ABSTRACT
Globally, more than 20 million newborns are born with low birth weight (LBW) every year. Most of the LBW occurs in low- and middle-income countries. It is the most critical risk of neonate mortality. Therefore, this study aims to identify determinants of low birth weight among women who gave birth in public health facilities in the North Shewa zone. Institutional-based unmatched case-control study was conducted from February to June 2020 to select 180 cases and 380 controls. Interviewer-administered questionnaire was used to collect data. Data were entered through EPI Info and exported to Statistical Package for Social Science (SPSS) for analysis. Text, percentage and tables were used to present data. Bivariate and multivariate logistic regression analyses were performed to see the association and adjusted odds ratios with 95% confidence interval (CI), and P-value < .05 was considered to declare statistical significance. Lack of nutritional counseling (adjusted odds ratio [AOR] = 2.14; 95% CI = [1.13, 4.04]), unable to take iron-folate supplement (AOR = 2.3.78; 95% CI = [2.1, 6.85]), insufficient additional meal in take (AOR = 6.93; 95% CI = [3.92, 12.26]), restriction of foods (AOR=2.29; 95% CI =[1.81, 4.09]), maternal mid upper arm circumference (MUAC) < 23 cm (AOR=2.85; 95% CI = [ 1.68, 4.85]), maternal height ≤155 cm (AOR=3.58; 95% CI = [1.92, 6.7]), anemia (AOR = 2.34; 95% CI = [1.21, 4.53]), pregnancy-related complications (AOR=3.39; 95% CI = [2.02, 5.68]), and alcohol drinking during pregnancy (AOR = 2.25; 95% CI = [1.24, 4.08]) were significantly associated with LBW. Nutritional counseling, iron-folate supplementation, additional meal intake, restriction of some foods in pregnancy, MUAC of the mother, maternal stature, maternal anemia status, pregnancy-related complications, and a history of alcohol drinking during pregnancy were identified as determinants of low birth weight. The intervention-targeted nutritional counseling, early detection and treatment of anemia, and behavioral change communication to pregnant women are mandatory.
Subject(s)
Health Facilities/classification , Infant, Low Birth Weight , Prenatal Care , Case-Control Studies , Ethiopia , Female , Humans , Infant, Newborn , Pregnancy , Risk FactorsABSTRACT
BACKGROUND: This study analyzes the pattern of use of single agent anticancer therapy (SAACT) in the treatment and survival of advanced hepatocellular carcinoma (aHCC) before and after sorafenib was FDA approved in 2007. METHODS: Adult patients diagnosed with HCC and treated with only ACT from 2004 - 2014 were identified in NCDB database. Patients were analyzed during three time frames: 2004-2006 (pre-sorafenib (PS)), 2007-2010 (early sorafenib (ES)) and 2011-2014 (late sorafenib (LS)). Cox proportional hazards models and Kaplan-Meier method were used for analyses. RESULTS: The NCDB contained 31,107 patients with HCC diagnosed from 2004-2014 and treated with ACT alone. Patients were generally men (78.0%), >50 years of age (92.5%). A significant increase in the rate of adaption of SAACT was observed over time: 6.2% PS, 15.2% ES, and 22.2% LS (p < 0.0001). During this later period, the highest proportion of SAACT is among academic and integrated network facilities (23.3%) as compared to community facilities (17.0%, p < 0.0001). The median overall survival of patients with aHCC treated only with SAACT improved significantly over time from 8.0 months (m) (95% CI: 7.4-8.8) to 10.7 m (10.4-11.2) to 15.6 m (15.2-16.0, p < 0.001). Multivariate analysis indicates worse outcomes for patients treated at community cancer programs (HR 1.28, (5% CI: 1.23-1.32), patients without insurance (HR 1.11, 1.06-1.16) and estimated household income of <$63,000 (HR 1.09, 1.05-1.13). CONCLUSION: aHCC patients treated only with ACT have experienced an overall improvement in survival, but significant differences exist between facility type, insurance status, and income.