Prevalence and factors associated with unskilled childbirth attendance in Guinea: Analysis of the 2018 Demographic and Health Survey.

This study aimed to analyze the prevalence and factors associated with the unassisted delivery by qualified health personnel in the Republic of Guinea, based on data from the 2018 demographic and health survey. Multivariate logistic regression was used to identify the associated factors. The prevalence of unassisted delivery was 40.8%; it was 38.4% in rural areas and 2.3% in urban areas. Factors associated with this type of delivery included the performance of no ANC (ORa = 6.19 IC95%: [4.86 - 7.87], p<0.001) and those who had performed one to three ANC (ORa =1.75 IC95%: [1.49 - 2.05], p<0.001) the perception of the distance to the health institution as a problem (ORa =1.28 IC95%: [1.10 - 1.48], p<0.001), belonging to the poor wealth index (ORa = 2.77 IC 95%: [2.19 - 3.50], p<0.001) and average (ORa = 2.01 IC95%: [1.57 - 2.57], p<0.001), the fact of residing in the region of Faranah (ORa = 2.24 IC95%: [1.37 - 3.65], p<0.001) and rural areas (ORa = 4.15 IC95%: [3.10 - 5.56], p<0.001). Strengthening community awareness, making functional ambulances available to rural health centers and making prenatal care inputs available in health institutions would help to reduce the scale of unassisted deliveries in the Republic of Guinea.

Cette étude visait à analyser la prévalence et les facteurs associés à l'accouchement non assisté par un personnel de santé qualifié en Guinée, partant des données de l'enquête démographique et de santé de 2018. La régression logistique multivariée a servi à identifier les facteurs associés. La fréquence de l'accouchement non assisté était de 40.8% ; elle était de 38.4% en milieu rural et 2.3% en milieu urbain. Les facteurs associés à ce type d'accouchement comprenaient la réalisation d'aucune CPN (ORa =6.19 IC95% : [4.86 - 7.87], p<0.001) et celles qui avaient réalisées une à trois CPN (ORa =1.75 IC95% : [1.49 - 2.05], p<0.001) la perception de la distance pour la structure de santé comme un problème (ORa =1.28 IC95% : [1.10 - 1.48], p<0.001), l'appartenance à l'indice de richesse pauvre (ORa =2.77 IC95% : [2.19 - 3.50], p<0.001) et moyenne (ORa =2.01 IC 95% : [1.57 - 2.57], p<0.001), le fait de résider dans la région de Faranah (ORa =2.24 IC95% : [1.37 - 3.65], p<0.001) et rurale (ORa =4,15 IC 95% : [3,10 - 5,56], p<0,001). Le renforcement de la sensibilisation communautaire, la mise d'ambulances fonctionnelles à la disposition des centres de santé ruraux et rendre disponible les intrants de soins prénatals dans les structures sanitaires contribueraient serte à réduire l'ampleur des accouchements non assistés en Guinée.

The Impact of Bilateral Stone Disease on Patients' Disease Progression and Health-Related Quality of Life.

Purpose: Patients with recurring kidney stone events can expect significant morbidity and functional impairment. Few studies have evaluated the effect of bilateral kidney stones on disease progression and quality of life. We wanted to determine the association of bilateral stone disease on age of onset, and the impact on number of stone events and individual kidney stone disease-specific health-related quality of life (HRQOL) by analyzing the validated and prospectively collected Wisconsin Stone Quality of Life (WISQOL) database. Materials and Methods: We studied 2906 stone patients from 16 centers in North America after having completed the WISQOL questionnaire from 2014 to 2019. Kidney stone formers were assessed if kidney stones were bilateral or unilateral on imaging. Analysis with a chi-square test compared categorical variables. Bilateral kidney stone disease and its impact on HRQOL were evaluated through a multivariable linear regression model. Results: Of 2906 kidney stone formers, 1340 had unilateral kidney stones and 1566 had bilateral kidney stones. We observed more frequently that patients with bilateral stones had an increased number of depression/anxiety symptoms, renal tubular acidosis, and rheumatoid arthritis (all p < 0.05). Patients with bilateral stones had a younger mean (standard deviation [SD]) age of kidney stone disease onset (37.2 ± 15.8 vs 46.4 ± 15.9 years of age, p < 0.001). Bilateral kidney stone formers had a higher mean (SD) number of stone events (11.3 ± 21.8) than unilateral kidney stone formers (3.0 ± 5.1) (p < 0.001). Within our multivariable analysis, we found that HRQOL was negatively affected by the presence of bilateral stones for kidney stone patients (ß = -11.2 [confidence interval: -19.5 to -3.0] points, p < 0.05). Conclusions: Bilateral kidney stone formers had a younger age of kidney stone disease onset and a higher number of stone events compared with unilateral kidney stone disease formers. The presence of bilateral kidney stone disease negatively impacted HRQOL.