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Semanew Y, Tesfaye E, Tesgera D. Inadequate weight gain and factors influencing it among preterm neonates in neonatal intensive care units in the Amhara region, Ethiopia, in 2022. Front Pediatr 2024; 12:1381010. [PMID: 38774296 PMCID: PMC11106434 DOI: 10.3389/fped.2024.1381010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/22/2024] [Indexed: 05/24/2024] Open
Abstract
Background Adequate weight gain is crucial for the health and development of preterm neonates admitted to neonatal intensive care units (NICUs). Understanding the factors influencing weight gain in this vulnerable population is essential for improving outcomes. This study aimed to assess the weight gain status and associated factors among preterm neonates admitted to NICUs in specialized hospitals in the Amhara region of Ethiopia. Methods A cross-sectional study design involving 363 preterm neonates admitted to NICUs in specialized hospitals within the Amhara region was used. Data were collected using structured questionnaires and the Kobo Tool Box. Daily weight measurements were recorded for three consecutive days. Descriptive statistics, logistic regression analysis, and graphical presentations were utilized for data analysis and presentation. Results The study revealed that a significant proportion (80.8%) of preterm neonates experienced poor weight gain during their NICU stay. The factors significantly associated with poor weight gain were older maternal age, delayed initiation of enteral feeding, lack of kangaroo mother care (KMC), and inadequate antenatal care visits. Conclusion Addressing the identified factors, such as providing adequate support during the antenatal period, promoting a timely initiation of enteral feeding, and encouraging KMC practices, is crucial for improving weight gain outcomes in preterm neonates. The findings highlight the importance of a comprehensive approach to neonatal care targeting both maternal and neonatal factors. Policymakers and healthcare providers should prioritize interventions aimed at optimizing weight gain in preterm neonates to improve these neonates' overall well-being and long-term outcomes.
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Affiliation(s)
- Yaregal Semanew
- Paediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Eleny Tesfaye
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Debrework Tesgera
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Fonzo M, Zuanna TD, Amoruso I, Resti C, Tsegaye A, Azzimonti G, Sgorbissa B, Centomo M, Ferretti S, Manenti F, Putoto G, Baldovin T, Bertoncello C. The HIV paradox: Perinatal mortality is lower in HIV-positive mothers-A field case-control study in Ethiopia. Int J Gynaecol Obstet 2023. [PMID: 36815783 DOI: 10.1002/ijgo.14738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/02/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVE Sub-Saharan African countries have the highest perinatal mortality rates. Although HIV is a risk factor for perinatal death, antioretroviral therapy (ART) programs have been associated with better outcomes. We aimed to investigate how maternal HIV affects perinatal mortality. METHODS The authors performed a nested case-control study at Saint Luke Hospital, Wolisso, Ethiopia. Data on sociodemographic characteristics, current maternal conditions, obstetric history, and antenatal care (ANC) services utilization were collected. The association between perinatal mortality and HIV was assessed with logistic regression adjusting for potential confounders. RESULTS A total of 3525 birthing women were enrolled, including 1175 cases and 2350 controls. Perinatal mortality was lower among HIV-positive women (18.3% vs. 33.6%, P = 0.007). Crude analysis showed a protective effect of HIV (odds ratio, 0.442 [95% confidence interval, 0.241-0.810]), which remained after adjustment (adjusted odds ratio, 0.483 [95% confidence interval, 0.246-0.947]). Among HIV-negative women, access to ANC for women from rural areas was almost half (18.8% vs. 36.2%; P < 0.001), whereas in HIV-positive women, no differences were noted (P = 0.795). CONCLUSION Among HIV-positive mothers, perinatal mortality was halved and differences in access to ANC services by area were eliminated. These data highlight the benefits of integrating ANC and HIV services in promoting access to the health care system, reducing inequalities and improving neonatal mortality.
