scholarly journals Neonatal sepsis and its associated factors in East Africa: a systematic review and meta-analysis, 2019

2019 ◽  
Author(s):  
Biruk Beletew Abate ◽  
Ayelign Mengesha Kasie ◽  
Mesfin Kassaw ◽  
Mikiyas Amare Getu

Abstract Background : Neonatal sepsis is one of the leading causes of inflated death and illness of neonates. Different primary studies in Eastern Africa showed the burden of neonatal sepsis. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review intended to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Methods : Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that assessed the prevalence and associated factors of neonatal sepsis from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to determine the prevalence and the effect size of associated factors. The subgroup analysis was done by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Result : A total of 26 studies with 11239 participants were used for analysis. The pooled prevalence of neonatal sepsis in East Africa was 29.65% (95% CI; 23.36–35.94).Home delivery(AOR =2.67; 95% CI: 1.15-4.00; I 2 = 0.0%; P=0.996), maternal history of UTI (AOR=2.083; 95% CI :0.24-3.93; I 2 = 69.1%; P=0.001),gestational age (preterm) (AOR=1.56; 95% CI: 1.04-2.08; I 2 = 27.8%;P=0.000) ,prolonged labor (AOR=3.23 ;95% CI: -0.04-6.51; I 2 = 62.7%; P=0.020) and PROM (AOR= 1.95; 95% CI: 0.53-3.37; I 2 = 43.2%; P=0.062) were identified factors of neonatal sepsis. Conclusions : The prevalence of neonatal sepsis in Eastern Africa remains high. This review may help policy-makers and program officers to design neonatal sepsis preventive interventions.

2019 ◽  
Author(s):  
Biruk Beletew ◽  
Ayelign Kassie ◽  
Mesfin Wudu kassaw ◽  
Mikias Amare Getu

Abstract Background: Neonatal sepsis is one of the most leading causes of inflated death and illness of neonates. Different primary studies in Eastern Africa showed the burden of neonatal sepsis. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Methods: Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of neonatal sepsis from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Result: A total of 26 studies with 11239 participants were used for analysis. The pooled prevalence of neonatal sepsis in East Africa was 29.65% (95% CI; 23.36–35.94).Home delivery(AOR =2.67; 95% CI: 1.15-4.00; I2= 0.0%; P=0.996), maternal history of UTI (AOR=2.083; 95% CI :0.24-3.93; I2= 69.1%; P=0.001),gestational age (preterm) (AOR=1.56; 95% CI: 1.04-2.08; I2= 27.8%;P=0.000) ,prolonged labor (AOR=3.23 ;95% CI: -0.04-6.51; I2= 62.7%; P=0.020) and PROM (AOR= 1.95; 95% CI: 0.53-3.37; I2= 43.2%; P=0.062) were identified factors of neonatal sepsis. Conclusions: The prevalence of neonatal sepsis in Eastern Africa remains high. This review may help policy-makers and program officers to design neonatal sepsis preventive interventions. Keywords: Neonatal sepsis, Eastern Africa


2020 ◽  
Author(s):  
Biruk Beletew Abate ◽  
Melaku Getahun Bimrew ◽  
Ayelign Mengesha Kasie ◽  
Mesfin Kassaw Wudu ◽  
Molla Azmeraw

Abstract Introduction Pneumonia is defined as an acute inflammation of the Lungs’ parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Objective The aim of this systematic review and meta-analysis was to assess the magnitude of pneumonia and its associated factors among under-five children in East Africa. Methods Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies. Result A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of hypothermia in East Africa was 34% (95%CI; 23.80–44.21). Use of wood as fuel source (AOR= 1.53; 95%CI:1.30-1.77; I 2 = 0.0% ;P=0.465), cook food in living room (AOR= 1.47;95%CI:1.16-1.79; I 2 = 0.0% ;P=0.58), caring of a child on mother during cooking (AOR= 3.26; 95%CI:1.80-4.72; I 2 = 22.5% ;P=0.26), Being unvaccinated (AOR= 2.41; 95%CI:2.00-2.81; I 2 = 51.4% ;P=0.055), Child history of ARTI(AOR= 2.62; 95%CI:1.68-3.56; I 2 = 11.7% ;P=0.337) were identified factors of pneumonia. Conclusions The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.


