BackgroundVertical transmission of Human Immunodeficiency Virus (HIV) is the primary route of infection among children. Ethiopia is among the top ten countries in the world with the highest burden of HIV infections among children. Therefore we aimed to assess mother to child transmission (MTCT) of HIV and associated factors among HIV exposed infants (HEIs).MethodsA cross-sectional study was conducted using retrospective data collected from HEIs paired with their mothers who had received the services in prevention of mother to child transmission (PMTCT) programs from January 2014 to December 2017 in public health facilities in Dessie town. Data of a total of 313 HEIs paired with their mothers were obtained by using semi-structured data extraction proforma from their medical records. The data were processed in Epi-info version 7.1.2.0 and analyzed using SPSS version 22. Crude and adjusted odds ratios with their 95% confidence intervals and p-value were used to identify significant factors.ResultsThe prevalence of HIV among exposed infants was 3.8%. Absence of maternal antenatal care visit (AOR = 4.6, 95% CI: 1.17–17.99), home delivery (AOR = 4.2, 95% CI: 1.04 −16.76), absence of antiretroviral intervention to the mother (AOR= 5.7, 95% CI: 1.10–29.36), and failure to initiate nevirapine prophylaxis for the infant (AOR = 5.3, 95% CI: 1.11 −25.44) were significant factors of MTCT of HIV.ConclusionPrevalence of MTCT of HIV was low (3.8%) in Dessie town public health facilities. Having ANC visit, delivery at health facility, maternal ARV drug intake, and infant ARV prophylaxis were the significant protective factors against MTCT of HIV. Promoting ANC service utilization among pregnant women and providing counseling as well as setting up linkage with PMTCT and giving ARV intervention to all HIV positive pregnant women and timely initiation of NVP prophylaxis to all HEIs should be recommended by the minister of health and health facilities.
Introduction Birth asphyxia is one of the leading causes of early neonatal mortality, which causes an estimated 900,000 deaths annually. Therefore, assessing the survival status and predictors of mortality among asphyxiated neonates will be highly helpful to policymakers in designing, implementing, and evaluating programs to achieve the sustainable development goal of reducing neonatal mortality as low as 12/1,000 live births by 2030. Methods A facility-based retrospective cohort study was conducted among 378 asphyxiated neonates admitted to the NICU of Dessie Comprehensive Specialized Hospital from January, 2017 –December, 2019. The data were collected from eligible records by using a structured data extraction tool from March 30 –April 21, 2020. The data were cleaned manually and entered into Epi-data version 7.1.2.0, and STATA version 16 was used for the analysis. Bivariate and Multivariate Cox proportional hazard regression analysis were performed, and significant predictors were identified using 95% confidence interval and p-value <0.05. Result A total of 378 neonates were followed for 2298 neonatal days, ranging from 1 to 28 days. The mortality incidence rate was 5.3/100 person-days-of observation (95% CI: 4.41, 6.29), and 32% (95% CI: 27.6%, 36.8%) of the study subjects died. Admission weight (AHR: 1.72; 95% CI: 1.09, 2.72), seizure (AHR: 1.52; 95% CI: 1.02, 2.27), neonates who received resuscitation (AHR: 2.11; 95% CI: 1.18, 3.80), and stage of asphyxia (moderate (AHR: 3.50; 95% CI: 1.55, 8.36), and severe (AHR: 11.55; 95% CI: 4.73, 28.25)) were significant predictors of neonatal mortality among asphyxiated neonates. Conclusion The magnitude of neonatal mortality among asphyxiated neonates in the study area was high. Admission weight, seizure, resuscitation, and stage of asphyxia were significant predictors of mortality among neonates with asphyxia. Therefore, special attention should be given to asphyxiated neonates with low admission weight and those who had seizure. Additionally, the timing, quality, and effectiveness of resuscitation might need further assessment and evaluation.
Background: Globally, more than 20.5 million infants are born with low birth weight, and the majorities were from Asia and Africa. Even though efforts were made to reduce low birth weight worldwide, it remains a global public health problem, especially in sub-Saharan Africa. Objective: To assess low birth weight and associated factors among newborn babies in health institutions in Dessie, Amhara, Ethiopia. Methods: An institution-based cross-sectional study was conducted among 358 newborn/ mother pairs from March 1 to April 15, 2017, in Dessie town health institutions. The data were collected using a semi-structured interviewer-guided questionnaire. The numbers of newborn/mother pairs surveyed from each health institution were allocated proportionally, and systematic random sampling was used to select the respondents. Epi-info version 7.0 was used for data entry, and Statistical Package for Social Sciences version 20 was used for the analysis. Multivariate logistic regression with adjusted odds ratios and 95% confidence intervals were used to identify significantly associated variables with low birth weight. Results: In this study, the prevalence of low birth weight was 15.6%. Maternal age <20 years (AOR: 3.78, 95% CI, 1.02-13.97), rural residence (AOR: 3.49, 95% CI, 1.48-8.24), having antenatal care follow-up (AOR: 3.79, 95% CI, 1.08-13.23), gestational age <37 weeks (AOR: 3.82, 95% CI, 1.55-9.42), and females (AOR: 3.37, 95% CI, 1.17-9.72) were significantly associated with low birth weight. Conclusion: The proportion of LBW in this study is comparable to the estimated global prevalence. Maternal age, residence, antenatal care, gestational age, and sex were significantly associated variables with low birth weight. Therefore, special attention should be given to antenatal care services and preventive strategies for preterm delivery.
