/215) of our subjects required oral anticoagulant (OAC) therapy; however, only 4.1% actually received it. Moreover, hypertension (66.5%), dyslipidaemia (32.6%) and diabetes (24.2%) were highly prevalent in patients with AF, but their control rates were unacceptably low (7.0%, 8.6% and 28.8%, respectively).ConclusionsThe burden of AF in northeast China was substantial. Underuse of OAC therapy and uncontrolled comorbidities will likely contribute to the cardiovascular outcomes of patients with AF in the coming decades. Long-term management strategies for AF and related risk factors are required in northeast China.


Vaccines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1000
Author(s):  
Filip Raciborski ◽  
Piotr Samel-Kowalik ◽  
Mariusz Gujski ◽  
Jarosław Pinkas ◽  
Magdalena Arcimowicz ◽  
...  

We aimed to assess the factors associated with a lack of willingness to vaccinate against COVID-19 among adults in Poland three months after the introduction of mass vaccination against COVID-19 in Poland. This cross-sectional study was carried out between 8 and 18 April 2021 on a representative nationwide sample of 1131 inhabitants of Poland aged 18 and over. Almost one-third of adult inhabitants of Poland (30%; 95%CI: 27.4–32.7%) declared a lack of willingness to vaccinate against COVID-19. Females had higher odds of refusing COVID-19 vaccination compared with males (OR = 1.68; 95%CI: 1.25–2.27). The lack of higher education was significantly (p < 0.001) associated with greater odds of refusing the COVID-19 vaccination. Participants living in rural areas compared with those living in the largest cities (over 500,000 inhabitants) had three times higher odds of refusing the COVID-19 vaccination (OR = 3.20; 95%CI: 1.71–6.01). Respondents who declared willingness to vote for one of the right-wing political parties publicly supporting the anti-vaccination movement in Poland had eight times higher odds (OR = 8.01; 95%CI: 3.65–17.60) of refusing the COVID-19 vaccination compared with other groups. Moreover, those who had three children or more, respondents who declared passivity towards participating in religious practices as well as active internet users had significantly higher odds of refusing the COVID-19 vaccination.


2019 ◽  
Vol 9 (4) ◽  
pp. 370-375
Author(s):  
Anthonia A. Ikpeme*,Nchiewe E. Ani, Edoise M. Isiwele, Andrew E. Ekpenyong,Emmanuel E. Ekanem

Introduction: Over 80% of cardiovascular deaths take place in low and middle incomecountries. These cardiovascular deaths are caused by modifiable risk factors. Evidenceis emerging that some of these factors maybe even more prevalent in rural areas whichare generally underserved.Aim: The aim of this study was to record risk factors for cardiovascular disease inrural communities in south southern Nigeria and review some related literature.Methods: A cross sectional study during clinical outreach activities that took placein 2016 to 2018 in several rural and few urban communities in Cross River State,Nigeria. Participating individuals gave full consent and ethical clearance obtained.Socio-demographic data, Anthropometric data and Blood sugar measurements wereobtained. Data extracted was transferred into EXCEL thereafter analysis was doneusing SPSS version 21. p values less than 0.05 were deemed statistically significant.Tests of significance included Anova, chi square and student t- tests.Results: Total population investigated over the 3 year period was 504. (2016-33.1%),(2017 -37.9%), (2018 – 28%) with a Female: Male distribution of 1:1.Most participants tended to be overweight across the years 59.7%, 59.1%, 73.7%,2016, 2017, and 2018 respectively. The prevalence of Hypertension was 10.71%. Nosignificant gender difference in the prevalence of Hypertension (6.94% males to 3.77%females, p=0.097). The prevalence of Diabetes Mellitus was 10.67%. There was nosignificant gender prevalence (6.67% males to 4.00% females, p =0.431)Conclusion: Cardiovascular disease remains relatively uncommon in Sub-SaharanAfrica, despite an increasing prevalence of risk factors, but it’s incidence is rising.Steps should be taken in Sub-Saharan Africa to prevent an epidemic. This involvesdetailed and regular screening for cardiovascular risk factors in rural communities.Key words: RISK FACTORS, Cardio vascular disease, South South Nigeria.


2018 ◽  
Vol 1 ◽  
pp. 22 ◽  
Author(s):  
Fred Maniragaba ◽  
Betty Kwagala ◽  
Emmanuel Bizimungu ◽  
Stephen Ojiambo Wandera ◽  
James Ntozi

Background: Little is known about the quality of life of older persons (OPs) in Uganda in particular, and Africa in general. This study examined factors associated with quality of life of older persons in rural Uganda. Method: We performed a cross-sectional survey of 912 older persons from the four regions of Uganda. Data were analyzed at univariate, bivariate and multivariate level where ordinal logistic regression was applied. Results: Older persons in northern (OR=0.39; CI=0.224-0.711) and western (OR=0.33; CI=0.185-0.594) regions had poor quality of life relative to those in central region. Those who were HIV positive had poor quality of life (OR=0.45; CI=0.220-0.928) compared to those who were HIV negative. In contrast, living in permanent houses predicted good quality of life (OR=2.04; CI=1.391-3.002). Older persons whose household assets were controlled by their spouses were associated with good quality of life (OR=2.06;CI=1.032-4.107) relative to those whose assets were controlled by their children. Conclusion: Interventions mitigating the HIV and AIDS related Quality of life should target older persons. The government of Uganda should consider improving housing conditions for older persons in rural areas.


2022 ◽  
Author(s):  
Sultan Mahmud ◽  
Md Mohsin ◽  
Saddam Hossain Irfan ◽  
Abdul Muyeed ◽  
Ariful Islam

Introduction: Tuberculosis (TB) is an infectious disease that causes thousands of deaths in Bangladesh. Bangladesh is one of the high-risk countries among 30 high TB burden countries. In this study, we aimed to assess the knowledge, practices, attitudes towards TB, and the factors associated with them in the general population of Bangladesh. Method: A web-based anonymous cross-sectional survey was conducted among the general population in Bangladesh. A comprehensive consent statement was included at the beginning of the survey by explaining the study's intent, types of questions, anonymous and voluntary nature. Analysis was carried out using the chi-square test and univariate and multivariate logistic regression. Results: Among 1,180 eligible respondents, 58.64% were males, and 62.37% were married. The majority of the participants (78.28%) were aged between 15 to 44 years. Overall adequate knowledge, favorable attitudes, and good practices about TB were found respectively in 47.8%, 44.75%, and 31.19% of the general population of Bangladesh. Almost the same sets of associated factors were found to influence adequate knowledge, favorable attitudes, and good practices towards TB among general people. Males, young, unmarried, respondents with higher education, and urban respondents were more likely to have adequate knowledge, favorable attitudes, and good practices towards TB. Conclusion: Policymakers need to design programs and interventions to improve knowledge, attitudes, and good practices towards TB among the general people by focusing on vulnerable groups such as females, young and older people, people who live in the rural areas, and illiterate/less educated people.


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