Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

Under Five ◽

Abstract Background: The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods: A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result: The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), mother’s perception of baby’s size (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after one hour (AHR=3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion: Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

10.21203/rs.2.12599/v5 ◽

2019 ◽

Author(s):

Alaka Adiso Limaso ◽

Mesay Hailu Dangisso ◽

Desalegn Tsegaw Hibstu

Keyword(s):

Risk Factors ◽

Neonatal Mortality ◽

Breast Feeding ◽

Newborn Care ◽

Public Health Problem ◽

Southern Ethiopia ◽

Essential Newborn Care ◽

Under Five ◽

Abstract Background: The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods: A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result: The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), mother’s perception of being small baby’s size (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after one hour (AHR=3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion: Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

10.21203/rs.2.12599/v4 ◽

2019 ◽

Author(s):

Alaka Adiso Limaso ◽

Mesay Hailu Dangisso ◽

Desalegn Tsegaw Hibstu

Keyword(s):

Risk Factors ◽

Neonatal Mortality ◽

Breast Feeding ◽

Newborn Care ◽

Public Health Problem ◽

Southern Ethiopia ◽

Essential Newborn Care ◽

Under Five ◽

Abstract Background: The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods: A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result: The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), mother’s perception of baby’s size (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after one hour (AHR=3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion: Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

Neonatal Survival and Determinants of Mortality in Aroresa District, Southern Ethiopia: a Prospective cohort study

10.21203/rs.2.12599/v2 ◽

2019 ◽

Author(s):

Alaka Adiso Limaso ◽

Mesay Hailu Dangisso ◽

Desalegn Tsegaw Hibstu

Keyword(s):

Risk Factors ◽

Neonatal Mortality ◽

Breast Feeding ◽

Newborn Care ◽

Public Health Problem ◽

Southern Ethiopia ◽

Essential Newborn Care ◽

Under Five ◽

Abstract Background: The first day, week and month of life are the most critical period for the survival of children. In Ethiopia, despite a significant reduction in under-five mortality during the last fifteen years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia. Methods: A community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant. Result: The overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR=3.643; 95% CI, 1.36-9.77), male neonates (AHR=2.71; 95% CI, 1.03-7.09), mother’s perception of baby’s size (AHR=3.46; 95% CI, 1.119-10.704), neonates who had initiated exclusive breast feeding (EBF) after one hour (AHR=3.572; 95% CI, 1.255-10.165) and mothers who had no postnatal care (AHR=3.07; 95% CI, 1.16-8.12). Conclusion: Neonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

Study on outcome of guided newborn care in postnatal ward and common practices of newborn care among mothers followed in outpatient department at Hi-Tech medical college and hospital, Bhubaneswar

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20213222 ◽

2021 ◽

Author(s):

Maneesha Sabat ◽

Suryakanta Swain ◽

Hemant Agrawal ◽

Aishwarya Panda ◽

Sthita Prajnya Beura ◽

...

Keyword(s):

