scholarly journals A retrospective review of facility-level obstetric complications and stillbirths in southern Haiti, 2013 – 2016

2019 ◽  
Vol 43 ◽  
pp. 1
Author(s):  
Alka Dev ◽  
Keegan O’Hern ◽  
Joseph Yves Domerçant ◽  
Gerard Lucien ◽  
Lafortune Lucie ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Low Income ◽  
Postpartum Hemorrhage ◽  
Incidence Rates ◽  
Obstetric Complications ◽  
Low Income Countries ◽  
Published Data ◽  
Integrated Monitoring ◽  
Cross Sectional ◽  
High Volume Hospital

Objective. To assess the incidence of obstetric complications—eclampsia, dystocia, cesarean section, postpartum hemorrhage, and stillbirths—in hospitals in southern Haiti in 2013 – 2016 and to discuss implications for improvements to the surveillance of birth outcomes. Methods. This was a cross-sectional, retrospective study of data for 32 442 deliveries recorded in 2013 – 2016 by the Integrated Monitoring, Evaluation, and Surveillance System for facilities across three departments and one high-volume hospital in southern Haiti. Annual incidence rates of eclampsia, dystocia, cesarean section, postpartum hemorrhage, and stillbirths (both macerated and fresh) were calculated. Results. The incidence of eclampsia in the study sample was 2% – 3% and of dystocia approximately 5%, comparable to elsewhere in Haiti and other low-income countries. Cesarean delivery rates averaged about 15% annually. Postpartum hemorrhage rates were lower than published data from similar settings. Stillbirth rates ranged from 30 – 62 per 1 000 births at all facilities, higher than previously recorded by the country’s population surveys. The rates of macerated stillbirths were remarkably high, close to 50% of total stillbirths, indicating severe delays in seeking or receiving emergency obstetric care. Conclusions. This study provides important benchmarks for the current burden of preventable labor- and delivery-related complications in Haiti. Surveillance data suggest an urgent need for the management of hypertensive disorders during pregnancy, timely cesarean sections for dystocia, and management and treatment of postpartum hemorrhage in Haiti. Frequent data reviews may help address facility-specific bottlenecks.

scholarly journals Delay in maternal near miss case and associated factors among women admitted in Felege Hiwot comprehensive specialized hospital, Northwest Ethiopia

2019 ◽  
Author(s):  
Amsalu Worku Mekonnin ◽  
Endalkachew Worku Mengesha ◽  
Getu Dinku
Keyword(s):  
Low Income ◽  
Associated Factors ◽  
Multiple Logistic Regression Analysis ◽  
Northwest Ethiopia ◽  
Near Miss ◽  
Obstetric Complications ◽  
Maternal Near Miss ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Specialized Hospital

Abstract Background: The current discrepancies in maternal mortality and near miss cases of high and low income countries are usually due to the differences in timely management of obstetric complications and the differences in time management comes up with idea of delay in receiving obstetric care. For each maternal death there will be 20 others that suffer as maternal near miss cases worldwide. This study aimed to assess delay of maternal near miss (MNM) and associated factors among women in Felege Hiwot Comprehensive Specialized Hospital (FHCSH), Northwest Ethiopia. Methods: Cross sectional facility based study was conducted among 287 women who were managed as MNM from May 2018 to September 30, 2018. A checklist and structured questionnaire was used to retrieve information from the patient and her medical document. The collected data was cleaned, coded and entered for analysis. The results were presented in tables. Binary and multiple logistic regression analysis were calculated at 95 % CI.Results: There were 2694 patients admitted in wards in the study period and proportion of maternal near miss was 10.65% with maternal near miss mortality ratio of 31.9 and mortality index of 3%. From all maternal near misses studied 44.3% had first delay and 35% had second delay with 51.2% had third delay. Seventy four percent of them had at least one delay. Determinant factors identified were rural residence [AOR, 3.2 P = 0.001], distance more than 10 Kms away from hospital [AOR, 2.18, p =0.025], lack of ambulance [AOR, 3.9 P= 0.009] and lack of awareness on obstetric complications [AOR,27.9, p = 0.001] which were statistically associated with any maternal delay. Conclusion: Maternal near miss proportion is still high in study site and majority of them had at least one delay in receiving care which needs an intervention at community and low level health institutions.

scholarly journals Factors influencing the success of trial of labor after one previous caesarean section in a secure inter-delivery interval at Panzi Hospital.