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Affiliation(s)
- M Fonzo
- Hygiene and Public Health Unit, DCTVSP, University of Padova, Padova, Italy
| | - T D Zuanna
- Hygiene and Public Health Unit, DCTVSP, University of Padova, Padova, Italy
| | - I Amoruso
- Hygiene and Public Health Unit, DCTVSP, University of Padova, Padova, Italy
| | - C Resti
- Doctors with Africa CUAMM, Addis Ababa, Ethiopia
| | - A Tsegaye
- Doctors with Africa CUAMM, Addis Ababa, Ethiopia
| | | | - B Sgorbissa
- Hygiene and Public Health Unit, DCTVSP, University of Padova, Padova, Italy
| | - M Centomo
- Hygiene and Public Health Unit, DCTVSP, University of Padova, Padova, Italy
| | - S Ferretti
- Hygiene and Public Health Unit, DCTVSP, University of Padova, Padova, Italy
| | - F Manenti
- Doctors with Africa CUAMM, Padova, Italy
| | - G Putoto
- Doctors with Africa CUAMM, Padova, Italy
| | - T Baldovin
- Hygiene and Public Health Unit, DCTVSP, University of Padova, Padova, Italy
| | - C Bertoncello
- Hygiene and Public Health Unit, DCTVSP, University of Padova, Padova, Italy
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Sampurna MTA, Handayani KD, Utomo MT, Angelika D, Etika R, Harianto A, Mapindra MP, Mahindra MP, Efendi F, Kaban RK, Rohsiswatmo R, Visuddho V, Permana PBD. Determinants of neonatal deaths in Indonesia: A national survey data analysis of 10,838 newborns. Heliyon 2023; 9:e12980. [PMID: 36820170 PMCID: PMC9938489 DOI: 10.1016/j.heliyon.2023.e12980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 01/08/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Background Neonatal mortality is one of the key impediments in achieving global sustainable development goals, especially in lower middle income countries (LMICs). As an LMIC with the highest reported neonatal mortality rate in Southeast Asia, Indonesia faces inequitable distribution of health facilities across the archipelago. Therefore, in this paper, we aim to evaluate the determinants of neonatal mortality rate in Indonesia to search for better strategies to overcome this problem. Methods We conducted an analysis of the 2017 Indonesia Demographic Health Survey dataset of 10,838 live-born infants born from singleton pregnancies in 2017. Using a hierarchical approach, multivariate analysis was conducted to identify potential factors (including socioeconomic, household, and proximate determinants) that contributed to neonatal mortality. Results The lack of participation in postnatal care [odds ratio (OR) = 20.394, p = 0.01)] and delivery complications other than prolonged labour (OR = 2.072, p = 0.02) were the maternal factors that significantly associated with increased risk of neonatal death. Regarding neonatal factors, low-birth-weight infants appeared to be more vulnerable to neonatal death (OR = 12.489, p = 0.01). Conclusion Low participation in postnatal care, development of labour complications, and low birth weight were associated with higher neonatal mortality. It implies that in a limited resource and geographically challenging country such as Indonesia, improving the quality and optimizing services of public hospitals with equitable distribution of quality health care services in all regions should be prioritized in the efforts of reducing neonatal mortality rate.
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Affiliation(s)
- Mahendra Tri Arif Sampurna
- Department of Pediatrics, Airlangga University Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia,Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia,Corresponding author. Jl. Mayjen Prof. Dr. Moestopo No. 47, Pacar Kembang, Kec. Tambaksari, Kota Surabaya, Jawa Timur, 60132, Indonesia.
| | - Kartika Dharma Handayani
- Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Martono Tri Utomo
- Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Dina Angelika
- Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Risa Etika
- Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Agus Harianto
- Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Muhammad Pradhika Mapindra
- Neonatology Department, Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, United Kingdom
| | - Muhammad Pradhiki Mahindra
- Maternal-Fetal Medicine Department, Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, United Kingdom
| | - Ferry Efendi
- Nursing Faculty, Universitas Airlangga, Indonesia
| | - Risma Kerina Kaban
- Neonatology Division, Department of Pediatrics, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rinawati Rohsiswatmo
- Neonatology Division, Department of Pediatrics, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Visuddho Visuddho
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
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Tesfay N, Hailu G, Woldeyohannes F. Effect of optimal antenatal care on maternal and perinatal health in Ethiopia. Front Pediatr 2023; 11:1120979. [PMID: 36824654 PMCID: PMC9941639 DOI: 10.3389/fped.2023.1120979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 01/09/2023] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Receiving at least four antenatal care (ANC) visits have paramount importance on the health of mothers and perinates. In Ethiopia, several studies were conducted on ANC service utilization; however, limited studies quantified the effect of care on maternal and perinate health. In response to this gap, this study is conducted to quantify the effect of optimal ANC care (≥4 visits) on maternal and perinatal health among women who received optimal care in comparison to women who did not receive optimal care. METHODS The study utilized the Ethiopian perinatal death surveillance and response (PDSR) system dataset. A total of 3,814 reviewed perinatal deaths were included in the study. Considering the nature of the data, preferential within propensity score matching (PWPSM) was performed to determine the effect of optimal ANC care on maternal and perinatal health. The effect of optimal care was reported using average treatment effects of the treated [ATT]. RESULT The result revealed that optimal ANC care had a positive effect on reducing perinatal death, due to respiratory and cardiovascular disorders, [ATT = -0.015, 95%CI (-0.029 to -0.001)] and extending intrauterine life by one week [ATT = 1.277, 95%CI: (0.563-1.991)]. While it's effect on maternal health includes, avoiding the risk of having uterine rupture [ATT = -0.012, 95%CI: (-0.018 to -0.005)], improving the utilization of operative vaginal delivery (OVD) [ATT = 0.032, 95%CI: (0.001-0.062)] and avoiding delay to decide to seek care [ATT = -0.187, 95%CI: (-0.354 to -0.021)]. CONCLUSION Obtaining optimal ANC care has a positive effect on both maternal and perinatal health. Therefore, policies and interventions geared towards improving the coverage and quality of ANC services should be the top priority to maximize the benefit of the care.
