scholarly journals Factors associated with births protected against neonatal tetanus in Africa: Evidences from Demographic and health surveys of five African countries

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253126
Author(s):  
Yigizie Yeshaw ◽  
Tadeg Jemere ◽  
Henok Dagne ◽  
Zewudu Andualem ◽  
Yonas Akalu ◽  
...  

Introduction Maternal and neonatal tetanus remains a global public health problem affecting mainly the poorest and most marginalized subpopulations. In spite of the problem, studies conducted on the associated factors of births protected against neonatal tetanus are scarce in Africa. Therefore, this study aimed to identify both individual and community-level factors associated with births protected against neonatal tetanus in the region. Methods The most recent Demographic and Health Survey datasets of five African countries (Ethiopia, Burundi, Comoros, Zimbabwe and Zambia) were used to investigate the associated factors of births protected from neonatal tetanus. STATA Version 14 statistical software was used for the analysis. The data were weighted before doing any statistical analysis and deviance was used for model comparison. Multilevel binary logistic regression was used to identify the associated factors of births protected against neonatal tetanus. Finally, the adjusted odds ratio (AOR) with its 95% confidence interval (CI) was calculated for each potential factors included in the multivariable multilevel logistic regression model. Results A total weighted sample of 30897 reproductive age women who had a birth within 5 years preceding the survey were included in the analysis. Those women with age of 20–34 (AOR = 1.32, 95%CI: 1.18–1.48) and 35–49 years (AOR = 1.26, 95% CI: 1.10–1.44), high community level of women education (AOR = 1.13, 95%CI: 1.04–1.23), being from poorer(AOR = 1.23, 95% CI: 1.14–1.33), middle (AOR = 1.31, 95%CI: 1.21–1.43), richer (AOR = 1.21, 95%CI: 1.11–1.32) and richest households (AOR = 1.59, 95%CI: 1.44–1.74), having antenatal care follow up (AOR = 9.62, 95% CI: 8.79–10.54), not perceiving distance to health facility as a big problem (AOR = 1.18, 95% CI: (1.11–1.25) had higher odds of having births protected against neonatal tetanus. Conclusion Both individual and community level factors were found to be associated with births protected against neonatal tetanus in Africa. This suggests that a variety of factors are affecting births protected against neonatal tetanus in the region. Hence, the impact of these factors should be recognized while developing strategies to reduce neonatal tetanus in the region.

2020 ◽  
Vol 23 (15) ◽  
pp. 2759-2769
Author(s):  
Djibril M Ba ◽  
Paddy Ssentongo ◽  
Duanping Liao ◽  
Ping Du ◽  
Kristen H Kjerulff

AbstractObjective:To identify countries in sub-Saharan Africa (SSA) that have not yet achieved at least 90 % universal salt iodization and factors associated with the consumption of non-iodized salt among women of reproductive age.Design:A cross-sectional study using data from Demographic and Health Surveys (DHS). The presence of iodine in household salt (iodized or non-iodized), which was tested during the survey process, was the study outcome. Multivariable logistic regression models were used to determine independent factors associated with the consumption of non-iodized salt among women of reproductive age.Setting:There were eleven countries in SSA that participated in the DHS since 2015 and measured the presence of iodine in household salt.Participants:Women (n 108 318) aged 15–49 years.Results:Countries with the highest rate of non-iodized salt were Senegal (29·5 %) followed by Tanzania (21·3 %), Ethiopia (14·0 %), Malawi (11·6 %) and Angola (10·8 %). The rate of non-iodized salt was less than 1 % in Rwanda (0·3 %), Uganda (0·5 %) and Burundi (0·8 %). Stepwise multivariable logistic regression showed that women were more likely to be using non-iodized salt (adjusted OR; 95 % CI) if they were poor (1·62; 1·48, 1·78), pregnant (1·16; 1·04, 1·29), aged 15–24 years (v. older: 1·14; 1·04, 1·24) and were not literate (1·14; 1·06, 1·23).Conclusions:The use of non-iodized salt varies among SSA countries. The higher level of use of non-iodized salt among poor, young women and pregnant women is particularly concerning.


2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Betregiorgis Zegeye ◽  
Felix Emeka Anyiam ◽  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
Eugene Budu ◽  
...  

