scholarly journals Determinants of perinatal mortality in Ethiopia from 2012 up to 2020: systematic review and meta-analysis

2021 ◽  
Author(s):  
Daniel Getahun ◽  
Samuel Habtegiorgis ◽  
Wodaje Assfaw ◽  
Moges Assemie
Keyword(s):  
Perinatal Mortality ◽  
Birth Interval ◽  
Maternal Education ◽  
Perinatal Death ◽  
Random Effect Model ◽  
Previous History ◽  
Cochrane Library ◽  
Child Birth ◽  
Time Period ◽  
History Of

Abstract Background: The perinatal mortality is defined as neonatal deaths of less than seven days of age and fetal deaths after 28 weeks of gestation for developing countries. Perinatal mortality is a worldwide health problem even if variation exists among countries. Despite the presence different studies done on the determinants of perinatal mortality in Ethiopia, there is no comprehensive and currently updated study in this time period in Ethiopia. The objective of this study was to determine the determinants of perinatal mortality in Ethiopia from 2012 up to 2020 time period.Method: The articles were identified through electronic search of reputable databases: Google scholar, PubMed, Cochrane library, MIDLINE, EMBASE and Ovid Maternity and Infant Care Databases. Nine studies were selected based on a comprehensive list of inclusion and exclusion criteria. Analysis was done by using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used and a random effect model was also used to estimate the pooled prevalence of perinatal mortality rate. Results: The determinant factors for perinatal mortality were gestational age less than 37weeks , birth weight greater than or equal 2500 gram , had not history of previous abortion, had not history of perinatal death, illiterate maternal education, not using partograph , not vaccinated women about TT vaccine, had not history of obstetric complication ,level of hemoglobin greater than or equal to 11mg/dl ,women who had no prenatal visit ,child birth interval less than two years and non-vertex fetal presentation were significantly associated with perinatal mortality.Conclusion: Government should give especial emphasis for women’s with previous history of abortion, perinatal death and child birth interval less than two years.as well as strengthen all the above associated variables.

Extended Perinatal Mortality Audit in a Rural Hospital in India

2021 ◽  
Author(s):  
Núria Torre Monmany ◽  
Joaquín Américo Astete ◽  
Dasarath Ramaiah ◽  
Jyothi Suchitra ◽  
Xavier Krauel ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Perinatal Death ◽  
Gestational Hypertension ◽  
Action Plan ◽  
Previous History ◽  
Rural Hospital ◽  
Neonatal Deaths ◽  
The Status ◽  
History Of

Objective The aim of the study is to describe the status of perinatal mortality (PM) in an Indian rural hospital. Study Design Retrospective analysis of data was compiled from PM meetings (April 2017 to December 2018) following “Making Every Baby Count: audit and review of stillbirths and neonatal deaths (ENAP or Every Newborn Action Plan).” Results The study includes 8,801 livebirths, 105 stillbirths (SBs); 74 antepartum stillbirths [ASBs], 22 intrapartum stillbirths [ISBs], and nine unknown timing stillbirths [USBs]), 39 neonatal deaths or NDs (perinatal death or PDs 144). The higher risks for ASBs were maternal age >34 years, previous history of death, and/or SBs. Almost half of the PDs could be related with antepartum complications. More than half of the ASB were related with preeclampsia/eclampsia and abruptio placentae; one-third of the ISB were related with preeclampsia/eclampsia and gestational hypertension, fetal growth restriction, and placental dysfunction. The main maternal conditions differed between PDs (p = 0.005). The main causes of the ND were infections, congenital malformations, complications of prematurity, intrapartum complications, and unknown. The stillbirth rate was 11.8/1,000 births, neonatal mortality rate 4.4/1,000 livebirths, and perinatal mortality rate 15.8/1,000 births. Conclusion This is the first study of its kind in Andhra Pradesh being the first step for the analysis and prevention of PM. Key Points

scholarly journals Impact of COVID-19 on Neurological Manifestations: An Overview of Stroke Presentation in Pandemic.