2019 ◽  
Author(s):  
Mizan Kindu ◽  
Esayas Aklilu Zeleke ◽  
Baye Gelaw Tarekegn ◽  
Feleke Moges Yehuala

Abstract Background: Surgical site infection is the third most commonly reported nosocomial infection. Different primary studies on Surgical site infection (SSI) were conducted in Ethiopia. However, variation among those studies was seen. This study was aimed to estimate the national prevalence of SSI, its bacterial profile and associated factors of SSI in Ethiopia. Methods: PubMed, Cochrane library, and Google Scholar were searched. A funnel plot and Egger’s regression test were used to see publication bias. I-squared statistic was applied to check heterogeneity of studies. A weighted inverse variance random-effects model was applied to estimate the national prevalence of SSI, its bacterial profile and the effect size of associated factors. The subgroup analysis was conducted by region, study design, and year of study conducted. Result: A total of 18 studies were used for prevalence of SSI, its bacterial profile and associated factors. The pooled prevalence of SSI was 11.58 (95% CI 9.78, 13.38). The pooled prevalence of culture positive SSI infection among patients who develop clinical sign and symptoms of SSI was also 80.42% (95% CI 70.86, 89.99). SSI was majorly caused by S. aureus (28.47%) and E. coli (15.93%). Drinking an alcohol (AOR = 6.28; 95%CI: 2.9–13.3); women’s having chorioaminities (AOR = 8.67; 95%CI: 4.63–16.27); patients living in rural areas (AOR = 3.10; 95%CI: 1.57–6.14); patients who undergo previous surgery (AOR = 3.94; 95%CI: 1.7–7.17) and women’s who had rupture of membrane >12 hour (AOR=5.29; 95%CI: 2.73–10.25) were identified factors of SSI. Conclusions: The prevalence of SSI in Ethiopia was high. This indicates calling for the need of better allocating resources and implementing a program for controlling Surgical site infections in Ethiopia.


2020 ◽  
Author(s):  
Asteray Assmie Ayenew ◽  
Azezu Nigussie ◽  
Biruk Zewdu

Abstract BackgroundGlobally, maternal morbidity and mortality remained a major public health challenge. Delivering at home is associated with a higher risk of maternal deaths. Findings on the prevalence and associated factors of home delivery are highly variable and inconsistent across Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of home delivery and its associated factors in Ethiopia.MethodPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The databases used were; PubMed, Google Scholar, Cochrane Library, African Journals Online, Ethiopian's university research repository online library, and manual searching. The search was further limited to studies conducted in Ethiopia and reported in English. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 11 software was used to analyze the data. The Cochrane Q and I2 test were used to assess the heterogeneity of studies. The pooled estimate prevalence and the odds ratios with 95% confidence intervals were computed by a random effect model.ResultA total of 13 studies were included in this meta-analysis with a sample size of 13,535. The national pooled prevalence of home delivery was 48.53 % (95% CI:35, 62). The pooled adjusted odds ratio (AOR) of home delivery for Place of rural residence was 4.3(AOR = 4.3; 95% CI 2.7, 6.8), husband preference was 5(AOR=5.1 95%CI:1.1, 22), not having ANC follows up was 3.3(AOR= 3.3,95%CI:2,6), Women who cannot read & write was 4(AOR=4.36,95% CI:3.1, 6.12), Primary level was 4(AOR=4.21, 95%CI:1.5, 11.6) ,and secondary & above was 1.9(AOR=1.9,95%CI:1.1, 3.45), distance from the health facility was 7(AOR= 7.33, 95%CI:5.75, 9.35), age of mothers 15-24 was 4(AOR =3.7,95%CI:2, 6.6), knowledge of danger sign of pregnancy was 4(AOR=4.60 95%CI:3, 6.8), and no media access was 3.4(AOR=3.495%CI: 1.5, 7.5).ConclusionThis systematic review and meta-analysis showed that home delivery was high in Ethiopia. Place of residence, husband preference, no having ANC follows up, educational status of mothers, distance from health facility, age of mothers, knowledge of danger sign of pregnancy, and no media access increased the risk of home delivery.