Developing Countries ◽

Neonatal Mortality ◽

Neonatal Period ◽

Newborn Care ◽

Mortality Rates ◽

Essential Newborn Care ◽

Under Five ◽

Postnatal Ward ◽

Thermal Care ◽

Abdominal Colic

Background: Neonatal period is the most vulnerable phase in a child's life. The aim and goal of newborn care is not only to reduce neonatal mortality but more importantly to ensure their survival to the fullest. The neonatal mortality rate of India is 22 per 1000 live births. The neonatal period is only for 28 days yet it accounts for significant deaths under 5 years of age. Newborn morbidity and mortality contribute significantly to the infant mortality and under-five mortality rates in developing countries. About two-thirds of all infant deaths and 38% of all under-five deaths occur during the neonatal period, resulting in about 4 million neonatal deaths globally per year. Infant and under-five mortality ratio in developing countries have declined significantly in the past couple of decades, yet neonatal mortality rates have remained relatively static. The objective of this study was to understand the outcome of guided newborn care along with the patterns and determinants of essential newborn care and practices.Methods: A prospective cohort study was done among newborns in the postnatal ward and the outpatient (OPD) based newborns at HMCH Bhubaneswar from July 2020 to June 2021. The mothers in the postnatal ward were taught cord care, skin care, optimal thermal care and neonatal feeding practices. The regular follow-up was done maximum up to 7 days. Newborn who came to OPD were evaluated on perspective of essential newborn care and practices, followed by their mothers at home. A questionnaire was formulated for the OPD based patients to be answered before and after guidance.Results: 100 early neonates were taken (N=50 from postnatal ward and N=50 from OPD). Out of 50 neonates in the postnatal ward. 4 (8%) had abdominal colic, 10 (20%) had skin rashes, 2 (4%) had fever, 5 (10%) had feeding issues and 9 (18%) had neonatal hyperbilirubinemia respectively. In OPD neonates 3 (6%) were diagnosed with early onset neonatal sepsis (EONS), 7 (14%) had refusal to feed, 12 (24%) had skin rashes, 5 (10%) had abdominal colic, 14 (28%) were applying coconut oil and 7 (14%) developed hyperbilirubinemia. Whereas in OPD 5 (10%) neonates needed admission NICU and rest were managed symptomatically.Conclusions: Newborn care education and guidance helped in reduction of EONS, in gaining appropriate weight, in delivering optimal thermal care, practicing healthy skin care and implementing proper feeding techniques. All mothers need proper counselling and guidance in essential newborn care.

Analysis of nutritional inequalities in children under five in Togo

10.21203/rs.3.rs-118844/v1 ◽

2020 ◽

Author(s):

Yaovi Tossou

Keyword(s):

Risk Factors ◽

Health Insurance ◽

Quantile Regression ◽

Lower Risk ◽

Public Health Problem ◽

P Value ◽

Health Coverage ◽

Child Gender ◽

Children Under Five ◽

Under Five

Abstract Background: Malnutrition is a widespread public health problem in Togo. The aim of this article is to identify the risk factors for malnutrition in children under five and the variations between socio-economic factors. Methods: We conducted a simultaneous quantile regression analysis to identify the risk factors of malnutrition in Togo. In addition, concentration curves were constructed to explore the nature of variability in malnutrition. We identified risk factors at the child level such as child gender, age, health insurance, wealth index that explain the risk of stunting and underweight. Results: The decomposition results show that the mother's education contributes about 0.07% of the variability for stunting and underweight for secondary or higher education. Simultaneous quantile regression results show that children of mothers with primary education have a lower risk of stunting (q.0.2 coef 0.2, p-value 0.041) while health insurance is associated with a lower risk of severe stunting in children under five years of age (q0.5, coef = 0.348, p-value .032). Finally, health insurance contributed about 0.17% and living in an urban area contributed 0.12% to the variability in stunting and underweight respectively. Conclusion: Critical risk factors for malnutrition can help in formulating policies for children's nutritional health. The results suggest that there is a need to encourage critical policies aimed at improving female literacy and universal health coverage to reduce child malnutrition.

Essential newborn care practice and its associated factors in Southwest Ethiopia

Archives of Public Health ◽

10.1186/s13690-021-00568-6 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Haimanot Abebe ◽

Daniel Adane ◽

Solomon Shitu

Keyword(s):

