scholarly journals Termination of pregnancy data completeness and feasibility in population-based surveys: EN-INDEPTH study

2021 ◽  
Vol 19 (S1) ◽  
Author(s):  
Yeetey Akpe Kwesi Enuameh ◽  
◽  
Francis Dzabeng ◽  
Hannah Blencowe ◽  
Sanne M. Thysen ◽  
...  

Abstract Background Termination of pregnancy (TOP) is a common cause of maternal morbidity and mortality in low- and middle-income countries. Population-based surveys are the major data source for TOP data in LMICs but are known to have shortcomings that require improving. The EN-INDEPTH multi-country survey employed a full pregnancy history approach with roster and new questions on TOP and Menstrual Restoration. This mixed methods paper assesses the completeness of responses to questions eliciting TOP information from respondents and reports on practices, barriers, and facilitators to TOP reporting. Methods The EN-INDEPTH study was a population-based cross-sectional study. The Full Pregnancy History arm of the study surveyed 34,371 women of reproductive age between 2017 and 2018 in five Health and Demographic Surveillance System (HDSS) sites of the INDEPTH network: Bandim, Guinea-Bissau; Dabat, Ethiopia; IgangaMayuge, Uganda; Kintampo, Ghana; and Matlab, Bangladesh. Completeness and time spent in answering TOP questions were evaluated using simple tabulations and summary statistics. Exact binomial 95% confidence intervals were computed for TOP rates and ratios. Twenty-eight (28) focus group discussions were undertaken and analysed thematically. Results Completeness of responses regarding TOP was between 90.3 and 100.0% for all question types. The new questions elicited between 2.0% (1.0–3.4), 15.5% (13.9–17.3), and 11.5% (8.8–14.7) lifetime TOP cases over the roster questions from Dabat, Ethiopia; Matlab, Bangladesh; and Kintampo, Ghana, respectively. The median response time on the roster TOP questions was below 1.3 minutes in all sites. Qualitative results revealed that TOP was frequently stigmatised and perceived as immoral, inhumane, and shameful. Hence, it was kept secret rendering it difficult and uncomfortable to report. Miscarriages were perceived to be natural, being easier to report than TOP. Interviewer techniques, which were perceived to facilitate TOP disclosure, included cultural competence, knowledge of contextually appropriate terms for TOP, adaptation to interviewee’s individual circumstances, being non-judgmental, speaking a common language, and providing detailed informed consent. Conclusions Survey roster questions may under-represent true TOP rates, since the new questions elicited responses from women who had not disclosed TOP in the roster questions. Further research is recommended particularly into standardised training and approaches to improving interview context and techniques to facilitate TOP reporting in surveys.

PLoS Medicine ◽  
2019 ◽  
Vol 16 (10) ◽  
pp. e1002921 ◽  
Author(s):  
Rishi Caleyachetty ◽  
Olalekan A. Uthman ◽  
Hana Nekatebeb Bekele ◽  
Rocio Martín-Cañavate ◽  
Debbie Marais ◽  
...  

Author(s):  
Shwetha Ballal K. ◽  
Amritha Bhandary

Background: Menstrual cup is an alternative to sanitary pads, which has received attention in relatively small-scale studies in high income, and low- and middle-income countries, including among schoolgirls. Made of high-grade medical grade silicone (biodegradable) have the advantage of reuse, and can potentially last up to 10 years. Objective of this study was to assess and analyse the awareness regarding menstrual cup among the women of reproductive age group.Methods: Data collected from the selected eligible participants by an interviewer administered study proforma. It is a descriptive cross-sectional study over 1 month in women in reproductive age in A. J. Institute Mangalore, Karnataka, India.Results: A total 82% were aware about menstrual cup but only 2.6% have used it.Conclusions: One challenge of menstruation that is taken for granted in affluent countries is the simple question of how to manage or contain the menstrual flow and what happens to a girl or woman who is not able to do this successfully. Menstrual hygiene management is therefore an increasingly important (yet often unrecognized) issue that is heavily intertwined with girls’ education, empowerment, and social development.


2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Shweta R Singh ◽  
Bunsoth Mao ◽  
Konstantin Evdokimov ◽  
Pisey Tan ◽  
Phana Leab ◽  
...  

