1
|
Abuosi AA, Anaba EA, Daniels AA, Baku AAA, Akazili J. Determinants of early antenatal care visits among women of reproductive age in Ghana: evidence from the recent Maternal Health Survey. BMC Pregnancy Childbirth 2024; 24:309. [PMID: 38658859 PMCID: PMC11044554 DOI: 10.1186/s12884-024-06490-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/07/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Antenatal care services play a crucial role in promoting positive pregnancy outcomes by facilitating the early identification of pregnancy risk factors and early diagnosis of pregnancy-related complications. This study aimed to assess the frequency and timing of ANC attendance of mothers in Ghana as well as determine the predictors of early ANC attendance. METHODS The data for this study was extracted from the 2017 Ghana Maternal Health Survey (GMHS). The study population was women aged 15-49 years with a live birth or stillbirth in the 5 years preceding the survey. Data was analysed using STATA/SE version 17, using descriptive statistics and multiple binary logistic regression analysis. RESULTS It was found that 44.4% of the women obtained eight (8) + ANC visits. A majority of the women (66%) initiated ANC visits in the first trimester of pregnancy. Early ANC visit was significantly associated with age of the respondent, education, wealth index, religion, region and reason for first ANC visit. For instance, women between the ages of 25-29 years (aOR = 1.75, 95% CI: 1.31-2.33) had increased odds of early ANC visit compared to those aged 15-19 years. Women with higher education (aOR = 1.83, 95% CI: 1.27-2.64) were about twice as likely to initiate early ANC visits compared to those with no education. Also, women in the highest wealth index (aOR = 2.43, 95% CI: 1.83-3.23) were two times more likely to initiate early ANC visits compared to those in the lowest wealth index. CONCLUSION This study has shown that a majority of women in Ghana start their first ANC visit during the first trimester of pregnancy. A considerable proportion of the women failed to meet the WHO's recommendation of having a minimum of eight ANC visits throughout pregnancy. Early ANC visit was determined by socio-demographic factors. Going forward, it should be a priority for stakeholders to ensure that ANC services are accessible to all mothers in a timely manner.
Collapse
Affiliation(s)
- Aaron Asibi Abuosi
- Department of Health Services Management, Business School, University of Ghana, Legon-Accra, Ghana
| | - Emmanuel Anongeba Anaba
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon-Accra, Ghana.
| | - Anita Anima Daniels
- Department of Health Services Management, Business School, University of Ghana, Legon-Accra, Ghana
| | - Anita Asiwome Adzo Baku
- Department of Health Services Management, Business School, University of Ghana, Legon-Accra, Ghana
| | - James Akazili
- School of Public Health, C.K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
- BCEPS, University of Bergen, Bergen, Norway
| |
Collapse
|
2
|
Issa MY, Diagana Y, Khalid ELK, Coulibaly SM, Gueye A, Dehah RMH, Vall OEKM. Dietary diversity and its determinants among women of reproductive age residing in the urban area of Nouakchott, Mauritania. BMC Public Health 2024; 24:916. [PMID: 38549049 PMCID: PMC10979579 DOI: 10.1186/s12889-024-18211-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/25/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND The intake of nutrient-rich foods from diverse diets ensures adequate nutrition for women. This study aims to determine dietary diversity among women of reproductive age (WRA) using the MDD-W indicator and how it relates to their socio-economic characteristics in the city of Nouakchott, Mauritania. METHODS A community-based cross-sectional study was conducted on 240 women of reproductive age, aged 15-49 years. Food consumption data were obtained through unquantified 24 h recall which is designed to identify all foods consumed by the women during this period. We computed MDD-W as the consumption of at least five out of ten predefined food groups according to the guideline of the Food and Agriculture Organization (FAO) of the United Nations. In order to determine which factors had a statistically significant influence on dietary diversity among women, we used a value of P < 0.05. RESULTS The mean of dietary diversity was 5.48 and 71.7% of WRA had an acceptable minimum dietary diversity. During the study period, 96.25% and 80% of women consumed vitamin A and iron-rich foods respectively. The consumption rate of starchy foods, vitamin A-rich fruits and vegetables, meat, fish and chicken, milk and dairy products, dark green leafy vegetables and finally other vegetables was higher; 99.6%, 75.3%, 80%, 62.5%, 60.4% and 83.3% respectively. On the other hand, the consumption of legumes, eggs and other fruits was low; at 21.7%, 14.2% and 13.8% respectively. CONCLUSIONS The study showed that more than half of the studied population had an acceptable minimum dietary diversity. The diet was mainly based on the consumption of starchy foods, meat and other vegetables than those rich in vitamin A.