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Affiliation(s)
- Neamin Tesfay
- Center of Public Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Girmay Hailu
- Center of Public Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Fitsum Woldeyohannes
- Health Financing Department, Clinton Health Access Initiative, Addis Ababa, Ethiopia
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Rahman MO, Yamaji N, Sasayama K, Yoneoka D, Ota E. Technology-based innovative healthcare solutions for improving maternal and child health outcomes in low- and middle-income countries: A network meta-analysis protocol. Nurs Open 2022; 10:367-376. [PMID: 35978460 PMCID: PMC9748107 DOI: 10.1002/nop2.1310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/29/2022] [Accepted: 07/29/2022] [Indexed: 01/04/2023] Open
Abstract
AIM The aims of the study were to synthesize the role of technology-based healthcare interventions (TBIs) and to identify the most effective interventions for the best functional maternal and child health (MCH) outcomes among low-risk pregnant women in low- and middle-income countries (LMICs). DESIGN A systematic review and network meta-analysis (NMA). METHODS We will perform a comprehensive search in electronic databases and other resources to identify relevant randomized controlled trials. Two reviewers will independently perform study selection, data extraction and quality assessment. Our primary outcomes include proportion of recommended antenatal care visits, skilled delivery care, postnatal care visits and exclusive breastfeeding practices. We will use pairwise random-effects meta-analysis and NMAs to estimate direct, indirect and relative effects using the relevant intervention classifications for each outcome separately. We plan to assess hierarchy of interventions, statistical inconsistency and certainty of evidence. RESULTS This review will compare the effectiveness of different form of TBIs on a comprehensive range of MCH outcomes and will provide the outcome-specific reliable evidence of the most effective interventions on improving MCH in LMICs. The review findings will guide researchers, stakeholders or policymakers on the potential use of TBIs in the given contexts that could achieve the best functional MCH outcomes in LMICs.
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Affiliation(s)
- Md. Obaidur Rahman
- Department of Global Health Nursing, Graduate School of Nursing ScienceSt. Luke's International UniversityTokyoJapan,Center for Surveillance, Immunization, and Epidemiologic ResearchNational Institute of Infectious DiseasesTokyoJapan,Center for Evidence‐Based Medicine and Clinical ResearchDhakaBangladesh
| | - Noyuri Yamaji
- Department of Global Health Nursing, Graduate School of Nursing ScienceSt. Luke's International UniversityTokyoJapan
| | - Kiriko Sasayama
- Department of Global Health Nursing, Graduate School of Nursing ScienceSt. Luke's International UniversityTokyoJapan
| | - Daisuke Yoneoka
- Center for Surveillance, Immunization, and Epidemiologic ResearchNational Institute of Infectious DiseasesTokyoJapan
| | - Erika Ota
- Department of Global Health Nursing, Graduate School of Nursing ScienceSt. Luke's International UniversityTokyoJapan,Tokyo Foundation for Policy ResearchTokyoJapan
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Tola MA, Semahegn A, Tiruye G, Tura AK. Magnitude of neonatal near miss in public hospitals in Eastern Ethiopia: A cross-sectional study. SAGE Open Med 2022; 10:20503121221108926. [PMID: 35837571 PMCID: PMC9274431 DOI: 10.1177/20503121221108926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 06/06/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives: Although neonatal near miss is an emerging concept and a tool for improving
neonatal care, its magnitude and associated factors are less researched in
Ethiopia. Thus, this study was aimed to uncover the magnitude of neonatal
near miss and its associated factors in public hospitals in Eastern
Ethiopia. Methods: A facility-based cross-sectional study was employed on a randomly selected
405 mother–neonate pairs. An interview using a structured questionnaire
accompanied by review of medical records was used to collect data from the
mothers and records of the neonates. Neonatal near miss was defined as
having any of the pragmatic (gestational age < 33 weeks, birth
weight < 1750 g, and fifth minutes Apgar score < 7) or management
criteria. Crude and adjusted logistic regression analysis was done to
identify associated factors and presented with adjusted odds ratio with 95%
confidence interval. Results: Of 401 mother–neonate pairs included in the study, 126 (31.4%, 95% confidence
interval = [26.9, 36.2]) neonates had at least one neonatal near miss event
