scholarly journals Prevalence and determinants of cervical cancer awareness among women of reproductive age: evidence from Benin and Zimbabwe population-based data

2020 ◽  
Vol 40 (1) ◽  
Author(s):  
Amadou Barrow ◽  
Adeyinka Onikan ◽  
Chimezie Igwegbe Nzoputam ◽  
Michael Ekholuenetale
Keyword(s):  
Cervical Cancer ◽  
Health Survey ◽  
Household Wealth ◽  
Population Based ◽  
Demographic And Health Survey ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Women Of Reproductive Age ◽  
Incidence And Mortality ◽  
Sub Saharan

Abstract Background Cervical cancer is a prominently diagnosed form of cancer in several resource-constrained settings particularly within the sub-Saharan African region. Globally, Africa region has the highest incidence and mortality rates of cervical cancer. The high prevalence has been attributed to several factors including lack of awareness of the disease. The aim of this paper is to explore the prevalence and factors associated with awareness of cervical cancer among women of reproductive age in Republic of Benin and Zimbabwe, sub-Saharan Africa. Methods We used population-based cross-sectional data from Benin Demographic and Health Survey (BDHS) and Zimbabwe Demographic and Health Survey (ZDHS) respectively. BDHS 2017–18 and ZDHS - 2015 are the 5th and 6th rounds of the surveys respectively. About 15,928 and 9955 women aged 15–49 years were included in this study respectively. The awareness of cervical cancer among women of reproductive age in Benin and Zimbabwe was measured dichotomously; yes (if a woman heard of cervical cancer) vs. no (if a woman has not heard of cervical cancer). All significant variables from the bivariate analysis were included in the multivariable logistic regression model to calculate the adjusted odds ratios (AOR) with corresponding 95% confidence interval. Results While majority (79.2%) of women from Zimbabwe have heard about cervical cancer, only about one-tenth (10.2%) of their Beninese counterparts have heard about the disease. Advanced maternal age, having formal education, use of internet, having professional/technical/managerial occupation significantly increased the odds of awareness of cervical cancer after adjusting for other confounders. However, in Benin, women who resided in the rural area and those of Islamic belief had 20% (AOR = 0.80; 95%CI: 0.64, 0.99) and 35% (AOR = 0.65; 95%CI: 0.50, 0.86) reduction in the odds of awareness of cervical cancer respectively, when compared with women from urban residence and Christianity. Results from the predictive marginal effects showed that, assuming the distribution of all factors remained the same among women, but every woman is an urban dweller, we would expect 11.0 and 81.0% level of awareness of cervical cancer; If everywoman had higher education, we would expect 20.0 and 90% level of awareness of cervical cancer and if instead the distribution of other maternal factors were as observed and other covariates remained the same among women, but all women were in the richest household wealth quintile, we would expect about 11.0 and 83.0% level of awareness of cervical cancer, among women of reproductive age from Benin and Zimbabwe respectively. Conclusion The study has revealed that socio-demographical factors including geographical location and selected economic factors explained the inequality in distribution of women’s awareness on cervical cancer in both countries. Designing an effective population-based health education and promotion intervention programs on cervical cancer will be a great way forward to improving women’s awareness level on cervical cancer.

scholarly journals Direct maternal morbidity and the risk of pregnancy-related deaths, stillbirths, and neonatal deaths in South Asia and sub-Saharan Africa: A population-based prospective cohort study in 8 countries

PLoS Medicine ◽  
2021 ◽  
Vol 18 (6) ◽  
pp. e1003644
Author(s):  
Fahad Aftab ◽  
Imran Ahmed ◽  
Salahuddin Ahmed ◽  
Said Mohammed Ali ◽  
Seeba Amenga-Etego ◽  
...  
Keyword(s):  
Cohort Study ◽  
South Asia ◽  
Maternal Morbidity ◽  
Population Based ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Women Of Reproductive Age ◽  
Neonatal Deaths ◽  
Newborn Outcomes ◽  
Sub Saharan