2020 ◽  
Author(s):  
Biruk Beletew ◽  
Melaku Getahun Bimrew ◽  
Ayelign Mengesha Kasie ◽  
Mesfin Kassaw Wudu ◽  
Molla Azmeraw

Abstract Background: Pneumonia is defined as an acute inflammation of the Lungs’ parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa.Objective: The aim of this systematic review and meta-analysis was to assess the magnitude of pneumonia and its associated factors among under-five children in East Africa.Methods: Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies.Result: A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of hypothermia in East Africa was 34% (95%CI; 23.80–44.21). Use of wood as fuel source (AOR= 1.53; 95%CI:1.30-1.77; I2= 0.0% ;P=0.465), cook food in living room (AOR= 1.47;95%CI:1.16-1.79; I2= 0.0% ;P=0.58), caring of a child on mother during cooking (AOR= 3.26; 95%CI:1.80-4.72; I2= 22.5% ;P=0.26), Being unvaccinated (AOR= 2.41; 95%CI:2.00-2.81; I2= 51.4% ;P=0.055), Child history of ARTI(AOR= 2.62; 95%CI:1.68-3.56; I2= 11.7% ;P=0.337) were identified factors of pneumonia.Conclusions: The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.


2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Temesgen Getaneh ◽  
Ayenew Negesse ◽  
Getenet Dessie ◽  
Melaku Desta ◽  
Agimasie Tigabu

Objective. Urinary tract infection (UTI) is the most common bacterial infections during pregnancy. It is associated with different maternal and neonatal adverse outcomes such as low birth weight, preterm birth, still birth, preeclampsia, maternal anemia, sepsis, and amnionitis, even when the infection is asymptomatic. However, in Ethiopia, it is represented with fragmented and inconclusive pocket studies. Therefore, this systematic review and meta-analysis is aimed at estimating the pooled prevalence of UTI and its associated factors among pregnant women in Ethiopia. Methods. PubMed/Medline, Embase, Cochrane Library, Google Scholar, and local sources were used to access eligible studies. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was applied for critical appraisal. Heterogeneity and publication bias were evaluated using I 2 statistic, funnel plot asymmetry, and Egger’s tests. Random effect model was employed to estimate the pooled burden of UTI and its associated factors among pregnant women with its corresponding odds ratio (OR) and 95% confidence interval (CI). Result. From all systematically searched articles, 14 studies were eligible for this analysis. The overall pooled prevalence of UTI among pregnant women in Ethiopia was 15.37% (95% CI: 12.54, 18.19). Family monthly income ( OR = 3.8 and 95% CI: 1.29, 11.23), parity ( OR = 1.59 and 95% CI: 1.01, 2.50), history of catheterization ( OR = 2.76 and 95% CI: 1.31, 5.84), and history of UTI ( OR = 3.12 and 95% CI: 1.74, 5.60) were factors significantly associated with UTI among pregnant women in Ethiopia. Conclusion. The overall pooled estimate of UTI among pregnant women in Ethiopia was higher compared with CDC estimation which was 8%. Family   monthly   income < 1000 ETB , multipara, previous history of catheterization, and history of UTI were factors increased burden of UTI during pregnancy. So, strategies targeting in economic reforms, universal access of family planning, and standardized prenatal care service should be addressed to alleviate this high prevalence of UTI during pregnancy.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Asmamaw Demis Bizuneh ◽  
Getnet Gedefaw Azeze

