Communities and community genetics in Ethiopia

Preconception care utilization and associated factors among reproductive age women in Mizan-Aman town, Bench Sheko zone, Southwest Ethiopia, 2020. A content analysis

Background

Preconception care is highly important in reducing a number of adverse pregnancy outcomes and helps to improve maternal health. Preconception care optimizes women’s health and improves pregnancy outcomes. It is a cost-effective first-line preventive strategy for birth defects. However, preconception care utilization in Ethiopia was very low. Studies on these issues are limited in Ethiopia in general and in Mizan-Aman town in particular.

Objective

To assess preconception care utilization and associated factors among reproductive age women in Mizan-Aman town, Bench-Sheko Zone, Southwest Ethiopia.

Methods

A community based cross-sectional study design was employed from April 16 to May 26, 2020 in Mizan-Aman town. The total study participants were 624 reproductive age women. Data were collected by using pre-tested interviewer administered questionnaires and entered into Epi-data version 3.1 then exported to STATA version 14 and analyzed accordingly. Univeriate and Bivariable analysis was done by analysis of variance (ANOVA) and independent t-test. Multivariable statistical analysis using generalized linear regression model (GLM) approach was used to classify factors of preconception care utilization. Since our response variable is measured in terms of count variable, we used a Poisson regression model with a log link function. Finally, Statistical significance between dependent and independent variables were assessed by odds ratios and 95% confidence intervals.

Results

Overall, 28.6% of the women receipt atleast one item of preconception care while only 1.5% were taken the whole recommended components of preconception care services. The most common item received in the study area was taking micronutrient supplementation (18.5%). Age of women, educational status, husbands educational status, husbands occupation, wealth status, distance from the health facility, waiting time to get services, planning to pregnancy, age at first pregnancy, previous ANC use, Previous PNC use, adverse pregnancy experience, women’s knowledge of preconception care, and attitude on preconception care were determinants of preconception service utilization.

Conclusions

Preconception care component utilization was lower as compare with recommended service with different disparities. Multipurpose tailored strategies which incorporate a woman with no formal education, poor knwledge on preconception care,never take maternal services previously and distant from health facility could improve preconception care service utilization. Advocative strategies on preconception care component and planning pregnancy may elicite more women to use the services of preconception care.

A survey on women's awareness of iron and folic acid intake during preconception period and its associated factors in Manna District, Oromia region, Southwest Ethiopia

Aim

This study aimed to assess pregnant women's awareness of iron and folic acid intake during the preconception period and associated factors.

Design

A cross‐sectional study.

Methods

This study was conducted on 636 pregnant women in Manna District, Oromia region, Southwest Ethiopia. Women's awareness of iron and folic acid intake during the preconception period was measured using a pre‐tested structured questionnaire. Descriptive, binary and multivariable logistic regression analyses were carried out.

Results

Of the total of 623 participants, 6.7% of them had an awareness of iron and folic acid intake during preconception period. Women's husband who had formal education, women who had ≥four ANC visits and women who were at distance of <30 min from the nearest health facility were significant predictors of pregnant women's awareness iron and folic acid intake during the preconception period.

Conclusions

Women's awareness of iron and folic acid intake during the preconception period was very low. Husband educational status, frequency of ANC visits and distance from health facility were predictors of women's awareness of iron and folic acid intake during the preconception period.

Evidence of the interplay of genetics and culture in Ethiopia

The rich linguistic, ethnic and cultural diversity of Ethiopia provides an unprecedented opportunity to understand the level to which cultural factors correlate with-and shape-genetic structure in human populations. Using primarily new genetic variation data covering 1,214 Ethiopians representing 68 different ethnic groups, together with information on individuals' birthplaces, linguistic/religious practices and 31 cultural practices, we disentangle the effects of geographic distance, elevation, and social factors on the genetic structure of Ethiopians today. We provide evidence of associations between social behaviours and genetic differences among present-day peoples. We show that genetic similarity is broadly associated with linguistic affiliation, but also identify pronounced genetic similarity among groups from disparate language classifications that may in part be attributable to recent intermixing. We also illustrate how groups reporting the same culture traits are more genetically similar on average and show evidence of recent intermixing, suggesting that shared cultural traits may promote admixture. In addition to providing insights into the genetic structure and history of Ethiopia, we identify the most important cultural and geographic predictors of genetic differentiation and provide a resource for designing sampling protocols for future genetic studies involving Ethiopians.

Seroprevalence of Anti-Toxoplasma gondii Antibodies and Associated Factors Among Pregnant Women Attending Antenatal Care at Debre Markos Referral Hospital, Northwest Ethiopia

Background

Toxoplasma gondii is an obligate intracellular protozoan parasite that causes a zoonotic disease called toxoplasmosis. If the infection acquired during pregnancy is not detected and treated early, the parasite can be transmitted transplacentally to the fetus, resulting in congenital toxoplasmosis, which likely leads to serious consequences in the fetus. Toxoplasmosis constitutes a major public health problem particularly in low- and middle-income countries including Ethiopia. This study aimed to determine the seroprevalence and to assess the potential risk factors of toxoplasmosis among pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia.