Background Maternal morbidity occurs several times more frequently than mortality, yet data on morbidity burden and its effect on maternal, foetal, and newborn outcomes are limited in low- and middle-income countries. We aimed to generate prospective, reliable population-based data on the burden of major direct maternal morbidities in the antenatal, intrapartum, and postnatal periods and its association with maternal, foetal, and neonatal death in South Asia and sub-Saharan Africa. Methods and findings This is a prospective cohort study, conducted in 9 research sites in 8 countries of South Asia and sub-Saharan Africa. We conducted population-based surveillance of women of reproductive age (15 to 49 years) to identify pregnancies. Pregnant women who gave consent were include in the study and followed up to birth and 42 days postpartum from 2012 to 2015. We used standard operating procedures, data collection tools, and training to harmonise study implementation across sites. Three home visits during pregnancy and 2 home visits after birth were conducted to collect maternal morbidity information and maternal, foetal, and newborn outcomes. We measured blood pressure and proteinuria to define hypertensive disorders of pregnancy and woman’s self-report to identify obstetric haemorrhage, pregnancy-related infection, and prolonged or obstructed labour. Enrolled women whose pregnancy lasted at least 28 weeks or those who died during pregnancy were included in the analysis. We used meta-analysis to combine site-specific estimates of burden, and regression analysis combining all data from all sites to examine associations between the maternal morbidities and adverse outcomes. Among approximately 735,000 women of reproductive age in the study population, and 133,238 pregnancies during the study period, only 1.6% refused consent. Of these, 114,927 pregnancies had morbidity data collected at least once in both antenatal and in postnatal period, and 114,050 of them were included in the analysis. Overall, 32.7% of included pregnancies had at least one major direct maternal morbidity; South Asia had almost double the burden compared to sub-Saharan Africa (43.9%, 95% CI 27.8% to 60.0% in South Asia; 23.7%, 95% CI 19.8% to 27.6% in sub-Saharan Africa). Antepartum haemorrhage was reported in 2.2% (95% CI 1.5% to 2.9%) pregnancies and severe postpartum in 1.7% (95% CI 1.2% to 2.2%) pregnancies. Preeclampsia or eclampsia was reported in 1.4% (95% CI 0.9% to 2.0%) pregnancies, and gestational hypertension alone was reported in 7.4% (95% CI 4.6% to 10.1%) pregnancies. Prolonged or obstructed labour was reported in about 11.1% (95% CI 5.4% to 16.8%) pregnancies. Clinical features of late third trimester antepartum infection were present in 9.1% (95% CI 5.6% to 12.6%) pregnancies and those of postpartum infection in 8.6% (95% CI 4.4% to 12.8%) pregnancies. There were 187 pregnancy-related deaths per 100,000 births, 27 stillbirths per 1,000 births, and 28 neonatal deaths per 1,000 live births with variation by country and region. Direct maternal morbidities were associated with each of these outcomes. Conclusions Our findings imply that health programmes in sub-Saharan Africa and South Asia must intensify their efforts to identify and treat maternal morbidities, which affected about one-third of all pregnancies and to prevent associated maternal and neonatal deaths and stillbirths. Trial registration The study is not a clinical trial.

scholarly journals HIV and cardiovascular disease in sub-Saharan Africa: Demographic and Health Survey data for 4 countries

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonard E. Egede ◽  
Rebekah J. Walker ◽  
Patricia Monroe ◽  
Joni S. Williams ◽  
Jennifer A. Campbell ◽  
...  
Keyword(s):  
South Africa ◽  
Cardiovascular Disease ◽  
Health Survey ◽  
Survey Design ◽  
Logistic Models ◽  
Population Data ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
The Relationship