2020 ◽  
Author(s):  
Nida Fatima ◽  
Maher Saqqur ◽  
Ashfaq Shauib
Keyword(s):  
Risk Factors ◽  
Virus Disease ◽  
Previous History ◽  
Neurological Manifestation ◽  
Cochrane Library ◽  
Mesh Terms ◽  
History Of ◽  
The Mean ◽  
Almost All ◽  
Underlying Risk

Abstract Introduction: Corona virus disease 2019 (COVID-19) pandemic has become a globally challenging issue after its emergence in December 2019 from Wuhan, China. Despite its common presentation as respiratory distress, patients with COVID-19 have also shown neurological manifestation especially stroke. Therefore, the authors sought to determine the etiology, underlying risk factors, and outcomes among patients with COVID-19 presenting with stroke. Methods: We conducted a systematic review of the electronic database (PubMed, Google Scholar, Scopus, Medline, EMBASE, and Cochrane library) using different MeSH terms from January 2000 to June 2020. Results: A total of 39 patients with stroke from 6 studies were included. The mean age of our included patients was 61.4±14.2 years. Majority of the patients (92.3%) with COVID-19 had ischemic stroke, 5.1% had hemorrhagic stroke, and 2.6% had cerebral venous thrombosis at the time of initial clinical presentation. Almost all of the patients presented had underlying risk factors predisposing to stroke which included, diabetes mellitus, hyperlipidemia, hypertension, and previous history of cerebrovascular disease. 51.2% of the included patients infected with COVID-19 with stroke died, while remaining patients were either discharged home or transferred to a rehabilitation unit. Conclusion: Exploring the neurological manifestation in terms of stroke among patients with COVID-19 is a step towards better understanding of the virus, preventing further spread, and treating the patients affected by this pandemic.

scholarly journals Magnitude and Determinants of Perinatal Mortality in Southwest Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Gurmesa Tura Debelew
Keyword(s):  
Perinatal Mortality ◽  
Previous History ◽  
Multivariate Logistic Regression Analysis ◽  
Mortality Data ◽  
Skilled Attendant ◽  
Southwest Ethiopia ◽  
Danger Signs ◽  
Pregnancy And Childbirth ◽  
History Of ◽  
Knowledge Of Danger Signs

Despite several efforts globally, the problem of perinatal mortality remained an unsolved agenda. As a result, it continued to be an essential part of the third sustainable development goals to end preventable child deaths by 2030. With a rate of 33 per 1000 births, Ethiopia has the highest level of perinatal mortality in the world. Thus, determining the magnitude and identifying the determinants are very crucial for evidence-based interventions. A community-based longitudinal study was conducted in Southwest Ethiopia among 3474 pregnant women to estimate the magnitude of perinatal mortality. Then, a case-control study among 120 cases and 360 controls was conducted to identify the determinants of perinatal mortality. Data were collected by using an interviewer-administered questionnaire and analyzed by using SPSS version 20. Multivariate logistic regression analysis was used to identify variables having a significant association with perinatal mortality at p<0.05. The perinatal mortality rate was 34.5 (95% CI: 28.9, 41.1) deaths per 1000 births. Attending ≥4 ANC visits (AOR=0.46; 95% CI: 0.23, 0.91), having good knowledge on key danger signs (AOR=0.27; 95% CI: 0.10, 0.75), and having a skilled attendant at birth (AOR=0.34; 95% CI: 0.19, 0.61) were significantly associated with a reduction of perinatal mortality. Being a primipara (AOR=3.38; 95% CI: 1.90, 6.00), twin births (AOR=5.29; 95% CI: 1.46, 19.21), previous history of perinatal mortality (AOR=3.33; 95% CI: 1.27, 8.72), and obstetric complication during labor (AOR=4.27; 95% CI: 2.40, 7.59) significantly increased perinatal mortality. In conclusion, the magnitude of perinatal mortality in the study area was high as compared to the national target for 2020. Care during pregnancy and childbirth and conditions of pregnancy and labor were identified as determinants of perinatal mortality. Hence, interventions need to focus on increasing knowledge of danger signs and utilization of skilled maternity care. Special emphasis needs to be given to mothers with a previous history of perinatal mortality, twin pregnancies, and having obstetric complications.

