Immediate unfavorable birth outcomes and determinants of operative vaginal delivery among mothers delivered in East Gojjam Zone Public Hospitals, North West Ethiopia: A cross-sectional study.

INTRODUCTION: Operative vaginal delivery is the use of forceps or vacuum devices to assist the eligible laboring mother to avoid poor birth outcomes. It is associated with increased maternal, neonatal morbidity and perinatal complications if it is not used appropriately. Instrumental delivery use needs health care providers' skills, knowledge, and decision-making ability for good maternal outcomes. OBJECTIVE: This study aimed to assess immediate unfavorable birth outcomes and associated factors of operative vaginal delivery among women delivered in East Gojjam Zone Public Hospitals, North West Ethiopia. METHOD: The study design was institution based cross-sectional and consecutive sampling procedure was used to select 313 mothers in the study, from March 1, 2019, to April 30, 2019. We used Epi data version 3.1 for data entry and SPSS version 25 software for cleaning and analysis. A Bivariable logistic regression analysis was used to identify the association between each outcome variable and each factor. Again, a multivariable logistic regression analysis was employed to identify factors associated with each outcome variable, and variables with a p-value less than 0.05 were taken as significant variables. RESULTS: The overall unfavorable maternal outcomes of operative vaginal delivery were found to be 32.9% [95% CI: 27.8, 38.3]. No formal education (AOR = 8.36; 95% CI: 1.01, 69.2), rural residence (AOR: 11.77; 95% CI: 2.02, 68.41), male sex of the neonate (AOR: 2.87; 95% CI: 1.08, 7.61) and zero station during instrumental application (AOR: 6.93; 95% CI: 1.75, 27.5) were factors associated with unfavorable maternal outcomes. The study also showed that the magnitude of unfavorable neonatal outcomes was 34.8% (95% CI: 29.7, 40.3). Vaginal first-degree tear (AOR = 0.03, 95% CI: 0.001, 0.951) and blood transfusion (AOR = 7.38, 95% CI: 1.18-46.15) was statistically significant factors associated with unfavorable neonatal outcomes. CONCLUSION: The overall unfavorable maternal and neonatal outcomes of operative vaginal delivery were high compared with some other studies done in Ethiopia.

Self-reported hypoglycemia in adult diabetic patients in East Gojjam, Northwest Ethiopia: institution based cross-sectional study.

BACKGROUND: Hypoglycemia presents a barrier to optimum diabetes management and it is related to a negative impact on health-related quality of life, healthcare resource use, and work productivity. Despite the fact that the magnitude of hypoglycemia and factors associated with hypoglycemia in diabetic population were demonstrated in clinical trial settings; there is no adequate evidence concerning to the problem in real-world settings, in particular in the study area. The aim of the study was to assess the magnitude of hypoglycemia and factors associated with hypoglycemia among adult diabetic patients attending chronic follow up clinic at Debre Markos referral hospital, East Gojjam Zone, Northwest Ethiopia, 2017. METHODS: An institution-based cross-sectional study was conducted among 394 sampled diabetic patients who were selected through systematic random sampling technique at Debre Markos referral hospital. Data were collected using structured interviewer-administered questionnaire. The collected data were entered and cleared using epi-data version 3.1 and analyzed by SPSS version 20. We used bivariate and multivariate logistic regression models to identify variables for multivariate analysis and to identify associated factors for hypoglycemia, respectively. RESULT: The study revealed that 279(70.8%) of diabetic patients had experienced hypoglycemic event since the diagnosis of diabetes. Patients with type 1 diabetes were more likely to have hypoglycemia as compared with type 2 diabetic patients. The factors found to be significantly associated with hypoglycemia included type 2 diabetes (AOR 0.34, 95%CI: 0.14, 0.82), duration of diabetes from 10 to 14 years (AOR 6.34, 95%CI: 2.12, 18.96) and insulin therapy (AOR 4.93, 95%CI: 2.05, 11.86). Diabetic patients who are government employees (AOR = 0.29, 95%CI: 0.11, 0.78) were less likely to have hypoglycemia when compared to farmers. CONCLUSION: The magnitude of hypoglycemia was found to be high and significantly associated with occupation, type of diabetes mellitus, type of medication and duration of diabetes mellitus since diagnosis. Therefore, attention is needed from health-related governmental organizations and health care providers to decrease the burden of hypoglycemia and to address the major contributing factors.