Abstract Background The rising incidence of infections caused by MDR organisms (MDROs) poses a significant public health threat. However, little has been reported regarding community MDRO carriage in low- and middle-income countries. Methods We conducted a cross-sectional study in Siem Reap, Cambodia comparing hospital-associated households, in which an index child (age: 2–14 years) had been hospitalized for at least 48 h in the preceding 2–4 weeks, with matched community households on the same street, in which no other child had a recent history of hospitalization. Participants were interviewed using a survey questionnaire and tested for carriage of MRSA, ESBL-producing Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) by culture followed by antibiotic susceptibility testing. We used logistic regression analysis to analyse associations between collected variables and MDRO carriage. Results Forty-two pairs of households including 376 participants with 376 nasal swabs and 290 stool specimens were included in final analysis. MRSA was isolated from 26 specimens (6.9%). ESBL-producing Escherichia coli was detected in 269 specimens (92.8%) whereas ESBL-producing Klebsiella pneumoniae was isolated from 128 specimens (44.1%), of which 123 (42.4%) were co-colonized with ESBL-producing E. coli. Six (2.1%) specimens tested positive for CPE (4 E. coli and 2 K. pneumoniae). The prevalence ratios for MRSA, ESBL-producing E. coli and ESBL-producing K. pneumoniae carriage did not differ significantly in hospital-associated households and hospitalized children compared with their counterparts. Conclusions The high prevalence of ESBL-E across both household types suggests that MDRO reservoirs are common in the community. Ongoing genomic analyses will help to understand the epidemiology and course of MDRO spread.


2021 ◽  
Vol 8 (1) ◽  
pp. 205510292098844
Author(s):  
Bao-Yen Luong-Thanh ◽  
Lan Hoang Nguyen ◽  
Linda Murray ◽  
Manuel Eisner ◽  
Sara Valdebenito ◽  
...  

To date, little attention has been given to prenatal depression, especially in low and middle-income countries. The aim of this research was to assess the prevalence of depression and its associated factors amongst pregnant women in a central Vietnamese city. This cross-sectional study included 150 pregnant women from 29 to 40 weeks of gestation, from eight wards of Hue city, via quota sampling from February to May 2019. We employed the Patient Health Questionnaire (PHQ-9) to assess depression. Findings suggest the need to provide routine screening of pregnant women in primary care for depressive symptoms and other mental health problems.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e033839
Author(s):  
Colette Andrea Cunningham-Myrie ◽  
Novie O Younger ◽  
Katherine P Theall ◽  
Lisa-Gaye Greene ◽  
Parris Lyew-Ayee ◽  
...  

ObjectiveTo derive estimates of the associations between measures of the retail food environments and mean body mass index (BMI) in Jamaica, a middle-income country with increasing prevalence of obesity.DesignCross-sectional study.SettingData from the Jamaica Health and Lifestyle Survey 2008 (JHLS II), a nationally representative population-based survey that recruited persons at their homes over a 4-month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts.ParticipantsA subsample of 2529 participants aged 18–74 years from the JHLS II who completed interviewer-administered surveys, provided anthropometric measurements and whose addresses were geocoded.Primary outcome measureMean BMI, calculated as weight divided by height squared (kg/m2).ResultsThere was significant clustering across neighbourhoods for mean BMI (intraclass correlation coefficients=4.16%). Fully adjusted models revealed higher mean BMI among women, with further distance away from supermarkets (β=0.12; 95% CI 8.20×10−3, 0.24; p=0.036) and the absence of supermarkets within a 1 km buffer zone (β=1.36; 95% CI 0.20 to 2.52; p=0.022). A 10 km increase in the distance from a supermarket was associated with a 1.7 kg/m2 higher mean BMI (95% CI 0.03 to 0.32; p=0.020) in the middle class. No associations were detected with fast-food outlets or interaction by urbanicity.ConclusionsHigher mean BMI in Jamaicans may be partially explained by the presence of supermarkets and markets and differ by sex and social class. National efforts to curtail obesity in middle-income countries should consider interventions focused at the neighbourhood level that target the location and density of supermarkets and markets and consider sex and social class-specific factors that may be influencing the associations.


Author(s):  
Taru Manyanga ◽  
Joel D. Barnes ◽  
Jean-Philippe Chaput ◽  
Peter T. Katzmarzyk ◽  
Antonio Prista ◽  
...  