at discharge. Neonatal near miss was more likely among neonates from
referred women (adjusted odds ratio = 2.24, 95% confidence interval = [1.25,
4.03]), no antenatal care (adjusted odds ratio = 2.08, 95% confidence
interval = [1.10, 3.93]), antepartum hemorrhage (adjusted odds ratio = 4.29,
95% confidence interval = [2.16, 8.53]), premature rupture of membrane
(adjusted odds ratio = 4.07, 95% confidence interval = [2.05, 8.07]),
obstructed labor (adjusted odds ratio = 2.61, 95% confidence interval =
[1.23, 5.52]), non-vertex presentation (adjusted odds ratio = 3.03, 95%
confidence interval = [1.54, 5.95]), and primiparous (adjusted odd
ratio = 2.67, 95% confidence interval = [1.49, 4.77]). Conclusions: In this study, we found that neonatal near miss is higher than previous
findings in Ethiopia. Improving neonatal near miss requires promoting
antenatal care, maternal referral system, and early identification and
management of obstetric complications.
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Affiliation(s)
- Melese Adugna Tola
- Department of Midwifery, College of Health Sciences, Mettu University, Mettu, Ethiopia.,School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Agumasie Semahegn
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Getahun Tiruye
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Gebremariam AD, Tiruneh SA, Engidaw MT, Tesfa D, Azanaw MM, Yitbarek GY, Asmare G. Development and Validation of a Clinical Prognostic Risk Score to Predict Early Neonatal Mortality, Ethiopia: A Receiver Operating Characteristic Curve Analysis. Clin Epidemiol 2021; 13:637-647. [PMID: 34366681 PMCID: PMC8336991 DOI: 10.2147/clep.s321763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/12/2021] [Indexed: 01/27/2023] Open
Abstract
Background Early neonatal death is the death of a live-born baby within the first seven days of life, which is 73% of all postnatal deaths in the globe. This study aimed to develop and validate a prognostic clinical risk tool for the prediction of early neonatal death. Methods A prospective follow-up study was conducted among 393 neonates at Debre Tabor Referral hospital, Northwest Ethiopia. Multivariable logistic regression model was employed to identify potential prognostic determinants for early neonatal mortality. Area under receiver operating characteristics curve (AUROC) was used to check the model discrimination probability using ‘pROC’ R-package. Model calibration plot was checked using ‘givitiR’ R-package. Finally, a risk score prediction tool was developed for ease of applicability. Decision curve analysis was done for cost-benefit analysis and to check the clinical impact of the model. Results Overall, 15.27% (95% CI: 12.03–19.18) of neonates had the event of death during the follow-up period. Maternal undernutrition, antenatal follow-up less than four times, birth asphyxia, low birth weight, and not exclusive breastfeeding were the prognostic predictors of early neonatal mortality. The AUROC for the reduced model was 88.7% (95% CI: 83.8–93.6%), which had good discriminative probability. The AUROC of the simplified risk score algorithm was 87.8% (95% CI, 82.7–92.9%). The sensitivity and specificity of the risk score tool was 70% and 89%, respectively. The true prediction accuracy of the risk score tool to predict early neonatal mortality was 86%, and the false prediction probability was 13%. Conclusion We developed an early neonatal death prediction tool using easily available maternal and neonatal characteristics for resource-limited settings. This risk prediction using risk score is an easily applicable tool to identify neonates at a higher risk of having early neonatal mortality. This risk score tool would offer an opportunity to reduce early neonatal mortality, thus improving the overall early neonatal death in a resource-limited setting.
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Affiliation(s)
- Alemayehu Digssie Gebremariam
- Department of Public Health (Human Nutrition), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sofonyas Abebaw Tiruneh
- Department of Public Health (Epidemiology), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melaku Tadege Engidaw
- Department of Public Health (Human Nutrition), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Desalegn Tesfa
- Department of Public Health (Reproductive Health), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkalem Mamuye Azanaw
- Department of Public Health (Epidemiology), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getachew Yideg Yitbarek
- Department of Biomedical Science (Medical Physiology), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getnet Asmare
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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