Collapse
Affiliation(s)
- Mariem Youssouf Issa
- Research Unit of Food, Nutrition, and Metabolic Disorders, Faculty of Sciences and Technics, University of Nouakchott, Nouakchott, Mauritania.
| | - Yacouba Diagana
- Marine Ecology, Environment Nutrition and Health, Faculty of Sciences and Technics, University of Nouakchott, Nouakchott, Mauritania
| | - E L Kari Khalid
- Joint Research Unit in Nutrition and Food, RDC-Nutrition Ibn Tofaïl University- CNESTEN, Rabat, Morocco
| | - Sidi Mohamed Coulibaly
- Marine Ecology, Environment Nutrition and Health, Faculty of Sciences and Technics, University of Nouakchott, Nouakchott, Mauritania
| | - Alioune Gueye
- Department of Demographic and Social Statistics, National Agency for Statistics and Demographic and Economic Analysis, Nouakchott, Mauritania
| | - Rabab M H Dehah
- Research Unit of Food, Nutrition, and Metabolic Disorders, Faculty of Sciences and Technics, University of Nouakchott, Nouakchott, Mauritania
| | - Ould El Kebir Mohamed Vall
- Research Unit of Food, Nutrition, and Metabolic Disorders, Faculty of Sciences and Technics, University of Nouakchott, Nouakchott, Mauritania
| |
Collapse
|
3
|
Kuche D, Abebe Z, Tessema M, Girma M, Hussen A, Baye K, Stoecker BJ. The effect of UNIMMAP multiple micronutrient supplements versus iron-folic acid and placebo in anemia reduction among women of reproductive age in Kebribeyah Woreda, Somali Regional State, Ethiopia: a study protocol for a community-based individual RCT. Trials 2024; 25:170. [PMID: 38448918 PMCID: PMC10916067 DOI: 10.1186/s13063-024-08024-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 02/27/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Women of reproductive age (WRA) in developing countries are often at risk of micronutrient deficiencies due to inadequate intakes and excessive losses. OBJECTIVE The purpose of this trial is to assess the effectiveness of United Nations International Multiple Micronutrient Antenatal Preparation-Multiple Micronutrient Supplements (UNIMMAP-MMS) versus iron-folic acid (IFA) among WRA in reducing anemia. METHODS Three parallel groups of WRA will participate in a community-based, individually randomized, double-blinded, placebo-controlled superiority trial. After consent, the sample of 375 mildly or moderately anemic women based on hemoglobin by Hemocue will be randomly assigned across two interventions and one control arm. Trial participants in intervention arms will receive UNIMMAP-MMS or IFA while those in the control arm will receive placebos twice a week for 17 weeks. The primary outcome will be a change in mean hemoglobin (Hb) concentrations. Outcome assessors and study participants will be blinded to the type of supplements and study arm. DISCUSSION The World Health Organization (WHO) added UNIMMAP-MMS to its essential medicine lists in 2021 but recommended rigorous study. Several factors in addition to inadequate intakes of iron and folic acid contribute to the high prevalence of anemia among WRA in the Somali region. The findings of this study will provide evidence on the effect of UNIMMAP-MMS and IFA on Hb concentrations and anemia prevalence among anemic WRA. TRIAL REGISTRATION ClinicalTrials.gov NCT05682261. Registered on January 12, 2023.
Collapse
Affiliation(s)
- Desalegn Kuche
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
- Oklahoma State University, Stillwater, OK, USA.
