Prevalence of birth injuries and associated factors among newborns delivered in public hospitals Addis Ababa, Ethiopia, 2021. Crossectional study.

BACKGROUND: Birth injury is harm that a baby suffers during the entire birth process. It includes both birth asphyxia and birth trauma. In Ethiopia, birth injury has become the leading cause of neonatal morbidity and mortality, accounting around 28%-31.6% of neonatal mortality. The study aimed to assess the prevalence and factors associated with birth injuries among newborns delivered in public hospitals Addis Ababa, Ethiopia, 2021. METHODS: Institution based cross-sectional study was conducted from February 15th to April 20th, 2021 in selected public hospitals of Addis Ababa, Ethiopia. Random sampling and systematic random sampling were used. Data was entered by using Epi data version 4.0.2 and exported in to SPSS Software version 25 for analysis. Both bivariate and multivariable logistic regressions analyses were used. Finally P-value <0.05 was used to claim statistically significant. RESULT: The prevalence of birth injury was 24.7%. In the final model, birth asphyxia was significantly associated with the short height of the mothers (AOR = 10.7, 95% CI: 3.59-32.4), intrapartal fetal distress (AOR = 4.74, 95% CI: 1.81-12.4), cord prolapse (AOR = 7.7. 95% CI: 1.45-34.0), tight nuchal cord (AOR = 9.2. 95% CI: 4.9-35.3), birth attended by residents (AOR = 0.19, 95% CI: 0.05-0.68), male sex (AOR = 3.84, 95% CI: 1.30-11.3) and low birth weight (AOR = 5.28, 95% CI: 1.58-17.6). Whereas, birth trauma was significantly associated with gestational diabetic mellitus (AOR = 5.01, 95% CI: 1.38-18.1), prolonged duration of labor (AOR = 3.74, 95% CI: 1.52-9.20), instrumental delivery (AOR = 10.6, 95% CI: 3.45-32.7) and night time birth (AOR = 4.82, 95% CI: 1.84-12.6). CONCLUSION: The prevalence of birth injury among newborns has continued to increases and become life-threatening issue in the delivery and neonatal intensive care unit in the study area. Therefore, considering the prevailing factors, robust effort has to be made to optimize the quality obstetric care and follow up and emergency obstetrics team has to be strengthened to reduce the prevalence of birth injury.

Time to death and its predictors among neonates who were admitted to the neonatal intensive care unit at tertiary hospital, Addis Ababa, Ethiopia: Retrospective follow up study.

Backgrounds: Neonatal death is the major problem in developing world. Burden and predictors of neonatal mortality vary across countries and even among regions of a country, so understanding the problem concerning these factors is essential to overcome the problem. Therefore, this study aimed to determine time to death and its predictors of neonatal mortality among neonates who were admitted to the neonatal intensive care unit of Tertiary Hospital, Addis Ababa, Ethiopia. Methods: A hospital-based retrospective cohort study was employed among 434 neonates admitted in Tertiary hospital, Addis Ababa, Ethiopia. A Kaplan Meier curve and a log-rank test were used to estimate the survival time and compare survival curves between variables. The cox proportional hazard model was also fitted to identify predictors. Results: A total of 434 neonates included in the study, 11.1% of which were died, and the incidence rate was 19.2 per 1000 live births. The time to death of neonates was 17 days. Independent predictors of neonatal mortality were incomplete maternal antenatal follow up[AHR: 3.7 (95% CI:1.86,7.60)], low(Appearance, Pulse, Grimily, Activity, and Respiration(APGAR)score[AHR:5.0 (95%CI:1.51-15.04)], perinatal asphyxia [AHR:5.2 (95%CI:1.92-14.30)], preterm 4.2 (95%CI: 1.32-8.83)]. Moreover, small for gestational age [AHR:4.8 (95%CI:2.33-9.72)], respiratory distress[AHR: 2.5 (95%CI: 1.24-5.09)], sepsis [AHR: 3.4 (95%CI: 1.71-4.01)], low birth weight[AHR: 7.3 (95%CI:2.69,1.91)], and tracheoesophageal fistula [AHR: 2.2 (95%CI: 1.13-4.32)]. Conclusion: The overall incidence rate was 19.2 deaths per 1,000 live births. Emphasis should be given to incomplete Antenatal care follow up, small for gestation, preterm, low birth weight, low 5th min APGAR score, neonatal sepsis, respiratory distress, perinatal asphyxia, and tracheoesophageal fistula.

Incidence and predictors of attrition among children attending antiretroviral follow-up in public hospitals, Southern Ethiopia, 2020: a retrospective study.