Contributing factors to perinatal mortality among women who gave birth at the Jimma University Medical Centre, southwest Ethiopia

2021 ◽  
Vol 15 (3) ◽  
pp. 1-10
Author(s):  
Tekle Wakjira ◽  
Dejene Asefa ◽  
Geremew Muleta ◽  
Dessalegn Tamiru
Keyword(s):  
Perinatal Mortality ◽  
Rural Areas ◽  
Maternal Education ◽  
Perinatal Death ◽  
Statistical Significance ◽  
Study Participant ◽  
Medical Centre ◽  
Contributing Factors ◽  
Neonatal Deaths ◽  
Jimma University

Background Perinatal mortality remains a challenge worldwide, particularly in developing countries. Although significant achievements have been made to reduce neonatal mortality worldwide, in the last two decades there was a total of 5.3 million neonatal deaths and stillbirths each year. This study aims to assess the magnitude of perinatal mortality and its contributing factors among births at the Jimma University Medical Centre in Ethiopia. Method A facility-based cross-sectional study was conducted between January and April 2017. Convenience sampling was used to select study participants and data were collected using interviewer-administered pretested structured questionnaires. Descriptive statistics were used to analyse the data, with the chi-square test used to assess the relationship between each factor and outcome. Statistical significance was set at P<0.05. Results The rate of perinatal death was 107 per 1000 births, of which 39.2%, 25.9% and 34.9% were fresh stillbirths, macerated stillbirths and early neonatal deaths respectively. The majority (77.8%) of stillbirths occurred before the study participant reached the hospital and 64.3% of stillbirths had low birth weight. Hyaline membrane disease (27.6%) and meconium aspiration syndrome (20.7%) were the two most common causes of early perinatal death. Obstetric complications contributed to 89.6% of perinatal deaths. Stillbirth was significantly associated with a lack of education (P=0.036). The rate of perinatal mortality was high among women with their first pregnancy (53.0%) and those who had no previous pregnancy-related problems (79.5%), and was significantly associated with mechanical causes and antepartum haemorrhage (P=0.015). Conclusions The findings indicated that the rate of perinatal mortality was high at the Himma University Medical Centre. Improving maternal education and health services in rural areas are important steps to prevent poor perinatal outcomes. Facilitating transport and improving referral procedures may help to prevent mechanical complications, which are the most common cause of perinatal death, particularly fresh stillbirths which, in the present study, often occurred before a participant arrived at the hospital.

scholarly journals Fear of child birth and associated factors among pregnant mothers who attend antenatal care service at Jinka public health facilities, Jinka town, Southern Ethiopia

2020 ◽  
Author(s):  
Aynalem Yetwale ◽  
Eneyew Melkamu
Keyword(s):  
Antenatal Care ◽  
Health Center ◽  
Previous History ◽  
Southern Ethiopia ◽  
Systematic Sampling ◽  
K Value ◽  
Child Birth ◽  
Two Samples ◽  
History Of ◽  
Pregnant Mothers