Abstract Background Investigate the relationship between two common cardiovascular diseases and HIV in adults living in sub-Saharan Africa using population data provided through the Demographic and Health Survey. Methods Data for four sub-Saharan countries were used. All adults asked questions regarding diagnosis of HIV, diabetes, and hypertension were included in the sample totaling 5356 in Lesotho, 3294 in Namibia, 9917 in Senegal, and 1051 in South Africa. Logistic models were run for each country separately, with self-reported diabetes as the first outcome and self-reported hypertension as the second outcome and HIV status as the primary independent variable. Models were adjusted for age, gender, rural/urban residence and BMI. Complex survey design allowed weighting to the population. Results Prevalence of self-reported diabetes ranged from 3.8% in Namibia to 0.5% in Senegal. Prevalence of self-reported hypertension ranged from 22.9% in Namibia to 0.6% in Senegal. In unadjusted models, individuals with HIV in Lesotho were 2 times more likely to have self-reported diabetes (OR = 2.01, 95% CI 1.08–3.73), however the relationship lost significance after adjustment. Individuals with HIV were less likely to have self-reported diabetes after adjustment in Namibia (OR = 0.29, 95% CI 0.12–0.72) and less likely to have self-reported hypertension after adjustment in Lesotho (OR = 0.63, 95% CI 0.47–0.83). Relationships were not significant for Senegal or South Africa. Discussion HIV did not serve as a risk factor for self-reported cardiovascular disease in sub-Saharan Africa during the years included in this study. However, given the growing prevalence of diabetes and hypertension in the region, and the high prevalence of undiagnosed cardiovascular disease, it will be important to continue to track and monitor cardiovascular disease at the population level and in individuals with and without HIV. Conclusions The odds of self-reported diabetes in individuals with HIV was high in Lesotho and low in Namibia, while the odds of self-reported hypertension in individuals with HIV was low across all 4 countries included in this study. Programs are needed to target individuals that need to manage multiple diseases at once and should consider increasing access to cardiovascular disease management programs for older adults, individuals with high BMI, women, and those living in urban settings.

scholarly journals Cervical cancer in Sub‐Saharan Africa: a multinational population‐based cohort study on patterns and guideline adherence of care

2021 ◽  
Author(s):  
Mirko Griesel ◽  
Tobias P Seraphin ◽  
Nikolaus CS Mezger ◽  
Lucia Hämmerl ◽  
Jana Feuchtner ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Guideline Adherence ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Prevention of Cervical Cancer in Sub-Saharan Africa: The Advantages and Challenges of HPV Vaccination

Vaccines ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 61 ◽  
Author(s):  
Eleanor Black ◽  
Robyn Richmond
Keyword(s):  
Cervical Cancer ◽  
Hpv Vaccination ◽  
Sub Saharan Africa ◽  
Current Status ◽  
Public Health Issue ◽  
Successful Implementation ◽  
Screening Programs ◽  
Incidence And Mortality ◽  
Sub Saharan ◽  
Ssa Countries

Cervical cancer is a critical public health issue in sub-Saharan Africa (SSA), where it is the second leading cause of cancer among women and the leading cause of female cancer deaths. Incidence and mortality rates are substantially higher than in high-income countries with population-based screening programs, yet implementing screening programs in SSA has so far proven to be challenging due to financial, logistical, and sociocultural factors. Human Papillomavirus (HPV) vaccination is an effective approach for primary prevention of cervical cancer and presents an opportunity to reduce the burden from cervical cancer in SSA. With a number of SSA countries now eligible for Global Alliance for Vaccines and Immunization (GAVI) support for vaccine introduction, it is timely to consider the factors that impede and facilitate implementation of vaccine programs in SSA. This article describes epidemiological features of cervical cancer in SSA and the current status of HPV vaccine implementation in SSA countries. Rwanda’s experience of achieving high vaccination coverage in their national HPV immunization program is used as a case study to explore effective approaches to the design and implementation of HPV vaccination programs in SSA. Key factors in Rwanda’s successful implementation included government ownership and support for the program, school-based delivery, social mobilization, and strategies for reaching out-of-school girls. These findings might usefully be applied to other SSA countries planning for HPV vaccination.

scholarly journals Paid sex among men in sub-Saharan Africa: Analysis of the demographic and health survey

2020 ◽  
Vol 11 ◽  
pp. 100459 ◽  
Author(s):  
Abdul-Aziz Seidu ◽  
Eugene Kofuor Maafo Darteh ◽  
Akwasi Kumi-Kyereme ◽  
Kwamena Sekyi Dickson ◽  
Bright Opoku Ahinkorah
Keyword(s):  
Health Survey ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Factors Associated with Duration of Breastfeeding in Bangladesh: Evidence from Bangladesh Demographic and Health Survey 2014   