Methods

In this cross-sectional study, data on the sociodemographic and potential obstetric and behavioral risk factors were gathered through pretested structured questionnaires, and 3 mL of venous blood was also drawn from each of randomly selected 233 study subjects. The serum samples were separated from the blood samples and tested for anti-Toxoplasma antibody using Toxo-latex slide agglutination test. Logistic regression analysis was used to examine the association between risk factors considered and T gondii infection.

Results

The overall prevalence of T gondii infection was 67.8%, indicating a high prevalence of toxoplasmosis in the study area. In multivariate analysis, keeping domestic cat at home was found to be the only explanatory variable of toxoplasmosis (adjusted odds ratio = 2.449, 95% confidence interval = 1.183-5.070, P = .016). All sociodemographic variables and most of the potential obstetric and behavioral risk factors were not statistically significant explanatory variables of T gondii infection.

Conclusion

The prevalence of toxoplasmosis is high in the study area. Thus, pregnant women should be aware of the potential risk of the disease when keeping cats at home and management of their litter. Inclusion of serologic screening for T gondii infection at antenatal care is warranted for prevention of congenital toxoplasmosis.

Patient preferences for prenatal testing and termination of pregnancy for congenital anomalies and genetic diseases in Ethiopia

OBJECTIVE

As prenatal diagnostic services expand throughout low-income countries, an important consideration is the appropriateness of these services for patients. In these countries, services now include prenatal ultrasound and occasionally genetic testing. To assess patient interest, we surveyed pregnant patients at a hospital in Addis Ababa, Ethiopia, on their preferences for prenatal testing and termination of affected pregnancies for congenital anomalies and genetic diseases.

METHOD

One hundred one pregnant patients were surveyed on their preferences for prenatal testing and termination of affected pregnancies using a survey covering various congenital anomalies and genetic diseases.

RESULTS

Eighty-nine percent of patients reported interest in testing for all conditions. Three percent of patients were not interested in any testing. Over 60% of patients reported interest in termination for anencephaly, early infant death, severe intellectual disability, hemoglobinopathy, and amelia. Patients were more likely to express interest in prenatal testing and termination for conditions associated with a shortened lifespan.

CONCLUSION

Ethiopian patients were interested in prenatal testing and termination of pregnancy for many conditions. Advancing prenatal diagnostic capacities is a potential strategy for addressing the incidence of congenital anomalies and genetic disease in Ethiopia. Importantly, there exist many factors and technological limitations to consider before implementation.

Introducing medical genetics services in Ethiopia using the MiGene Family History App

PURPOSE

Almost all low-income countries and many middle-income countries lack the capacity to deliver medical genetics services. We developed the MiGene Family History App (MFHA), which assists doctors with family history collection and population-level epidemiologic analysis. The MFHA was studied at St. Paul's Hospital in Addis Ababa, Ethiopia.

METHODS

A needs assessment was used to assess Ethiopian physicians' experience with genetics services. The MFHA then collected patient data over a 6-month period.

RESULTS

The majority of doctors provide genetics services, with only 16% reporting their genetics knowledge is sufficient. A total of 1699 patients from the pediatric ward (n = 367), neonatal intensive care unit (NICU) (n = 477), and antenatal clinic (n = 855) were collected using the MFHA with a 4% incidence of a MFHA-screened condition present. The incidence was 11.7% in the pediatric ward, 3% in the NICU, and 0.5% in the antenatal clinic. Heart malformations (5.5% of patients) and trisomy 21 (4.4% of patients) were the most common conditions in the pediatric ward.

CONCLUSION

Medical genetics services are needed in Ethiopia. As other countries increase their genetics capacity, the MFHA can provide fundamental genetics services and collect necessary epidemiologic data.

Folic acid usage and associated factors in the prevention of neural tube defects among pregnant women in Ethiopia: cross-sectional study

BACKGROUND

Neural tube defects are among the most common birth defects, contributing to miscarriage, infant mortality, severe congenital abnormalities and serious disabilities. It is burdensome to patients, caregivers, healthcare systems and society. It could be reduced if women consume a folic acid supplement before and during the early weeks of pregnancy. This study assesses folic acid usage and associated factors for the prevention of neural tube defects among pregnant women in Ethiopia.

METHODS

Institution based cross-sectional study was conducted on 417 systematically sampled, consented pregnant women that visited Adama hospital medical college for antenatal care during August to November 2014. Pretested interviewer administered questionnaire was used to collect socio-demographic, obstetric characteristics and folic acid usage of women.

RESULT

About 48.4% of women took a folic acid supplement at different period of pregnancy; but, only 1.92% of women took the supplement at a protective period against neural tube defects. Age, the early timing of antenatal registration, was a preconception consulted, previous unsuccessful pregnancies and level of folic acid awareness were significantly associated with folic acid usage for prevention of neural tube defects.

CONCLUSIONS

Folic acid usage during the protective period against neural tube defects among women in Ethiopia is very low, so healthcare plan to improve intake of folic acid is required.