RESUMO
Introduction: Puerperal sepsis is a leading cause of maternal morbidity and mortality in low-income countries, which can affect sustainable development goals. Even though it is a preventable problem through maternal self-care practices, maternal-reported self-care practices regarding puerperal sepsis were under-researched in Ethiopia. Therefore, this study aimed to assess the maternal reported self-care practice and associated factors among postnatal mothers for the prevention of puerperal sepsis. Objective: The study aimed to assess the reported self-care practice of postnatal mothers in Arba Minch town toward the prevention of puerperal sepsis and its associated factors. Methods: A community-based cross-sectional study was employed from 1st to 30th May 2022. Study participants were selected using a simple random sampling technique. Data was collected by the Open Data Kit tool and exported to SPSS version 26 for further analysis. Both crude and adjusted odds ratios with a 95% CI were calculated, and a p-value of less than 0.05 was used to declare statistically significant factors. Results: Of a total of 423 postpartum mothers, 417 participated, making a response rate of 98.5%. The study revealed that 45.6% (95% CI: 41.2%, 50.1%) of postnatal mothers had good reported self-care practices toward the prevention of puerperal sepsis. Tertiary educational level (AOR: 2.56; 95% CI: 1.43, 4.59), multiparity (AOR: 0.44; 95% CI: 0.26, 0.74), and having a good awareness of puerperal sepsis prevention (AOR: 2.17; 95% CI: 1.40, 3.37) were significantly associated at a p-value less than 0.05. Conclusion: This study revealed that less than half of postnatal mothers reported good self-care practices. Healthcare providers and all stakeholders should focus on strategies to improve self-care practice during antenatal and postnatal care and at a community level, with a special focus on postnatal mothers with no formal education and multiparous mothers.
RESUMO
Previous studies warned that heat extremes are likely to intensify and frequently occur in the future due to climate change. Apart from changing climate, the population's size and distribution contribute to the total changes in the population exposed to heat extremes. The present study uses the ensemble mean of global climate models from the Coupled Model Inter-comparison Project Phase six (CMIP6) and population projection to assess the future changes in high-temperature extremes and exposure to the population by the middle of this century (2041-2060) in Africa compared to the recent climate taken from 1991 to 2010. Two Shared Socioeconomic Pathways (SSPs), namely SSP2-4.5 and SSP5-8.5, are used. Changes in population exposure and its contributors are quantified at continental and for various sub-regions. The intensity of high-temperature extremes is anticipated to escalate between 0.25 to 1.8 °C and 0.6 to 4 °C under SSP2-4.5 and SSP5-8.5, respectively, with Sahara and West Southern Africa projected to warm faster than the rest of the regions. On average, warm days' frequency is also expected to upsurge under SSP2-4.5 (26-59%) and SSP5-8.5 (30-69%) relative to the recent climate. By the mid-21st century, continental population exposure is expected to upsurge by ~25% (28%) of the reference period under SSP2-4.5|SSP2 (SSP5-8.5|SSP5). The highest increase in exposure is expected in most parts of West Africa (WAF), followed by East Africa. The projected changes in continental exposure (~353.6 million person-days under SSP2-4.5|SSP2 and ~401.4 million person-days under SSP5-8.5|SSP5) are mainly due to the interaction effect. However, the climate's influence is more than the population, especially for WAF, South-East Africa and East Southern Africa. The study findings are vital for climate change adaptation.
Assuntos
Mudança Climática , Temperatura Alta , Previsões , Humanos , África do Sul , TemperaturaRESUMO
BACKGROUND: Uterine rupture is a major public health problem in low-income countries including Ethiopia. In Ethiopia, its prevalence is low, but it results in devastative health problems of the mother and her baby. Even though the Ethiopian government and nongovernmental organizations tried to strengthen the health care system, significant adverse maternal and fetal outcome is still associated with uterine rupture. The aim of this study was to identify determinants of uterine rupture in Jinka and Arba Minch General Hospitals. METHODS: The study was conducted in Jinka and Arba Minch General Hospitals, and the data collection period was 15 to 30 November 2018. A case-control study design was used with simple random sampling of 1:4. Data were collected using data extraction sheets. Variables with p < 0.25 in bivariate logistic regression were entered into multivariable logistic regression. Variables with p < 0.05 in multivariable logistic regression were used to determine significant association between dependent and independent variables. RESULT: Uterine rupture occurred in 112 cases with 448 controls. Women referred from health facilities (adjusted odds ratio = 8.0, 95% confidence interval: 3.5-17.8), multiparous women (adjusted odds ratio = 12.7, 95% confidence interval: 4.2-39.0), duration of labor more than 18 h (adjusted odds ratio = 11.5, 95% confidence interval: 5.5-24.1), malpresentation (adjusted odds ratio = 3.5, 95% confidence interval: 1.0-8.0) and gestational age of ⩾37 weeks (adjusted odds ratio = 5.2, 95% confidence interval: 1.4-19.3) were independent factors associated with uterine rupture. CONCLUSION: Mothers referred from health facilities, multiparous women, duration of labor more than 18 h, gestational age of ⩾37 weeks and malpresentation were significantly associated with uterine rupture. Early referral, encouraging family planning, proper use of partograph, early identification and appropriate intervention for malpresentation are recommended.