2021 ◽  
Author(s):  
Raha Maroyi ◽  
Naomi Bahaya ◽  
Celeste Ingersoll ◽  
Roselyn Nerville ◽  
Denis Mukwege
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Influencing Factors ◽  
Low Income ◽  
Low Income Countries ◽  
P Value ◽  
Cross Sectional ◽  
Trial Of Labor ◽  
Active Labor ◽  
Obstetric Factors

Abstract Background: In middle- and low-income countries, the inter-delivery interval is an important parameter considered in the decision of TOLAC. The objective of this study is to determine influencing factors for success of trial of labor after cesarean in women with secure inter-delivery interval after a cesarean-section at a referral hospital.Methods: A cross-sectional study was conducted at Panzi hospital on 231 cases in one year period. Women with one previous cesarean section, an inter-delivery interval space at least 18 months and no contracted pelvis were included. A successful TOLAC was defined as vaginal delivery and failed if cesarean section after trial of labor. Chi-square univariate testing and multi-variate logistic regression were used to understand the relationship between influencing factors the recorded variables and successful TOLAC, with a significance threshold of 5%.Results : 57.6% (133 cases) successfully completed TOLAC with vaginal delivery. Many obstetric factors have a significant effect on success of TOLAC. middle cervix was likely to increase success of TOLAC by 61.50 times (OR=61.50, p-value=0.000). Cervical softening was likely to increase success of TOLAC by 5.96 times (OR=5.96, p-value=0.001). Active labor was likely to increase success of TOLAC by 7.79 times (OR=7.79, p-value=0.013). Uterine height also has a significant effect such that every centimeter increase in uterine height decreased likelihood of successful TOLAC by about half (OR= 0.62, p-value=0.000). Every unit increase in Apgar score in the 1st minute after birth increased likelihood of successful TOLAC by 1.71 times (OR=1.71, p-value=0.010). For every increase in parity, the likelihood of successful TOLAC increases by 1.30 (OR=1.30, p-value=0.031). The remaining obstetric factors in the model had no significant effect on success of TOLAC. Conclusions: Our study shows that within a secure inter-delivery interval, high parity, uterine height less than 34 cm, active labor and cervical parameters such as cervical softening and middle cervix are important contributing factors to the success of TOLAC and VBAC. These factors should be considered by practitioners to influence their decision making regarding TOLAC.

Assessment of knowledge and practice of vaccination of dogs against rabies by dog owners in Makurdi, Benue State, Nigeria

2020 ◽  
Vol 1 ◽  
pp. 5
Author(s):  
Audu Onyemocho ◽  
Agwa Moses ◽  
Aboh Kisani ◽  
Omole Namben Victoria ◽  
Anejo-Okopi Joseph
Keyword(s):  
Low Income ◽  
Life Time ◽  
Knowledge Score ◽  
Educational Status ◽  
Low Income Countries ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Knowledge And Practice ◽  
Dog Owners ◽  
The Relationship

Objective: Rabies, one of the oldest and fatal infectious diseases known to human race, is transmitted by infected dogs. The global target of zero dog-mediated rabies human deaths has been set for 2030; however, the realization of this goal poses challenges in most low-income countries where rabies is endemic due to weak surveillance. Dogs have been increasingly deployed for domestic uses over the years, especially for security purposes. This study assessed the assessment of knowledge and practice of vaccination of dogs against rabies by dog owners. Materials and Methods: A cross-sectional community-based study was employed to study 400 dog owners in Makurdi metropolis through multistage sampling techniques. Sighting of valid dog vaccination card was used as criteria for current vaccination. Bivariate analysis was carried out to establish the relationship between the respondent knowledge of rabies and dog vaccination with significant value set at P < 0.05. Results: The mean age of the respondents was 31 (Â ± 0.8) years, majority of them had tertiary and secondary education (40.0% and 39.0%, respectively), 26.0% were traders, and 50.0% were married. Overall, 73.0% of the respondents had good knowledge score, 61.0% had seen at least a rabid dog in their life time, and 74.0% have a history of dog vaccination, but evidence of up to date vaccination of dogs by owners was seen in only 18.0% of all the vaccination cards sighted. The relationship between the educational status of the respondents, their knowledge score, and their dog vaccination was statistically significant (P < 0.05). Conclusion: Knowledge of rabies among dog owners in Makurdi was good, but the practice of dog vaccination was poor. Educational status was a good predictor of practice. Awareness campaign on dog vaccination should be strengthened and adequate measures should be put in place at the veterinary hospitals in Makurdi for vaccination of dogs.