Associated Factors ◽

Newborn Care ◽

Care Practice ◽

Framework Analysis ◽

Cross Sectional ◽

Essential Newborn Care ◽

Southwest Ethiopia ◽

The Past ◽

Newborn Care Practice ◽

Abstract Background Essential newborn care is a wide-ranging strategy intended to improve the health of newborns by implementing appropriate interventions. Approximately in 2018, an estimated 2.5 million children died in their first month of life, which is approximately 7000, newborns every day, with about a third of all neonatal deaths occurring within the first day after birth. Even though the most cause of death is preventable the burden of neonatal death is a still high in developing countries including Ethiopia. Therefore this study is aimed to assess the level of essential newborn care practice among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia. Methods A community-based cross-sectional study was conducted among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia. For the quantitative part, 624 study participants were involved by using a multi-stage sampling method. A systematic random sampling technique was to reach the study subjects. Data entry was carried out by Epi data version 4.0.0 and analysis was done by SPSS window version 24. Binary and multivariate logistic regressions were used to identify associated factors. For the qualitative part, three focus group discussions (FGD) with purposively selected 30 mothers were involved. The data were analyzed deductively by using the thematic framework analysis approach by using Open code version 4.02. Result Overall good essential newborn care practice was found to be 41.0% [95%CI, 36.6–44.7]. Being urban residence [AOR 1.70, 95%CI: 1.03–2.79], attending antenatal care visit [AOR = 3.53, 95%CI: 2.14–5.83], attending pregnant mothers meeting [AOR = 1.86, 95%CI: 1.21–2.86], had immediate postnatal care [AOR = 3.92, 95% CI: 2.65–5.78], and having good knowledge about ENC [AOR = 2.13, 95% CI: 1.47–3.10] were significantly associated with good essential newborn care practice. Conclusion This study indicated that the magnitude of essential newborn care practice was low. Thus, a primary health care provider should regularly provide ENC for newborns and take opportunities to counsel the mothers about ENC during pregnant mothers meeting and MCH services sessions.

Essential newborn care practices and associated factors among home delivered mothers in Damot pulasa Woreda, southern Ethiopia

Reproductive Health ◽

10.1186/s12978-018-0609-1 ◽

2018 ◽

Vol 15 (1) ◽

Cited By ~ 6

Author(s):

Tesfaye Yitna Chichiabellu ◽

Baze Mekonnen ◽

Feleke Hailemichael Astawesegn ◽

Birhanu Wondimeneh Demissie ◽

Antehun Alemayehu Anjulo

Keyword(s):

Associated Factors ◽

Newborn Care ◽

Southern Ethiopia ◽

Essential Newborn Care ◽

Care Practices

Substance Use: Prevalence, Pattern and Risk Factors among Undergraduate Students in a Tertiary Institution in Southwest Nigeria

Journal of Community Medicine and Primary Health Care ◽

10.4314/jcmphc.v33i2.6 ◽

2021 ◽

Vol 33 (2) ◽

pp. 83-99

Author(s):

K.A. Durowade ◽

O.E. Elegbede ◽

G.B. Pius-Imue ◽

A. Omeiza ◽

M. Bello ◽

...

Keyword(s):

Risk Factors ◽

Substance Use ◽

Secondary Education ◽

Undergraduate Students ◽

Statistical Significance ◽

Public Health Problem ◽

Peer Pressure ◽

Civil Servant ◽

P Value ◽

Global Public Health

Background: Substance use is a global public health problem with increasing burden among university students. This study assessed the prevalence, pattern and risk factors of substance use among undergraduate students of Afe Babalola University, Ado-Ekiti, Nigeria.Methods: This was a cross-sectional study of undergraduate students of Afe Babalola University, Ado-Ekiti. A multi-stage sampling technique was used to select respondents. Data collection tool was a structured self-administered questionnaire. Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 23. Statistical significance was set at p value <0.05Results: The respondents’ mean age was 19.5 ± 2.0 years and all 416 (100.0%) were aware of substance abuse. The prevalence of substance use was 299 (71.9%). Alcohol 133 (32.0%) and over-the-counter drugs (29.9%) were the two most commonly used substance. Being male (p=0.017) and in 400 level (p=0.047) were associated with substance use while curiosity 112 (37.5%), peer pressure 95 (31.8%) and school stress 85 (28.4%) were reasons given. Predictors of substance use were being a female (aOR: 2.54; 95% CI=1.89-3.66; p=0.011), civil servant mother (aOR: 5.75; 95% CI=1.90-17.4; p=0.002) and mother with secondary education (aOR: 5.27; 95% CI= 2.20- 12.65; p<0.001).Conclusion: There was high prevalence of substance use with curiosity, peer pressure and school stress being influencers of substance use among the study population. Predictors of substance use were being a female, civil servant mother and mother with secondary education. The University authority should institute measures to prevent access to alcohol and other substances by the students.