Abstract Background Sub-Saharan Africa (SSA) remains the region with the highest burden of anemia globally. Since anemia has both health and non-health-related consequences, its reduction is one of the Sustainable Development Goals. Therefore, this study aimed to examine the prevalence of anemia and its associated factors among married women in SSA. Methods Using Stata version-14 software, the analysis was done on 89,029 married women from the Demographic and Health Surveys of 19 countries in SSA. Pearson Chi-Square test and Binary logistic regression analyses were used to examine the factors associated with anemia. The results were presented using adjusted Odds Ratio (aOR) at a 95% Confidence Interval (CI). A p-value less than or equal to 0.05 (p ≤ 0.05) was considered statistically significant. Results The pooled analysis showed that 49.7% of married women were anemic. Of these, 1.04% and 15.05% were severely and moderately anemic respectively, and the rest 33.61% were mildly anemic. Husband education (primary school-aOR = 0.84, 95% CI; 0.71–0.99), wealth index (middle-aOR = 0.81, 95% CI; 0.68–0.96, richer-aOR = 0.69, 95% CI; 0.57–0.84, richest-aOR = 0.68, 95% CI; 0.51–0.91), modern contraceptive use (yes-aOR = 0.68, 95% CI; 0.56–0.81) and religion (Muslim-aOR = 1.27, 95% CI; 1.11–1.46, others-aOR = 0.73, 95% CI; 0.59–0.90) were factors associated with anemia among married women. Conclusion The findings show that nearly half of the married women are affected by anemia. Enhancing partners’ educational levels, and economic empowerment of women, strengthening family planning services, and working with religious leaders to reduce the perception and religious beliefs related to food restrictions can be the main focus to reduce the burden of anemia among married women in SSA.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Duah Dwomoh

Abstract Background Ghana did not meet the Millennium Development Goal 4 of reducing child mortality by two-thirds and may not meet SDG (2030). There is a need to direct scarce resources to mitigate the impact of the most important risk factors influencing high neonatal deaths. This study applied both spatial and non-spatial regression models to explore the differential impact of environmental, maternal, and child associated risk factors on neonatal deaths in Ghana. Methods The study relied on data from the Ghana Demographic and Health Surveys (GDHS) and the Ghana Maternal Health Survey (GMHS) conducted between 1998 and 2017 among 49,908 women of reproductive age and 31,367 children under five (GDHS-1998 = 3298, GDHS-2003 = 3844, GDHS-2008 = 2992, GDHS-2014 = 5884, GMHS-2017 = 15,349). Spatial Autoregressive Models that account for spatial autocorrelation in the data at the cluster-level and non-spatial statistical models with appropriate sampling weight adjustment were used to study factors associated with neonatal deaths, and a p-value less than 0.05 was considered statistically significant. Results Population density, multiple births, smaller household sizes, high parity, and low birth weight significantly increased the risk of neonatal deaths over the years. Among mothers who had multiple births, the risk of having neonatal deaths was approximately four times as high as the risk of neonatal deaths among mothers who had only single birth [aRR = 3.42, 95% CI: 1.63–7.17, p < 0.05]. Neonates who were perceived by their mothers to be small were at a higher risk of neonatal death compared to very large neonates [aRR = 2.08, 95% CI: 1.19–3.63, p < 0.05]. A unit increase in the number of children born to a woman of reproductive age was associated with a 49% increased risk in neonatal deaths [aRR = 1.49, 95% CI: 1.30–1.69, p < 0.05]. Conclusion Neonatal mortality in Ghana remains relatively high, and the factors that predisposed children to neonatal death were birth size that were perceived to be small, low birth weight, higher parity, and multiple births. Improving pregnant women’s nutritional patterns and providing special support to women who have multiple deliveries will reduce neonatal mortality in Ghana.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Befikaduwa Zekarias ◽  
Frehiwot Mesfin ◽  
Bezatu Mengiste ◽  
Adane Tesfaye ◽  
Lemma Getacher