- Addis Ababa University, Addis Ababa, Ethiopia.
| | | | | | - Meron Girma
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Kaleab Baye
- Addis Ababa University, Addis Ababa, Ethiopia
| | | |
Collapse
|
4
|
Mazigo HD, Montresor A. Validating a questionnaire to identify women in the first trimester of pregnancy during preventive chemotherapy interventions against soil-transmitted helminths in northwestern Tanzania. IJID Reg 2024; 10:214-218. [PMID: 38434235 PMCID: PMC10904898 DOI: 10.1016/j.ijregi.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 03/05/2024]
Abstract
Objectives To evaluate the performance of a questionnaire in assessing the pregnancy status of women of reproductive age during preventive chemotherapy interventions. Methods A questionnaire (20 questions) was administered to 1217 women of reproductive age (≥18 years) from Ilemela and Buchosa districts, northwestern Tanzania. A single urine sample was collected from each of them and tested using a rapid pregnancy test for presence of pregnant. Results Overall, 10.8% (132/1217) of the women reported to be pregnant at the specific question in the questionnaire. The rapid pregnancy test identified 15.1% (184/1217) of the women to be pregnant. In total, 86.4% (114/132) of the women who reported to be pregnant during the interview were confirmed to be pregnant using the rapid pregnant test. The question on pregnancy demonstrated an overall sensitivity of 62% and specificity of 98.3%. Conclusions The questionnaire performance was not completely satisfactory; however, it managed to identify pregnant women in the first trimester. The question on the last date of the start of the menstrual period yield the highest sensitivity and appeared to be the key one used in combination with other questions. Further validation of these results in other countries with different cultures are recommended to fully evaluate the performance of this method.
Collapse
Affiliation(s)
- Humphrey D. Mazigo
- Department of Medical Parasitology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- School of Public Health, Dean Office, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | | |
Collapse
|
5
|
Izadi S, Mohammad-Alizadeh-Charandabi S, Yadollahi P, Mirghafourvand M. Effect of vitamin E with and without saffron on the sexual function in women of reproductive age with sexual dysfunction: a randomized controlled trial. BMC Womens Health 2024; 24:143. [PMID: 38408971 PMCID: PMC10897983 DOI: 10.1186/s12905-024-02980-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 02/17/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Sexual satisfaction is a crucial part of a fulfilled life, and the ability to have satisfying sexual function is crucial to one's sexual health. This study investigated the effect of the combined administration of saffron and vitamin E and vitamin E alone on the sexual function of women in their reproductive years. METHODS A triple-blind randomized controlled trial was conducted with 50 participants experiencing sexual dysfunction without comorbid sleep disorders or severe depression. They were allocated into two groups using a block randomization method (stratified based on the severity of moderate or mild/normal depression). During the 8-week intervention period, participants in the experimental group were administered a 15 mg saffron capsule (safrotin) in the morning and a combination capsule containing 15 mg saffron and 50 mg vitamin E (safradide) in the evening. During the same period, the control group consumed one saffron placebo capsule in the morning and one capsule containing 50 mg of vitamin E and saffron placebo in the evening (in identical appearance to safradide). The Female Sexual Function Index was used to assess sexual function, and the Depression, Anxiety, and Stress Scale-21 (DASS-21) was used to measure levels of depression, anxiety, and stress. These measures were administered at baseline as well as four and eight weeks post-intervention, with an additional measurement taken four weeks after the intervention ceased. The repeated measures ANOVA, ANCOVA, and Mann-Whitney U tests were used to compare the groups. RESULTS Following the intervention, the experimental group (saffron and vitamin E) demonstrated a statistically significant increase in the overall mean score of sexual function compared to the control group (placebo of saffron and vitamin E) (adjusted mean difference (AMD): 4.6; 95%CI: 3.1 to 6.1; p < 0.001). The mean scores for sexual function dimensions, namely libido, arousal, orgasm, and satisfaction, except for pain, were consistently higher than those of the control group across all time points (p < 0.001). Additionally, the mean score for lubrication was significantly higher only at the eighth-week measurement (p = 0.004). The mean depression score in the experimental group was significantly lower than in the control group at all-time points, i.e., four (p = 0.011) and eight weeks after the intervention (p = 0.005), and four weeks after the end of the intervention (p = 0.007). The experimental group exhibited a statistically significant decrease in mean anxiety score compared to the control group at four weeks into the intervention (p = 0.016) and four weeks following the end of the intervention (p = 0.002). At eight weeks post-intervention, however, there was no significant difference between the groups (p = 0.177). Additionally, the experimental group exhibited a significant reduction in the overall mean stress score compared to the control group after the intervention (AMD: -2.3; 95%CI: -3.1 to -1.5; p < 0.001). CONCLUSION Using the combination of saffron and vitamin E is more effective in improving sexual function and its domains compared to vitamin E alone in women of reproductive age with sexual dysfunction without severe depression. Also, it diminishes the degree of depression, anxiety, and stress more compared to vitamin E alone. However, further research is required to arrive at a more definitive conclusion. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT): IRCT20100414003706N36. Date of registration: 17/05/2020; URL: https://en.irct.ir/trial/45992 ; Date of first registration: 21/05/2020.