Abstract BackgroundWomen face many challenges from conception to postpartum and fear of childbirth is one of the challenges the women encounters during pregnancy. This could have been resulted from different perspectives and it could intern lead to various pregnancy and child birth problems. Thus, understanding child birth fear and factors associated with this is of paramount importance and this study was aimed at addressing this issue.MethodologyA facility base cross sectional study was done on 423 pregnant mothers who came for antenatal care services at Jinka hospital and Jinka health center. The study was conducted from June 01 to 30, 2018. Sample size was calculated using single population proportion formula and samples was taken after proportional allocation was done for the hospital and health center using proportion allocation formula. Individual participants were selected with systematic sampling technique using k- value of 2 for both the hospital and health center and the first participant was selected by lottery method from the first two samples. Data were entered in to epi-data version 3.1.1.and exported in to statistical packages for social sciences version 21.0 for cleaning and further analysis. Level of significance was declared at p-value less than 0.05 in multivariable logistic regression model. Narratives, figure and tables were used to put the result.ResultFrom 423 samples, two of the questionnaires were incomplete and thus 421 were used for analysis giving a response rate of 99.5%. Around a quarter of 102 (24.2%) mothers had fear of child birth and the remaining 319 (75.8%) had no fear of child birth. From the factors under consideration, history of previous pregnancy complication, previous history of labor and delivery complications, educational status and depression status were significantly associated with mother’s fear of child birth.ConclusionEven though it is physiological to have some fear of child birth, the figure obtained is relatively higher. Factors found to have significant effect on child birth fear are those which could be tackled through improved health literacy and integrated maternal health services

Immune-related adverse events (irAEs) and survival in solid tumors treated with immune checkpoint inhibitors (ICIs): A systematic review and meta-analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14130-e14130
Author(s):  
Giulia Grizzi ◽  
Fausto Petrelli ◽  
Michele Ghidini ◽  
Antonio Ghidini ◽  
Margherita Ratti ◽  
...  
Keyword(s):  
Solid Tumors ◽  
T Cell Activation ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Previous History ◽  
Cochrane Library ◽  
Risk Of Death ◽  
Reduced Risk

e14130 Background: irAEs are autoimmune-toxic effects associated with ICIs used for treatment of advanced solid tumors. The correlation of these irAEs with survival is presently unknown. The objective of this meta-analysis is to assess the outcome of cancer patients treated with ICIs who develop irAEs. Methods: Two independent reviewers selected prospective or retrospective studies from PubMed, EMBASE, and the Cochrane library database from their inception to November 2018. Studies were selected if: 1) they reported correlation of irAEs (any) with outcome, 2) they included patients with solid tumors; 3) they included treatment with anti-PD-(L)1 or anti-CTLA-4 agents, 4) patients had no previous history of autoimmune disorders, 5) they were published in English language, and 6) they provided availability of adequate data to calculate hazard ratios (HRs) or odds ratios (ORs) and 95% confidence intervals (CIs). Data were pooled using HRs for overall survival (OS) or progression-free survival (PFS) or ORs for overall response rate (ORR) of irAEs vs no irAEs according to fixed or random effect model. HRs for OS (the primary outcome measure) were pooled to provide an aggregate value. Hazard ratio for PFS and ORs for ORR were secondary endpoints. Results: A total of 29 studies for a total of 4242 patients treated with ICIs were selected. Patients who developed irAEs presented a reduced risk of death (HR = 0.52, p < .001). Similarly, the occurrence of irAEs was associated with a reduced risk of progression (HR = 0.51, p < .001). The combined odds of response was 4.87 (p < .001). Conclusions: In patients treated with ICIs, irAEs predict survival and response. Although this correlation cannot be fully explained, it may be related to the strongest T cell activation. Patients showing any form of irAEs can be informed about the positive prognostic effect, and physicians can detect patients with favorable outcome to ICIs.

scholarly journals Perinatal mortality and its association with antenatal care visit, maternal tetanus toxoid immunization and partograph utilization in Ethiopia: a meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Melaku Desta ◽  
Tadesse Yirga Akalu ◽  
Yoseph Merkeb Alamneh ◽  
Asmare Talie ◽  
Addisu Alehegn Alemu ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Perinatal Mortality ◽  
Tetanus Toxoid ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Previous History ◽  
Major Public Health Problem ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Tetanus Toxoid Immunization