2020 ◽  
Author(s):  
Ummay Ayesha ◽  
ASMA Mamun ◽  
Md. Abu Sayem ◽  
Golam Hossain
Keyword(s):  
Health Survey ◽  
Mode Of Delivery ◽  
Multiple Linear Regression Model ◽  
Household Wealth ◽  
T Test ◽  
Demographic And Health Survey ◽  
Reproductive Age ◽  
Age At First Birth ◽  
Optimum Duration ◽  
Duration Of Breastfeeding

Abstract Background: Breastfeeding for optimum duration is one of the most effective ways to reduce infant morbidity and mortality and confirm expected growth and development of children. The aim of this study was to find out the effect of socio-demo­graphic and anthropometric determinants on duration of breast­feeding among Bangladeshi mothers.Methods: The data was extracted from the Bangladesh Demographic and Health Survey (BDHS)-2014. A total of 3541 married non–pregnant Bangladeshi mothers in reproductive age who had at least one child aged 6-36 months were included in this study. Independent sample t-test and analysis of variance (ANOVA) were used to find the significance difference in duration of breastfeeding between two and more than two groups respectively. Multiple linear regression model was utilized to determine the effect of some quantitative variables on duration of breastfeeding. Results: This study raveled that the mean and median duration of breastfeeding among Bangladeshi mothers was 18.91 (95% CI: 18.65-19.17) and 19.00 months respectively. Independent sample t-test and ANOVA showed that duration of breastfeeding among Bangladeshi mothers was significantly influenced by (i) ANC service, (ii) religion, (iii) mode of delivery, (iv) parents’ education, (v) geographical location and (vi) household wealth quintile. Multiple regression analysis demonstrated that mothers’ age, mothers’ body mass index, total number of children and mothers’ age at first birth were important predictors of duration of breastfeeding.Conclusions: Healthcare providers and decision makers can consider these findings to make plan for counseling of mothers and family members to promote optimum duration of breastfeeding practice in first two years of baby’s life.

scholarly journals Determinants for Choice of Home Birth over Health Facility Birth among Women of Reproductive Age in Tanzania: An Analysis of Data from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey

2020 ◽  
Author(s):  
Fabiola Vincent Moshi ◽  
Christopher H. Mbotwa
Keyword(s):  
Health Survey ◽  
Wealth Index ◽  
Demographic And Health Survey ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Home Childbirth ◽  
Malaria Indicator Survey ◽  
Birth Attendants ◽  
Home Based ◽  
Antenatal Visits

Abstract Background While evidence has shown an association between place of childbirth and birth outcomes, still factors contributing to the choice of home childbirth have not been adequately investigated. Childbirth assisted by unskilled birth attendants has been cited as a contributing factor for the high maternal and neonatal mortalities in low resources countries. This study aimed at determining determinants of preference for home childbirth assisted by unskilled attendants in Tanzania Method The study used the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS) dataset. A total of 2286 women of reproductive age (15-49 years) who had childbirth within one year preceding the survey were included in the analysis. Both univariate and multivariable regression analysis was used to determine predictors for home-based childbirth. Results A total of 805(35.2%) of women had home childbirth assisted by unskilled providers. After adjusting for confounders, the determinants of preference for home childbirth were the level of education (primary education, AOR=0.666; p=0.001; secondary and higher education, AOR=0.417; p<0.001); not owning mobile phone, AOR= 1.312; p=0.018; parity (parity 2-4, AOR=1.594; p=0.004; Parity 5 and above, AOR=2.158; p<0.001); inadequate antenatal visits, AOR=1.406; p=0.001; wealth index (poorest, AOR=9.395; p<0.001; poorer, AOR=7.701; p<0.001; middle, AOR=5.961; p<0.001; richer, AOR=2.557; p<0.001) and Zones (Southern Highlands, AOR=0.189; p<0.001; Southern, AOR=0.225; p<0.001; Zanzibar, AOR=2.55; p<0.001). Conclusion There are large proportions of women who use home childbirth assisted by unskilled birth attendant’s mainly traditional birth attendants (TBA). Predictors for home-based childbirth were being illiterate women, poor access to communication, inadequate antenatal visits, low socio-economic status and those from Zanzibar. Innovative strategies targeting these groups are highly needed to increase the use of health facilities for childbirth and hence reduce maternal and neonatal mortalities in Tanzania.

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