Abstract Background Utilization of post-abortion family planning is very critical to reduce high levels of unintended pregnancy, which is the root cause of induced abortion. In Eastern Africa, it is estimated that as many as 95% of unintended pregnancies occurred among women who do not practice contraception at all. Therefore, this meta-analysis aimed to assess post-abortion family planning utilization and its determinant factors in Eastern Africa. Methods Published papers from Scopus, HINARI, PubMed, Google Scholar, and Web of Science electronic databases and grey literature repository were searched from database inception to January 30, 2020, with no restriction by design and date of publishing. We screened records, extracted data, and assessed risk of bias in duplicate. Cochrane I2 statistics were used to check the heterogeneity of the studies. Publication bias was assessed by Egger and Biggs test with a funnel plot. A random-effects model was calculated to estimate the pooled prevalence of post-abortion family planning utilization. Results A total of twenty-nine cross-sectional studies with 70,037 study participants were included. The overall pooled prevalence of post-abortion family planning utilization was 67.86% (95% CI 63.59–72.12). The most widely utilized post-abortion family methods were injectable 33.23% (95% CI 22.12–44.34), followed by implants 24.71% (95% CI 13.53–35.89) and oral contraceptive pills 23.42% (95% CI 19.95–26.89). Married marital status (AOR=3.20; 95% CI 2.02–5.05), multiparity (AOR=3.84; 95% CI 1.43–10.33), having a history of abortion (AOR=2.33; 95% CI 1.44–3.75), getting counselling on post-abortion family planning (AOR=4.63; 95% CI 3.27–6.56), and ever use of contraceptives (AOR=4.63; 95% CI 2.27–5.21) were factors associated with post-abortion family planning utilization in Eastern Africa. Conclusions This study revealed that the marital status of the women, multiparity, having a history of abortion, getting counselling on post-abortion family planning, and ever used contraceptives were found to be significantly associated with post-abortion family planning utilization.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zelalem Animaw ◽  
Addisu Melese ◽  
Habtamu Demelash ◽  
Girma Seyoum ◽  
Abiy Abebe

Abstract Background Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur among women of reproductive age. IPIs caused by helminthes and protozoan parasites are common among pregnant women. Data on the national pooled prevalence of intestinal parasites and associated factors during pregnancy is not documented well in Ethiopia. This review aims at summarizing evidences on the burden of IPIs and associated factors among pregnant women in Ethiopia. Methods Published and unpublished studies were thoroughly searched at MEDLINE/PubMed, EMBASE, Google Scholar, CINAHL, Cochrane library and Science Direct. In addition, repositories of Addis Ababa, Gondar and Jimma Universities were searched. Eligible studies were selected following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The pooled prevalence of intestinal parasites and summary odds ratios (ORs) were determined with 95 % confidence intervals (CI). Sub-groups analyses were done based on study region, types of parasites, methods of stool examination and study setting. The statistical analyses were performed using STATA version 14.0 software. Results Among 168 retrieved studies, 31 studies with a total population of 12,118 pregnant women were included. The estimated pooled prevalence of IPIs among pregnant women in Ethiopia was 27.32 % (95 % CI: 20.61, 33.87 %). In the subgroup analysis, Oromia and Amhara regions had the highest prevalence with a 29.78 % (95 % CI: 15.97, 43.60) and 29.63 % (95 % CI: 15.37, 43.89); respectively. In addition, studies conducted in the community showed higher prevalence than institution based studies (49.93 % Vs 24.84 %; respectively). The most prevalent type of intestinal parasite identified were Hookworm followed by Ascaris lumbricoides with a pooled prevalence of 11.2 and 10.34 %, respectively. In our analysis; residence, being bare footed, lack of hand washing habit and eating uncooked/raw vegetables were significantly associated with IPIs among pregnant women in Ethiopia. Conclusions Prevalence of IPIs during pregnancy is relatively high in Ethiopia. Poor hygienic practices were identified as risk factors. Based on our finding, targeted preventive measures shall be considered so as to prevent morbidity and mortality due to IPIs.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Habtamu Geremew ◽  
Demeke Geremew