Abstract Background Insufficient physical activity, short sleep duration, and excessive recreational screen time are increasing globally. Currently, there are little to no data describing prevalences and correlates of movement behaviours among children in low-middle-income countries. The few available reports do not include both urban and rural respondents, despite the large proportion of rural populations in low-middle-income countries. We compared the prevalence of meeting 24-h movement guidelines and examined correlates of meeting the guidelines in a sample of urban and rural Mozambican schoolchildren. Methods This is cross-sectional study of 9–11 year-old children (n = 683) recruited from 10 urban and 7 rural schools in Mozambique. Moderate- to vigorous-intensity physical activity (MVPA) and sleep duration were measured by waist-worn Actigraph GT3X+ accelerometers. Accelerometers were worn 24 h/day for up to 8 days. Recreational screen time was self-reported. Potential correlates of meeting 24-h movement guidelines were directly measured or obtained from validated items of context-adapted questionnaires. Multilevel multivariable logit models were used to determine the correlates of movement behaviours. Meeting 24-h movement guidelines was defined as ≥60 min/day of MVPA, ≤2 h/day of recreational screen time, and between 9 and 11 h/night of sleep. Results More rural (17.7%) than urban (3.6%) children met all three 24-h movement guidelines. Mean MVPA was lower (82.9 ± 29.5 min/day) among urban than rural children (96.7 ± 31.8 min/day). Rural children had longer sleep duration (8.9 ± 0.7 h/night) and shorter recreational screen time (2.7 ± 1.9 h/day) than their urban counterparts (8.7 ± 0.9 h/night and 5.0 ± 2.3 h/day respectively). Parental education (OR: 0.37; CI: 0.16–0.87), school location (OR: 0.21; CI: 0.09–0.52), and outdoor time (OR: 0.67; CI: 0.53–0.85) were significant correlates of meeting all three 24-h movement guidelines. Conclusions Prevalence and correlates of meeting movement guidelines differed between urban and rural schoolchildren in Mozambique. On average, both groups had higher daily MVPA minutes, shorter sleep duration, and higher recreational screen time than the 24-h movement guidelines recommend. These findings (e.g., higher than recommended mean daily MVPA minutes) differ from those from high-income countries and highlight the need to sample from both urban and rural areas.


Author(s):  
Le Thi Vui ◽  
Duong Minh Duc ◽  
Nguyen Thuy Quynh ◽  
Nguyen Thi Huong Giang ◽  
Vu Thi Thanh Mai ◽  
...  

Background: Early detection of autism spectrum disorders (ASDs) is essential given the under-reported cases in low- and middle-income countries. This first national representative survey was conducted to explore the prevalence of ASDs amongst 18 and 30 months in seven provinces in Vietnam.Design and Method: During 2017- 2018, a national cross-sectional and population-based survey for autism spectrum disorder (ASD) amongst 40,243 children aged 18 to 30 months was conducted in 7 provinces representing the socio-economic regions of Vietnam. M-CHAT was used to screen children and then confirmed by diagnostic assessment using DSM-IV criteria.Results: The prevalence of ASDs amongst children aged 18 and 30 months in Vietnam was high (0.758% or 1 in 132 children). Urban setting, male gender, and hereditable genes were associated with ASD prevalence.Conclusion: ASDs amongst children aged 18 and 30 months in Vietnam tend to be increasing and are similar to this rate in other middle-income countries but lower than that in Western countries. This under-recognized public health problem amongst children should be addressed by early detection and intervention for families with affected children.


2021 ◽  
Author(s):  
Murad Mohammed ◽  
Million Wesenu

Abstract Background: Abortion is a termination of pregnancy before the fetus has become viable, i.e., capable of independent existence once delivered by the mother. The purpose of this study was to assess the prevalence and determinants associated with second trimester termination of pregnancy among the women in the reproductive age. Methods: Cross sectional study, design was conducted from September 1-30, 2020. Eight hundreds thirty-five sample of women with induced abortion complication were used. The data were entered into statistical package and service solutions (SPSS) version 23.0 for cleaning and data analysis. Chi-square test of association was used to test the association between the response variable. Binary logistic regression was employed for variables one by one in bivariate logistic regression to determine the significant association between response variables and predictors at p-value 0.15. A 95% confidence interval (CI) and level of significance less than 0.05 were used to determine statistical significance. Results: The prevalence of second trimester termination of pregnancy in the reproductive Age (15-49 years) was found to be 18.2%. As a result multivariable logistic regression model, women with age category 20-24 years [Adjusted odds ratio(AOR)=2.055, 95% CI=1.102-3.831], age category 30-34 years [AOR=3.084, 95%CI=1.348-7.056] , age category greater than or equal to 35 had adjusted odds ratio(AOR=3.021, 95% CI=1.199-7.610), having safe abortion care (AOR=0.294, 95%CI=0.132-0.656), taking treatment in health care/hospital (AOR=2.385, 95% CI=1.057-5.382) and repeatedly acceptor of post-abortion contraception (AOR=0.533, 95%CI=0.291-0.979) were potential determinants associated with women’s in the reproductive age with second trimester termination of pregnancy. Conclusions: Second trimester termination of pregnancy is strongly affected by age of mother, abortion care, place of managed abortion and post-abortion contraception. Strategies on Antenatal care and task-oriented services should be given to community level about the second trimester medical termination of pregnancy to decrease further complications and maternal mortality.


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