A Cross-sectional Study of the Clinical Profile of Children With Cerebral Palsy in Benin, a West African Low-Income Country

2019 ◽  
Vol 34 (13) ◽  
pp. 842-850
Author(s):  
Emmanuel Segnon Sogbossi ◽  
Damienne Houekpetodji ◽  
Toussaint G. Kpadonou ◽  
Yannick Bleyenheuft
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
Low Income ◽  
Classification System ◽  
West African ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Common Cause ◽  
Low Income Country ◽  
Children With Cerebral Palsy

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.

scholarly journals Stigmatising attitudes towards the mentally ill: A survey in a Nigerian university teaching hospital

2010 ◽  
Vol 16 (2) ◽  
pp. 5 ◽  
Author(s):  
Dominic Ignatius Ukpong ◽  
Festus Abasiubong
Keyword(s):  
Mental Illness ◽  
Teaching Hospital ◽  
Low Income ◽  
Mentally Ill ◽  
Educational Programme ◽  
University Teaching ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Nigerian University

<p><strong>Background.</strong> The burden of mental illness is particularly severe for people living in low-income countries. Negative attitudes towards the mentally ill, stigma experiences and discrimination constitute part of this disease burden.</p><p><strong>Objective.</strong> The aim of this study was to investigate knowledge of possible causes of mental illness and attitudes towards the mentally ill in a Nigerian university teaching hospital population.</p><p><strong>Method.</strong> A cross-sectional descriptive study of a convenience sample of 208 participants from the University of Uyo Teaching Hospital, Uyo, Nigeria, using the Community Attitudes towards the Mentally Ill (CAMI) scale. Information was also obtained on beliefs about possible causes of mental illness. <strong></strong></p><p><strong>Results.</strong> The respondents held strongly negative views about the mentally ill, mostly being authoritarian and restrictive in their attitudes and placing emphasis on custodial care. Even though the respondents appeared to be knowledgeable about the possible role of psychosocial and genetic factors in the causation of mental illness, 52.0% of them believed that witches could be responsible, 44.2% thought mental illness could be due to possession by demons, and close to one-third (30%) felt that it could be a consequence of divine punishment.</p><p><strong>Conclusions.</strong> Stigma and discrimination against the mentally ill are widespread even in a population that is expected to be enlightened. The widespread belief in supernatural causation is likely to add to the difficulties of designing an effective anti-stigma psycho-educational programme. There is a need in Nigeria to develop strategies to change stigma attached to mental illness at both institutional and community levels.</p>

scholarly journals Personal and domiciliary hygiene practices and its association with incidence of infectious diseases among children aged 6-59 months

2021 ◽  
Vol 8 (9) ◽  
pp. 4204
Author(s):  
Md Hasanuzzaman ◽  
Md Hafizur Rahman ◽  
Md Shafiqul Islam Khan ◽  
Musammet Rasheda Begum ◽  
Farjana Alam ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Low Income ◽  
Cross Sectional Study ◽  
Hand Washing ◽  
Low Income Countries ◽  
Sectional Study ◽  
Child Feeding ◽  
Cross Sectional ◽  
Hygiene Practices ◽  
Prepared Food