Background: It is a global challenge to enrol and retain paediatric patients in HIV/AIDS care. Attrition causes preventable transmission, stoppable morbidity and death, undesirable treatment outcomes, increased cost of care and drug resistance. Thus, this study intended to investigate the incidence and predictors of attrition among children receiving antiretroviral treatment (ART). Method: A retrospective follow-up study was conducted among children <15 years who had ART follow-up in Gedeo public hospitals. After collection, data were entered into Epi-data V.4.6, then exported to and analysed using STATA V.14. Data were described using the Kaplan-Meier statistics, life table and general descriptive statistics. The analysis was computed using the Cox proportional hazard regression model. Covariates having <0.25 p values in the univariate analysis (such as developmental stage, nutritional status, haemoglobin level, adherence, etc) were fitted to multivariable analysis. Finally, statistical significance was declared at a p value of <0.05. Results: An overall 254 child charts were analysed. At the end of follow-up, attrition from ART care was 36.2% (92 of 254), of which 70 (76.1%) were lost to follow-up, and 22 (23.9%) children died. About 8145.33 child-months of observations were recorded with an incidence attrition rate of 11.3 per 1000 child-months (95% CI: 9.2 to 13.9), whereas the median survival time was 68.73 months. Decreased haemoglobin level (<10 g/dl) (adjusted HR (AHR)=3.1; 95% CI: 1.4 to 6.9), delayed developmental milestones (AHR=3.6; 95% CI: 1.2 to 10.7), underweight at baseline (AHR=5.9; 95% CI: 1.6 to 21.7), baseline CD4 count ≤200 (AHR=4.4; 95% CI: 1.6 to 12.2), and poor or fair ART adherence (AHR=3.5; 95% CI: 1.5 to 7.9) were significantly associated with attrition. Conclusion and recommendation: Retention to ART care is challenging in the paediatrics population, with such a high attrition rate. Immune suppression, anaemia, underweight, delayed developmental milestones and ART non-adherence were independent predictors of attrition to ART care. Hence, it is crucial to detect and control the identified predictors promptly. Serious adherence support and strengthened nutritional provision with monitoring strategies are also essential.

Predictors of neonatal sepsis in public referral hospitals, Northwest Ethiopia: A case control study.

BACKGROUND: Despite remarkable progress in the reduction of death in under-five children, neonatal mortality has shown little or no concomitant reduction globally. It is also one of the most common causes of neonatal death in Ethiopia. Little is known on predictors of neonatal sepsis. Risk based screening and commencement of treatment appreciably reduces neonatal death and illness. Therefore, the main aim of this study was to identify predictors of neonatal sepsis in public referral hospitals of Northwest Ethiopia. METHODS: Institutional based unmatched case-control study was conducted among a total of 231 neonates in Debre Markos and Felege Hiwot referral hospitals from March 2018- April 2018. Neonates who fulfill the preseted criteria for sepsis were considered as cases and neonates diagnosed with other medical reasons except sepsis were controls. For each case, two consecutive controls were selected by simple random sampling method. Data were collected using structured pretested questionnaire through a face to face interview with index mothers and by reviewing neonatal record using checklist. The collected data were entered into Epi data version 3.1 and exported to STATA/ SE software version 14. Binary and multivariable logistic regression analyses were employed. Statistical significance was declared at P<0.05. RESULT: Multivariable logistic regression analysis showed that, duration of rupture of membrane ≥ 18hours was significantly associated with sepsis (AOR = 10.4, 95%CI = 2.3-46.5). The other independent predictors of neonatal sepsis were number of maternal antenatal care service ≤3 (AOR = 4.4, 95%CI = 1.7-11.5), meconium stained amniotic fluid (AOR = 3.9, 95%CI = 1.5-9.8), urinary tract infection during pregnancy (AOR = 10.8, 95% CI = 3.4-33.9), intranatal fever (AOR = 3.2, 95% CI = 1.1-9.5), first minute APGAR score <7 (AOR = 3.2, 95% CI = 1.3-7.7), resuscitation at birth (AOR = 5.4, 95% CI = 1.9-15.5), nasogastric tube insertion (AOR = 3.7, 95% CI = 1.4-10.2). CONCLUSION: Neonatal invasive procedures, ANC follow up during pregnancy, different conditions during birth like meconium stained amniotic fluid, low APGAR score and resuscitation at birth were the independent predictors of neonatal sepsis.

Essential new-born care practices and associated factors among post natal mothers in Nekemte City, Western Ethiopia.

BACKGROUND: New-born survival is a prominent goal on the global health agenda and an important area of focus for programs seeking to ensure child survival. Geographically, neonatal deaths are most prevalent in Sub-Saharan Africa and southern Asia, accounting for 39% and 38% of all neonatal deaths respectively while Ethiopia in particular has 28% neonatal death. Promotion of essential new-born care practice is one of a cheap approach to improve health outcomes of new-born babies. Thus, this study was aimed to assess the magnitude of essential new-born care practices and associated factors among postnatal mothers in Nekemte city, Western Ethiopia. METHODS: An institution-based cross-sectional study was conducted from February to March, 2017, in Nekemte city, East Wollega Zone. Data was collected from 417 randomly selected mothers who have less than six months infants by face to face interview in three public health institutions of Nekemte City, Ethiopia. Women who were not biological mother to the new-born were excluded from the study. The collected data were coded, cleaned and entered using Epi-Data version 3.1 and analysed using Statistical Package for Social Science (SPSS) version 21.0. Both bivariable and multivariable logistic regression analysis were computed to identify associated factors. The strength of association was measured by odds ratios with 95% confidence interval (CI) at a p-value of < 0.05 and finally obtained results were presented by using simple frequency tables, graphs, and charts. RESULTS: The study revealed that the level of essential new-born care practice was 184(44.1%). The overall safe cord care practice of the respondents was 285 (68.3%) while the optimal thermal care practices and good neonatal feeding were 328 (78.7%) and 322 (77.2%) respectively. Having visit to Antenatal Care (ANC) [Adjusted Odds Ratio (AOR) = 4.38, 95% CI = (1.38, 13.94)], knowledge of essential new-born care [AOR = 4.58, 95% CI = (2.93, 7.16)], and counselled about essential new-born care [AOR = 2.32, 95% CI = (1.38, 3.91)] were factors significantly associated with good practices of essential new-born care. CONCLUSION: This study indicated that the level of essential new-born care practice was unsatisfactory in the study area. Promotion of essential new-born care through the provision of community awareness and provision of counselling on essential new-born care and neonatal danger signs to all pregnant women should be given emphasis.