Abstract 16055: Lipoprotein Subclasses, Size, and Statin-Associated Incident Diabetes: An Analysis From the JUPITER Trial

Circulation ◽

10.1161/circ.130.suppl_2.16055 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Sagar Dugani ◽

Akintunde O Akinkuolie ◽

Robert J Glynn ◽

Paul M Ridker ◽

Samia Mora

Keyword(s):

Risk Factors ◽

Cox Regression ◽

Incident Diabetes ◽

P Value ◽

Random Allocation ◽

Lipoprotein Subclass ◽

Lipoprotein Subclasses ◽

Ldl Particles ◽

Ldl Size ◽

Increased Risk

Statins reduce CVD events, LDL cholesterol (LDL-C) and triglycerides, with an increased risk of diabetes. The underlying predictors of statin-associated diabetes are unclear. We evaluated lipoprotein subclass and size changes in response to rosuvastatin to identify predictors of diabetes on statin therapy Among 11,918 non-diabetic participants in JUPITER (NCT00239681), lipoprotein subclasses and size were quantified by NMR spectroscopy (LipoScience, NC) prior to and 1 year after randomization to placebo or rosuvastatin (total 370 incident diabetes). Cox regression models were adjusted for diabetes risk factors Compared to baseline, rosuvastatin lowered LDL-C and particles by lowering cholesterol-enriched large LDL (58%) and IDL (46%), with less relative lowering of cholesterol-poor small LDL (22%), resulting in smaller LDL size (1.5%). Rosuvastatin lowered (15%-20%) triglycerides, VLDL triglycerides, and VLDL particles by lowering large (15%), medium (7%), and small (27%) particles, and increasing VLDL size (3%) (all p<0.0001). Among statin-allocated individuals, after adjusting for typical risk factors, incident diabetes was inversely associated with baseline levels of LDL-C, HDL-C, large LDL particles, and LDL size, and positively associated with baseline triglycerides, non-HDL-C, ApoB, LDL particles, VLDL particles, VLDL triglycerides and size (Table). Similar associations were seen in on-treatment rosuvastatin and placebo groups In JUPITER, random allocation to rosuvastatin altered the lipoprotein subclass profile in a manner associated with the development of diabetes Adjusted Hazard Ratios (95% CI) and Risk of Incident Diabetes with Rosuvastatin Baseline parameters HR per 1-SD p value LDL-C .86 (0.76-0.98) .02 HDL-C .69 (0.54-0.87) .002 Triglycerides 1.62 (1.41-1.86) <.0001 Non-HDL-C 1.20 (1.04-1.39) .01 ApoB 1.35 (1.18-1.55) <.0001 Total LDL* 1.32 (1.15-1.51) <.0001 Large LDL* .79 (0.71-0.87) <.0001 Small LDL* 1.71 (1.40-2.08) <.0001 IDL* .97 (0.85-1.11) .69 LDL size .66 (0.58-0.75) <.0001 Total VLDL* 1.16 (1.00-1.34) .046 Large VLDL* 1.78 (1.51-2.10) <.0001 Medium VLDL* 1.35 (1.15-1.58) .0002 Small VLDL* .93 (0.82-1.06) .30 VLDL size 1.58 (1.39-1.80) <.0001 VLDL triglycerides 1.51 (1.31-1.73) <.0001 *particles