Background. Iodine deficiency disorder is a major public health problem in Ethiopia that is more common in women of reproductive age. However, it is not well addressed and there is a lack of information on its prevalence and associated factors in women of reproductive age group. Therefore, the objective of this study was to assess goiter prevalence and associated factors among women of reproductive age in the Demba Gofa woreda, Gamo Gofa Zone, Southwest Ethiopia. Methods. A community-based cross-sectional study was used among 584 randomly selected women in the reproductive age group from February 05 to April 20, 2016. A simple random sampling technique was used to select the study kebeles, and a systematic random sampling technique was used to select the study samples. Data were collected through a pretested questionnaire, and the goiter examination was done clinically for each participant. The collected data were coded and entered into a computer for statistical analysis using EpiData version 3.2 and analyzed using SPSS version 20. Variables with a P value ≤0.25 in bivariate logistic regression analysis were entered into multivariate logistic regression analysis, and finally, variables with a P value <0.05 in multivariate logistic regression were considered significantly associated with the dependent variable. Results. The total goiter rate was 43%, 95% CI = 39.2–46.9. Cassava consumption (AOR: 2.02, 95% CI: 1.03–4), salt wash before use (AOR: 3.14, 95% CI: 1.1–11.3), salt use after >2 months of purchase (AOR: 11, 95% CI: 5–26), family history of goiter (AOR: 4.6, 95% CI: 1.4–15.8), and poor knowledge of iodized salt (AOR: 2.7, 95% CI: 1.4–5.5) were significant factors associated with goiter. Conclusion. Iodine deficiency was found to be severe in women of reproductive age in the study area. This showed that women of reproductive age, especially during pregnancy, are exposed to iodine deficiency and its adverse effects at delivery. Thus, they need urgent supplementation with iodine, improved access to foods rich in iodine, and intake of iodized salt. Additionally, health education should focus on the importance of iodized salt, the proper method of use, and the prevention of iodine deficiency, which are highly recommended to minimize the problem.


2018 ◽  
Vol 34 (1) ◽  
Author(s):  
Thiago G. Ramires ◽  
Luiz R. Nakamura ◽  
Ana J. Righetto ◽  
Edwin M. M. Ortega ◽  
Gauss M. Cordeiro

Renal insufficiency is a serious medical and public health problem worldwide. Recently, although many surveys have been developed to identify factors related to the lifetime of patients with renal insufficiency, controversial results from several studies suggest that researches should be conducted by region. Thus, in this study we aim to predict and identify factors associated with the lifetime of patients with chronic renal failure (CRF) in the metropolitan area of Maringá, Paraná State, Brazil, based on the generalized additive models for location, scale and shape (GAMLSS) framework. Data used in this study were collected from the Maringá Kidney Institute and comprehends 177 patients (classified with CRF and mostly being treated under the Brazilian Unified National Health System) enrolled in a hemodialysis program from 1978 up to 2010. By using this approach, we concluded that in other regions, gender, kidney transplant indicator, antibodies to hepatitis B and antibodies to hepatitis C are significant factors that affect the expected lifetime.


2020 ◽  
Vol 8 (2) ◽  
pp. 1-11
Author(s):  
Mane Hélène Faye ◽  
Nicole Idohou-Dossou ◽  
Abdou Badiane ◽  
Anta Agne-Djigo ◽  
Papa Mamadou DD Sylla ◽  
...  

Background: Like many developing countries, Senegal does not have data on the extent of vitamin A deficiency (VAD) that is representative of its population. The present survey was conducted to fill this gap and to identify factors associated with VAD, prior to the introduction of a large-scale vitamin A oil fortification program. Procedures: A nationwide representative cross-sectional survey involving 1887 children 12 to 59 months old and 1316 women of reproductive age (WRA) was conducted. Blood samples were collected and plasma concentrations of retinol (PR), C-reactive protein (CRP), and alpha-1-acidglycoprotein were measured. PR was adjusted for subclinical inflammation using the BRINDA regression methodology. Multivariate logistic regression was used to identify factors associated with VAD. Findings: The adjusted prevalence of VAD (PR ≤ 0.7 μmol/L) in children was 15.3% and differed by age group, area of residence, and socioeconomic status and half of them had subclinical inflammation. Among WRA, VAD was low (2.3%) and 18.1% had vitamin A insufficiency (VAI). Pregnant women were more affected by VAI (28.4%) and Dakar had lower figures compared with other cities and rural strata. Prevalence of VAI decreased with increasing wealth quintile. In logistic regression, abnormal CRP, poverty, scarce consumption of poultry, oysters, melon, red palm oil, palm kernel oil, Saba senegalensis fruit pulp (Maad) and cowpea, frequent consumption of leeks and consumption of Leptadenia hastata leaves (Mbuum tiakhat), were associated with VAD in children. For women, lower socioeconomic status, fair or poor health status and anemia were negatively associated with VAI. Conclusions: In Senegal, VAD is a moderate public health problem in children and slight among women. Particular attention should be paid to children older than 23 months, pregnant women, rural populations, and poorest households. Nutritional interventions should be implemented alongside morbidity prevention and control. Keywords: vitamin A deficiency, children 12-59 months, women of reproductive age, Senegal.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245528
Author(s):  
Almaz Tefera Gonete ◽  
Bogale Kassahun ◽  
Eskedar Getie Mekonnen ◽  
Wubet Worku Takele