Timely initiation of breastfeeding and its association with birth place in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Timely initiation of breastfeeding is defined as putting the newborn to the breast within 1 h of birth. In Ethiopia, different studies have been conducted to assess the prevalence of timely initiation of breastfeeding and associated factors. The findings of these studies were inconsistent and characterized by great variability. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of timely initiation of breastfeeding and its association with birth place in Ethiopia using the available studies. METHODS: Databases, including PubMed, Google scholar, Science direct and Cochrane library were systematically searched. All original studies reporting the prevalence of timely initiation of breastfeeding in Ethiopia were considered. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 11 statistical software was used to analyze the data. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity between the studies. A random effect model was computed to estimate the pooled prevalence of timely initiation of breastfeeding. In addition, the associations between timely initiation of breastfeeding and place of birth were determined. RESULTS: Sixteen studies were finally included in the meta-analysis. The findings of this meta-analysis revealed that, the pooled prevalence of timely initiation of breastfeeding in Ethiopia was 61.4% (CI: 51.4, 71.5%). The study also indicated that rural mothers had lower rate of initiating breastfeeding within the first 1 h after delivery as compared to their urban counterparts. Additionally, mothers who gave birth at health institution were almost 2.11 times more likely to initiate breastfeeding within 1 h as compared to mothers who did not give birth at health institution. CONCLUSION: In this study, timely initiation of breastfeeding in Ethiopia was significantly low compared to the current global recommendation on breastfeeding. Women from rural area were less likely to initiate breastfeeding within 1 h as compared with women from urban areas. Mothers who give birth at health institution were more likely to initiate breastfeeding timely.

Small scale water treatment practice and associated factors at Burie Zuria Woreda Rural Households, Northwest Ethiopia, 2015: cross sectional study.

BACKGROUND: Consuming unsafe water results in infections that lead to illness or death from water borne diseases. Though there is an increasing effort from Ethiopian government to access safe water still there are households with limited access of safe water as a result, they depend on rain, well and spring water source for domestic use. However, the water treatment practice with the available technology is not studied before in the study area. This study was conducted in rural area where there was no improved water source for domestic consumption. Households' access water from rain, spring, river and well water which need some ways of action to make water safe for the intended utilization termed as treatment. Hence, the aim of this study was to assess magnitude of small scale water treatment practices and associated factors at household level in Burie zuria woreda, North West Ethiopia, 2015. METHODS: Community based cross-sectional study design with multi-stage sampling technique was used to evaluate water treatment practice and associated factors among rural households in Burie Zuria Woreda. A total of 797 households included in the study. Completeness of questionnaires were checked daily and data were coded and entered into Epi-Data and transported to SPSS version 16 software package for further analysis. Binary and multivariable logistic regression models fit to identify associated factors at 95 % CI and P-value <0.05. RESULT: A total of 797 out of 846 participants responded to a questionnaire with a response rate of 94.2 %. The mean age of respondents was 44.9(SD ±10.7) years. Among the total study participants, 357(44.8 %) of them were practicing small scale water treatment at household level. Methods of water treatment at household level were; chlorine, boiling and let stand and settle. Associated factors were female headed households practice water treatment than male headed households (AOR = 1.80, 95 % CI = 1.24-2.62), educational status of being literate was associated with water treatment than illiterates (AOR = 2.07, 95 % CI = 1.51-2.83), dipping of water was associated with water treatment practice than pouring from the water collection jar (AOR = 4.11, 95 % CI = 2.89-5.85) and those households more frequently fetch water were practicing water treatment than those fetch less frequently (AOR = 4.90, 95 % CI = 2.92-8.22) and (AOR = 3.76, 95 % CI = 1.97-7.18) respectively were found to be significantly associated with small scale water treatment practice at household level. CONCLUSIONS: Small scale water treatment at household level is still low in the study area. Females headed households, educated people, dipping from the jar and those who fetch water more than twice a day were significant factors for water treatment. Therefore females' practice should be maintained and scale up for male headed households. Those with no primary education need special emphasis to educate them on the importance of water treatment. Encourage education through non formal mechanisms for rural people are also recommended.