Abstract Background Syphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Previously, studies showed inconsistent results and failed to show the actual picture of the diseases in Ethiopia. Thus, the aim of this meta-analysis was, first, to determine the updated pooled prevalence of syphilis among pregnant women in Ethiopia and, second, to assess its associated factors. Methods A comprehensive search was made on PubMed, Google scholar, Science Direct, and African Journals Online databases to identify relevant articles. A random effects model was used to estimate pooled syphilis prevalence and odds ratio (OR) with the respective 95% confidence intervals (CIs) using STATA 14 statistical software. I2 statistics and Egger’s regression test in conjunction with funnel plot was used to determine heterogeneity and publication bias among included studies respectively. Result We identified 13 suitable studies in this analysis. Accordingly, the pooled prevalence of syphilis among pregnant women in Ethiopia was 2.32% (95% CI, 1.68–2.97). Specifically, syphilis prevalence was 2.53% (95% CI, 1.92–3.14%) and 1.90% (95% CI, 0.40–3.40%) as per the treponemal and non-ytreponemal diagnostic test, respectively. On the other hand, regional analysis indicated that 4.06% (95% CI, 2.86–5.26) in Southern Nations Nationalities and Peoples (SNNP), 2.16% (95% CI, 1.57–2.75) in Amhara and 1.46% (95% CI, 0.69–2.23) in Oromia region. Being married (OR, 0.37 (95% CI, 0.12–0.91%)) was less likely to develop syphilis. On the other hand, women with history of multiple sexual partner (OR, 2.98 (95% CI, 1.15–7.70)) and women with history of previous sexually transmitted infection (STI) (OR, 4.88 (95% CI, 1.35–17.62)) have higher risk to develop syphilis. Besides, the pooled syphilis-HIV coinfection was 0.80% (95% CI, 0.60–1.01%). Conclusion This study provides evidence of relatively high prevalence of syphilis among pregnant women in Ethiopia. Therefore, it is recommended to further ramping up of current intervention measures to prevent future generations. Systematic review registration PROSPERO CRD42020211650


2020 ◽  
Author(s):  
Berhanu Boru Bifftu

Abstract Background Khat (Catha edulis) is a flowering green plant mainly chewed for recreational. Khat chewing is becoming on rising at alarming rate and adversely affects the socio-economic, psycho-social, and physical health including the health of the fetus. Thus, this study aimed to determine the pooled prevalence of khat chewing during pregnancy and its associated factors. Methods Databases: PubMed/Medline, CINAHL, SCOPUS and AJOL were searched. Weighted inverse variance random-effects model was used to calculate the pooled prevalence of depression. Heterogeneity across the studies was assessed by Cochrane chi-square and quantified by I2 statistics test. Funnel plots and Egger’s test were used to determine publication bias. Sensitivity test and subgroup analysis were also performed. Results In this study, a total of 9,915 study participants were included from 22 studies. The pooled prevalence of khat chewing was found to be 20% (95% CI; 14%-27%). Tests of heterogeneity demonstrated evidence of heterogeneity (I2 = 98.46%, p < 0.001). However, the analysis of sensitivity tests and publication bias showed absence of influential study and publication bias [Egger’s test (P = 0.02)]. Factors such as: being Muslim, lower educational status, family history of mental illness, and partner previous history of khat chewing were associated with khat chewing. Conclusion One in five pregnant women has history of khat chewing. Thus, authors’ suggest the need of screening for khat chewing as an integrated part of Antenatal care.


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