Background Stunting at birth is a chronic form of undernutrition majorly attributable to poor prenatal nutrition, which could persist in children’s later life and impact their physical and cognitive health. Although multiple studies have been conducted in Ethiopia to show the magnitude of stunting and factors, all are concentrated on children aged between 6 to 59 months. Therefore, this study was done to determine the prevalence and associated factors of stunting at birth among newborns delivered at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest, Ethiopia. Methods An institution-based cross-sectional study was conducted from February 26th to April 25th/2020. A systematic random sampling technique was used, to select a total of 422 newborn-mother pairs. The binary logistic regression was employed to identify factors associated with stunting and all independent variables were entered into the multivariable logistic regression model to adjust for confounders. Variables that had significant association were identified based on p-value < 0.05 and the adjusted odds ratio with its respective 95% confidence interval was applied to determine the strength as well as the direction of the association. Results About 30.5% (95% CI: 26.3%, 35.1%) of newborns were stunted at birth. Being male [Adjusted odds ratio (AOR) = 2.9(1.62, 5.21)], newborns conceived in Kiremt(rainy season) [AOR = 2.7(1.49, 4.97)], being low birth weight [AOR = 3.1(1.64, 6.06)] were factors associated with stunting at birth. Likewise, newborns born to short stature mothers [AOR = 2.8(1.21, 6.62)] and chronically malnourished mothers [AOR = 15.3(8.12, 29.1)] were at greater risk of being stunted. Conclusion Just under a third of newborns are stunted at birth, implying a pressing public health problem. Newborns born to chronically malnourished and short stature mothers were more stunted. Besides, stunting was prevalently observed among male neonates, newborns conceived in Kiremet, and being low birth weight. Thus, policymakers and nutrition programmers should work on preventing maternal undernutrition through nutrition education to reduce the burden of low birth weight and stunting. Further, paying due attention to newborns conceived in Kiremet season to improve nutritional status is recommended.


2021 ◽  
Vol 8 (2) ◽  
pp. 27-33
Author(s):  
Jiping Zeng ◽  
Ken Batai ◽  
Benjamin Lee

In this study, we aimed to evaluate the impact of surgical wait time (SWT) on outcomes of patients with renal cell carcinoma (RCC), and to investigate risk factors associated with prolonged SWT. Using the National Cancer Database, we retrospectively reviewed the records of patients with pT3 RCC treated with radical or partial nephrectomy between 2004 and 2014. The cohort was divided based on SWT. The primary out-come was 5-year overall survival (OS). Logistic regression analysis was used to investigate the risk factors associated with delayed surgery. Cox proportional hazards models were fitted to assess relations between SWT and 5-year OS after adjusting for confounding factors. A total of 22,653 patients were included in the analysis. Patients with SWT > 10 weeks had higher occurrence of upstaging. Using logistic regression, we found that female patients, African-American or Spanish origin patients, treatment in academic or integrated network cancer center, lack of insurance, median household income of <$38,000, and the Charlson–Deyo score of ≥1 were more likely to have prolonged SWT. SWT > 10 weeks was associated with decreased 5-year OS (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.15–1.33). This risk was not markedly attenuated after adjusting for confounding variables, including age, gender, race, insurance status, Charlson–Deyo score, tumor size, and surgical margin status (adjusted HR, 1.13; 95% CI, 1.04–1.24). In conclusion, the vast majority of patients underwent surgery within 10 weeks. There is a statistically significant trend of increasing SWT over the study period. SWT > 10 weeks is associated with decreased 5-year OS.