AbstractDespite remarkable progress in the reduction of under-five mortality; perinatal mortality is the major public health problem in Africa. In Ethiopia, the study findings on perinatal mortality and its predictors were inconsistent. Therefore, this systematic review and meta-analysis estimated the pooled perinatal mortality, and its association with antenatal care visit, maternal tetanus toxoid immunization, and partograph monitoring. International databases like PubMed, SCOPUS, Google Scholar and Science Direct were systematically searched. I squared statistics was used to determine the levels of heterogeneity across studies and the pooled estimate was computed using a random-effect model. The meta-analysis showed that a pooled prevalence of perinatal mortality in Ethiopia was 6.00% (95% CI 5.00%, 7.00%). The highest proportion of perinatal mortality was a stillbirth, 5.00% (95% CI 4.00%, 7.00%). Women who had antenatal care visit [OR = 0.20 (95% CI 0.12, 0.34)], maternal tetanus toxoid immunization [OR = 0.43 (95% CI 0.24, 0.77)] and partograph monitoring [POR = 0.22 (95% CI 0.06, 0.76)] reduced the risk of perinatal mortality. Whereas, previous history of perinatal mortality [POR = 7.95 (95% CI 5.59, 11.30)] and abortion history (POR = 2.02 (95% CI 1.18, 3.46)) significantly increased the risk of perinatal mortality. Therefore, antenatal care visit, maternal tetanus toxoid vaccination uptake, and partograph utilization should be an area of improvements to reduce perinatal mortality.

scholarly journals Pro-Vaccination Attitude and Associated Factors Towards COVID-19 Vaccine among Healthcare Workers and Nonhealthcare Workers: “A Call for Action”-A Systematic Review

2021 ◽  
Author(s):  
Addisu Wake
Keyword(s):  
Systematic Review ◽  
Healthcare Workers ◽  
Associated Factors ◽  
Positive Attitude ◽  
Close Contact ◽  
Risk Index ◽  
Previous History ◽  
Cochrane Library ◽  
History Of ◽  
Seasonal Flu

Abstract Introduction: Coronavirus disease 2019 (COVID-19) pandemic hasn’t been managed and controlled effectively, globally. The aim of this systematic review was to determine Pro-vaccination attitude and associated factors towards COVID-19 vaccine among healthcare workers (HCWs) and nonhealthcare workers (non-HCWs).Methods: Different databases such as PsycINFO, HINARI, Cochrane Library, PubMed, EMBASE, African Journals OnLine, Web of Science, Scopus, and Google Scholar for the related articles. Result: The levels of positive attitude towards COVID-19 vaccine among HCWs was ranged from 21% to 95%. Factors significantly associated with the attitude towards COVID-19 vaccine among HCWs were such as age, gender, race, work experience, home location, having no fear of injections, being a non-smoker, profession, presence of chronic illnesses, allergies, confidence in pharmaceutical companies, history of taking influenza vaccine, vaccine recommendation, perceived risk of new vaccines, perceived utility of vaccine, receiving a seasonal flu vaccination in the last 5 years, working in a private hospital, a high perceived pandemic risk index, low vaccine harm index, high pro-socialness index, being in close contact with a high-risk group, knowledge about the virus, confidence in and expectations about personal protective equipment and behaviors. The levels of positive attitude towards COVID-19 vaccine among non-HCWs was ranged from 21.4% to 91.99%. Factors associated with the attitude towards COVID-19 vaccine among non-HCWs were such as age, gender, educational level, occupation, marital status, residency, income, ethnicity, risk for severe course of COVID-19, direct contact with COVID-19 at work, being a health profession, being vaccinated against seasonal flu, perceived benefits, cues to actions, having previous history of vaccination, fear of passing on the disease to relatives, and the year of medical study, studying health-related courses, COVID-19 concern, adherence level to social distancing guidelines, history of chronic disease, being pregnancy, perceived vaccine safety, having more information about vaccine effectiveness, mandatory vaccination, being recommended to be vaccinated, lack of the confidence in the healthcare system to control epidemic, and believe in COVID-19 vaccines protection from COVID-19 infection. Conclusion: The level of positive attitude towards COVID-19 vaccine among both HCWs and non-HCWs were unfavorable and comparable. Globally, there is a need for a call for action to cease the time and crisis of this pandemic.