Background: Over 200 million under-five-children born in low-income countries are at risk of not reaching their development potential and infectious diseases are the leading cause of development deficits in these regions.Methods: A cross-sectional study was conducted to investigate personal and household hygiene practices among 154 mothers and their association with the incidence of infectious diseases among 167 children aged 6 months to 59 months in Patuakhali district, Bangladesh.Results: Only 13.6% of the mothers had proper hand washing knowledge. Besides, 14% and 53.9% of the mothers washed their hands with soap and only with water respectively before feeding their child. About 68.2% of mothers prepared food on the ground and half (49.5%) of the toilet did not have a hand washing location beside it. The risk of childhood infectious disease was significantly associated with hand washing of mothers before feeding a child (OR: 2.3, 95% CI: 1.5-4.1, p<0.05) and hand washing of child before eating (OR: 3.4, 95% CI: 1.8-5.7, p<0.05).Conclusions: Hand washing agents were inadequate and compliance to hand washing was poor. Therefore, the continuous focus is needed on the mother's awareness construction to increase the compliance to hand washing practice among mothers as well as their child with soap, especially during child feeding.

scholarly journals Local characterization of the Covid19 Response in low-income country: The case of a Lockdown in Zambia

2021 ◽  
Author(s):  
Choolwe Muzyamba
Keyword(s):  
Low Income ◽  
Mental Health Problems ◽  
Incidence Rates ◽  
Low Income Countries ◽  
Gender Based Violence ◽  
Low Income Country ◽  
Phone Calls ◽  
Heated Debate ◽  
Local Characterization

Abstract Background The onset of the covid19 pandemic has sparked heated debate among scholars on the relevance of lockdowns. There are those in favor of the lockdown and others who are critical of it. However, despite the increased interest in understanding the relevance of lockdowns, there still has not been much focus on its relevance in low income countries like Zambia. Thus with the help of the SRT, we set out to explore and document the local characterization of the lockdown by residents of Lusaka, Zambia.Methods A qualitative study in the form of interviews was conducted in Lusaka, Zambia involving a sample of 68 participants. Due to the lockdown measures that were in place during the study, the interviews were conducted via phone calls and the data collected were later analyzed by use of thematic analysis technique.Results The lockdown was on one hand lauded for slowing down the incidence rates, preventing fatalities, and for protecting the healthcare system from collapse. On the other hand, it was criticized for exacerbating poverty levels, unemployment rates, increasing the rate of mental health problems, aiding gender based violence, and intensifying political repression and corruption. The results speak to the complexity in the characterization of the lockdown as a response to covid19 in Zambia. This observation demonstrates the folly of viewing, applying and characterizing the covid19 lockdown as a ‘one-size-fits-all’ approach in Zambia.Conclusion Thus rather than definitely establishing the lockdown as an incontestable good, as it is depicted by some scholars or as useless by its critics, our findings instead demonstrate the diversity and complexity in how it is locally viewed by Zambians. The study provides grounds for caution on simplistic and binary characterization of lockdowns. It indicates the need for careful dialog between the designers of lockdowns and citizens in order to tailor such interventions to local realities in context-specific ways. It also shows that though the development of such interventions, all the various and complex elements it embodies must be taken into account in order to realize optimum outcomes.

Impact of Social Isolation on Physical Activity and Factors Associated With Sedentary Behavior in Older Adults During the COVID-19 Pandemic

2021 ◽  
pp. 1-5
Author(s):  
Giovana Z. Mazo ◽  
Felipe Fank ◽  
Pedro S. Franco ◽  
Bruna da Silva Vieira Capanema ◽  
Franciele da Silva Pereira
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Sedentary Behavior ◽  
Social Isolation ◽  
Low Income ◽  
Low Income Countries ◽  
Moderate Physical Activity ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Impact

The objective was to analyze the impact of social isolation on moderate physical activity and factors associated with sedentary behavior of older adults during the COVID-19 pandemic. This was a cross-sectional study involving 111 older adults (aged 71.0 ± 6.87 years). The data were collected at two time points: in November 2019 and in June 2020. There was a decline in moderate physical activity when the minutes/week were compared before and during social isolation (p < .001). Sedentary behavior was associated with the condition of living alone. Older adults who lived alone were 3.29 times more likely to spend 4 hr or more in sedentary behavior than those who lived with a partner (95% confidence interval [1.01, 10.74]). Government agencies must establish PA-related health promotion strategies, especially in developing and low-income countries. Therefore, home exercises need to be encouraged to prevent the consequences of this pandemic period.

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