Introduction. Neonatal hypothermia is the reduction in the body temperature of the newborn (less than 36.5°C). It is a global problem in neonates born both at hospitals and homes, but it showed a higher prevalence in developing countries (>90%). Although hypothermia is rarely a direct cause of death, it contributes to a substantial proportion of neonatal mortality globally. Objective. To assess neonatal hypothermia and associated factors among newborns admitted in the NICU of Dessie Referral Hospital. Methods and Materials. An institution-based cross-sectional study was conducted from March 15 to May 30, 2018. The data was collected from the mother and the chart of the newborn using a semistructured questionnaire. Data were cleaned, coded, and entered in EPI-info version 7.1.2.0 then exported to Statistical Package for Social Sciences (SPSS) version 20 software for analysis. Descriptive statistics were used to summarize the data. Bivariate and multivariate logistic regression and crude and adjusted odds ratio with their 95% confidence interval were computed. Finally, p value < 0.05 was used to identify variables that had a significant association with neonatal hypothermia. Result. The proportion of neonatal hypothermia in the study area was 66.8%. Preterm delivery (AOR=2.6, 95% CI: 1.1, 6.2), no skin-to-skin contact within 1 hour of delivery (AOR=3.0, 95% CI: 1.3, 7.8), delivered at night time (AOR=2.0, 95% CI: 1.02, 4.0), and neonates who had resuscitation (AOR=2.9, 95% CI: 1.1, 7.2) showed significant association with neonatal hypothermia. Conclusion. In this study, the proportion of hypothermia was high. Preterm delivery, no skin-to-skin contact within 1 hour, night-time delivery, and having resuscitation were significantly associated with neonatal hypothermia. Therefore, special attention is needed for the thermal care of preterm neonates and neonates delivered at night time. Furthermore, there should be strict adherence to cost-effective thermal care recommendations like warm resuscitation and skin-to-skin contact.
Background Lower respiratory infections are a leading cause of morbidity and mortality worldwide, particularly in children younger than 5 years. Even if the burden of lower respiratory infections in children under 5 years old had decreased dramatically in the last 10 years, it is still the main cause of morbidity and mortality in children under-5 years old in developing countries, so the aim of this study was to assess the magnitude of lower respiratory tract infections and associated factors among under-five children visiting Wolaita Sodo University Teaching and Referral Hospital. Method A cross-sectional study was conducted from 1st to 30th April 2019, among under-five child/mother or caretaker pairs visiting Wolaita Sodo University Teaching and Referral Hospital. Child/mother or caretaker pairs who visits outpatient department for curative care service or follow up were recruited for the study. Data were collected using a semi-structured pre-tested interviewer-guided questionnaire. Epi-info (version 7.1.2.0) was used for data entry, and Statistical Package for Social Sciences version 20 was used for analysis. Bivariate and multivariate logistic regression, crude and adjusted odds ratios with their 95 % confidence intervals was computed. Finally, a p-value ≤ 0.05 was used to identify variables that had a significant association with acute lower respiratory infection. Result A total of 414 child/mother or caretaker pairs were recruited for the study. The magnitude of acute lower respiratory infections among under-five children was 40.3 % (95 % CI: 35.7- 44.9 %). Unvaccinated children (AOR: 2, 95 % CI, (1.27–3.16)), non-exclusive/replacement feeding (AOR: 1.85, 95 % CI, (1.18–2.91)), households mainly used unclean fuel for cooking (AOR: 2.12, 95 % CI, (1.07–4.19)), absence of separate kitchen (AOR: 1.7, 95 % CI, (1.09–2.65)), and absence of window in the kitchen room (AOR: 1.69, 95 % CI, (1.07–2.68)) showed significant association with acute lower respiratory infection. Conclusions The magnitude of acute lower respiratory tract infections among under-five children visiting outpatient department was 40.3 %. Unvaccinated children, non-exclusive/replacement feeding, using unclean fuel for cooking, absence of a separate kitchen, and absence of window in the kitchen showed significant association with acute lower respiratory infection. Therefore, special attention should be given to the environmental sanitation and family health components of health extension packages.
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