Effect of Maternal Education on Prenatal Adherence of Iron-folic Acid Supplementation in Ethiopia: a Systematic review and Meta-analysis

2020 ◽  
Vol 15 ◽  
Author(s):  
Meresa Berwo Mengesha ◽  
Hagos Degefa Hidru ◽  
Fissaha Tekulu Welay ◽  
Tsige Shushay Gebremedhin
Keyword(s):  
Folic Acid ◽  
Maternal Education ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Folic Acid Supplementation ◽  
Cochrane Library ◽  
Acid Supplementation ◽  
Iron Folic Acid Supplementation ◽  
Iron Folic Acid

Background:: Iron-folic acid supplementation is a central preventive measure for maternal anemia, so a consideration of the factors leading to or deterring from adherence is important. This review aims to establish if there is a correlation between increasing maternal education and adherence of iron-folic acid supplementation in Ethiopia. Methods:: An electronic database search was conducted using PubMed, Google Scholar, Cochrane Library and African Journals Online. Joanna Briggs Institute Meta-Analysis of Statistical Assessment and Review Instrument was used for quality appraisal of the included studies. The extracted data were entered into Microsoft™ Excel sheet and exported to R-software version 3.6.1 for analysis. Maternal education on adherence of iron-folic acid supplementation was analyzed and subgroup analyses of difference between regions and time of study period were conducted. Results:: The online search yielded a total of 936 articles, and based on inclusion/exclusion criteria nine were included in this study with a total of 3263 participants. Applying the random effect model, the analysis revealed that the odds of prenatal adherence of iron-folic acid supplementation were 2.89 times higher in mothers with secondary school education and above as compared to those who had not received formal education. Conclusions:: Conclusions:

scholarly journals A study of maternal factors influencing very low birth weight babies

2017 ◽  
Vol 4 (4) ◽  
pp. 1173 ◽  
Author(s):  
Mani Madhavan Sachithanantha Mooorthi ◽  
Balakrishnan Nadesan ◽  
Ezhilarasu Ramalingam ◽  
Sivaraman Thirumalaikumarasamy
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Birth Interval ◽  
Very Low Birth Weight ◽  
Previous History ◽  
P Value ◽  
Maternal Factors ◽  
Maternal Risk ◽  
Vlbw Infants ◽  
History Of

Background: Very low birth weight (VLBW) infants present one of the greatest medical and ethical challenges to the medical field. Although they represent a small percentage of overall birth and NICU admissions, VLBW infants are often the most critically ill and at the highest risk for mortality and long-term morbidity of any NICU patients. The present study was conducted with aim to find out the maternal risk factors related to VLBW of newborn.Methods: This prospective case control study was conducted in Govt. R.S.R.M Lying in Hospital, which is affiliated to Stanley Medical College, during the period from January 2005- December 2005. The data related to maternal and new born variables were collected and evaluated by using Chi square test. P value less than 0.05 was considered as statistically significant.Results: The incidence of VLBW newborns was found to be 2.08%. The most common cause of VLBW is preterm delivery (84%). Maternal factors like age, weight, parity, literacy, mid arm circumference, income, bad obstetric history of the mother and birth interval showed a significant association with the incidence of VLBW of the infants (P <0.05). Antenatal visits, maternal occupation and maternal disease had no significant (P >0.05) influence on the delivery of VLBW babies.Conclusions: In the present study, incidence of VLBW was associated with the maternal factors like age, parity, literacy, nutritional status, income, birth interval and previous history of bad obstetrics. Hence, the study concludes that pregnant women need to be careful of all these above factors so as to avoid VLBW babies. 

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