Suboptimal child spacing practice and its associated factors among women of child bearing age in Serbo town, JIMMA zone, Southwest Ethiopia.

INTRODUCTION: Birth spacing is the time gaps between two consecutive life births. Optimal spacing until the next pregnancy is the resting period that allows the mother time to recover from pregnancy, and labor. Birth interval of 3 to 5 years increases maternal health and child survival and family planning programs have advocated this birth interval. OBJECTIVES: To assess prevalence of Suboptimal Child spacing practice and its associated factors among Women of Child bearing age in Serbo town, Jimma Zone Southwest Ethiopia. METHODS: Community based cross sectional study was conducted on a total of 314 women of child bearing age from March to April 2017 who were selected by simple random sampling. A semi structured questionnaire which was pretested was used to collect the data. Data was checked for completeness and analyzed using SPSS V.20. Bi-variable logistic regression and multi- variable regression were done for predictor variables associated at p-value < 0.05 with the outcome variable. RESULT: The prevalence of short birth interval in this study was 59.9%. Independent predictors like age at first marriage (AOR: 2.10, 95% CI = 1.19, 3.69), sex of index child (AOR: 1.964, 95% CI = 1.05 3.96), educational status (AOR: 3.05,95% CI = 1.68, 3.83), duration of breastfeeding (AOR: 3.09, 95% CI = 1.38, 6.96) and use of modern contraceptives (AOR: 1.94, 95% CI = 1.09, 3.45) were found to be statistically associated with short birth interval. CONCLUSION AND RECOMMENDATION: Majority of the study respondents were practicing short birth interval. Education level, age at first marriage, having female child, short duration of breastfeeding and not using of modern contraceptives were factors associated with the outcome variable. Therefore awareness about modern contraceptive utilization, importance of breastfeeding as birth spacing mechanism and impact of early marriage are recommended.

Prelacteal feeding practice and its associated factors among mothers of children age less than 24 months old in Southern Ethiopia.

BACKGROUND: Although Pre-lacteal feeding is a barrier for implementation of optimal breastfeeding practices and increases the risk of neonatal illness and mortality, still it is continued as a deep-rooted nutritional malpractice in developing countries. In Ethiopia pre-lacteal feeding continued as one of the nutritional malpractices in newborns. Therefore the aim of this study was to assess pre-lacteal feeding practice and its determinants among mothers of children less than 24 months of age in Sodo zuria district, Wolaita zone, Southern Ethiopia. METHODS: Community-based cross-sectional study was conducted from February 15, 2017 to March 12, 2017 in Sodo zuria district, Wolaita zone, Southern Ethiopia. Five hundred five (505) mothers of children aged less than 24 months were selected by multistage randomized sampling technique and the data were collected by using interview based structured questionnaire. Descriptive statistics, binary and multivariable logistic regression analysis were employed to identify the factors associated with pre-lacteal feeding practices. Variables with a p-value < 0.05 were identified as statistically significant factors. RESULTS: The prevalence of pre-lacteal feeding practice was 20.6%. The common type of pre-lacteal feeding given was plain water; 38(7.7%) and the major reason was insufficient breast milk 32(6.5%). Mothers living with extended family type (AOR = 10.64, 95% CI: 1.05, 10.71), Lack of breastfeeding counseling (AOR = 5.16, 95% CI: 1.76, 15.13) and mothers who avoid colostrum (AOR = 9.72, 95% CI: 3.46, 27.30) were statistically significant positive predictors of pre-lacteal feeding practice. CONCLUSION & RECOMMENDATION: Pre-lacteal feeding is commonly practiced in Soddo zuria district. Mothers who live with extended family type, mothers who did not get breastfeeding counseling and mothers who avoid colostrum were statistically significant positive predictors of pre-lacteal feeding practice. Therefore, strengthening breastfeeding counseling about the risks associated with pre-lacteal feeding and colostrum feeding intervention should be integrated. Promotion of intensive nutrition education program, on the benefit of colostrum by giving special emphasis to extended family mothers should be implemented in the community.