2020 ◽  
Author(s):  
Zemenu Tessema Tadesse

Abstract Background Besides, the presence of national law, the country has to set up its own mid-term and long term goals to bring about a significant reduction in child marriages in Ethiopia. To achieve this, determining the spatial pattern of early marriage and factors associated is important for government, other concerned bodies, program implementers and policy developers to end up early childhood marriage. Thus, the aim of this study was to assess the spatial patterns and associated factors of Early marriage among reproductive-age women in Ethiopia. Methods This study analyzed retrospectively a cross-sectional data on a weighted sample of 11,646 women aged 15-49 years after requesting from Ethiopian Demographic and Health Survey 2016 via the link www.measuredhs.com . ArcGIS version 10.7 software was used to visualize spatial distribution for Early marriage. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for Early marriage in Ethiopia multiple logistic regression analysis was used to identify factors associated with early marriage. Finally, variables with a p-value<0.05 were considered as statistically significant. Results In this analysis, about 62.8% (95%CI: 61.9, 63.74%) of the study participants were married before they reached 18 years. The overall median age at first marriage was 17.1 with IQR 5 years. The high clustering of early marriage was located in Amhara, Afar, and Gambella Regions. In spatial Scan statistics 87 clusters (RR = 1.28, P-value < 0.001) significant primary clusters were identified. The associated factors of early marriage were lesser among women’s attending primary (AOR=0.60; 95%CI: 0.51, 0.71), secondary (AOR=0.19; 95%CI: 0.13, 0.26) and tertiary education (AOR=0.11; 95%CI: 0.07, 0.18). Similarly, women found in Addis Ababa were at a lesser risk of early marriage compared to other regions of the country. Conclusion Marriage below age 18 was high in Ethiopia. High-risk area of early marriage was located in Amhara, Afar, and Gambella and special attention should be given for identified risk areas. Therefore, providing educational opportunities to young girls was important in addition to inhibiting the marriage of girls under 18 years.


2020 ◽  
Author(s):  
Wolde Melese Ayele ◽  
Tesfaye Birhane Tegegne ◽  
Yitayish Damite ◽  
Muluken Genetu Chane ◽  
Asnakew Molla

Abstract Background: Despite significant progress over the past decades to reduce transmission, HIV is continuing a public health problem. Although, consistent condom use has paramount help in reducing HIV transmission, its prevalence, and associated factors are not well studied. Therefore, this study was aimed to assess the proportion and factors associated with condom use among discordant couples in Northeast Ethiopia.Methods: An institution-based cross-sectional study by embedding qualitative design was conducted from October 1 2019 to June 2020. A total of 417 HIV discordant couples were included. A pre-tested structured and interviewer-administered questionnaire was used to collect the quantitative data. An interview guide unstructured questions were used to collect qualitative data. Binary logistic regression was employed to identify factors associated with the outcome variable. Variable those that had a P-value less than 0.05 in multivariable logistic regression were considered as statistical predictors of condom use. Results: A total of 401 HIV serodiscordant couples were participated, making a 94.8% response rate. The proportion of consistent condom use was 58.4%(95%CI: 53.1-63.1%). Unmarried partners AOR=0.44(95%CI: 0.229-0.877), students and employees AOR=0.33(95%CI 0.130-0.846), AOR=0.39(95%CI: 0.165-0.939) respectively, couples live together AOR=1.86(95%CI: 1.197-2.195), receiving counseling about condom use AOR=1.90(95%CI: 1.182-3.076), and knowledgeable participants AOR=1.61(95%CI: 1.031-2.525) were the independent predictors of consistent condom use. Conclusions: Despite its importance, the proportion of consistent condom use among serodiscordant couples was significantly low. Therefore, planners, policymakers, and health care practitioners should consider the aforementioned factors to improve consistent condom use. Also, special intervention on students and employees should be started. The authors recommend the researcher to quantify the new variable explored by qualitative design. Therefore, these results have high importance in designing tailored intervention method.


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