Collapse
Affiliation(s)
- Saeideh Izadi
- Student Research Committee, Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Parvin Yadollahi
- Maternal-fetal medicine Research Center, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
6
|
Demissie E, Amare A, Birhanu M, Gizachew M. Neisseria gonorrhoeae antimicrobial resistance patterns and associated risk factors in women of childbearing potential in northwestern Ethiopia. BMC Womens Health 2024; 24:82. [PMID: 38297305 PMCID: PMC10829321 DOI: 10.1186/s12905-024-02898-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUNDS Neisseria gonorrhoeae causes gonorrhea and poses public health problems, including antimicrobial resistance. Current data on gonorrhea in prenatal participants in the study area are required. Thus, we aimed to identify gonorrhea prevalence, antimicrobial resistance, and risk factors among antenatal care clinic visitors in northwestern Ethiopia. METHODS A cross-sectional study was conducted from March to August 2022 at the University of Gondar Comprehensive Specialized Hospital. We recruited 278 study participants using convenient sampling techniques. Sociodemographic, clinical and behavioral risk factors were recorded using pre-tested questionnaires. Endocervical swabs were collected by a physician, transported to the microbiology laboratory, immediately inoculated into modified Thayer-Martin medium, and it was incubated at 37 °C for 24-48 hours. Gram staining and biochemical tests were used to identify the organism. AMR testing was performed using disc diffusion and E-test methods. Data were entered in EPI-info version 7 and exported and analyzed in SPSS version 26. A p-value ≤0.05 was considered as statistically significant. Results were presented in words, tables and figure. RESULTS Of 278 subjects enrolled, majority (44.6%) were 26-35 years, with a mean age of 29.9 (SD = ±7.2) years, 69.4% were urban residents, and 70.5% were married. Twenty-one (7.6%) participants had gonorrhea. Overall antimicrobial resistance ranged from 19 to 100%. High resistant to tetracycline (100%) and penicillin (85.7%) were observed by both tests. Ciprofloxacin resistance was 52.4% by disc diffusion and 85.7% by E-test. By E-test, all isolates were sensitive to ceftriaxone, cefixime, azithromycin and spectinomycin; however, 7 (33.3%), 9 (42.9%), 9 (42.9%) and 5 (23.8%) isolates showed resistant to these antibiotics with disk method. Prevalence of beta-lactamase producing Neisseria gonorrhoeae was 85.7%. Alcohol consumption (p = 0.032), condom-free sexual practice (p = 0.010), multiple sexual partners (p < 0.001), pelvic pain (p = 0.018), and dysuria (p = 0.021) revealed increased risk of infection. CONCLUSIONS Compared with many previous studies in Ethiopia, we found high prevalence, antimicrobial resistance, and beta-lactamase-positive isolates. Multiple sexual partners, alcohol consumption, not using condom, pelvic pain and dysuria were predictors of this infection. Continuous large-scale monitoring of pathogen is essential for its prevention and control.
Collapse
Affiliation(s)
- Engdawork Demissie
- Department of Medical Laboratory Sciences, School of Medicine and Health Sciences, Jigjiga University, Jijiga, Ethiopia
| | - Azanaw Amare
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluken Birhanu
- Department of Medical Microbiology, Immunology and Parasitology, Addis Ababa University, and Assosa University, Addis Ababa, Ethiopia
| | - Mucheye Gizachew
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| |
Collapse
|
7
|
Mostafa I, Hasan SMT, Gazi MA, Alam MA, Fahim SM, Saqeeb KN, Ahmed T. Alteration of stool pH and its association with biomarkers of gut enteropathy among slum-dwelling women of reproductive age in Bangladesh. BMC Womens Health 2023; 23:661. [PMID: 38071298 PMCID: PMC10710701 DOI: 10.1186/s12905-023-02758-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 11/01/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Recent evidence suggests that measures of maternal gut enteropathy are associated with unfavorable fetal outcomes. It is, therefore, crucial to identify and treat the features of intestinal enteropathy among reproductive-age women living in areas where enteropathy is highly prevalent. However, there is a lack of non-invasive diagnostic tests to determine EED, making it difficult to identify the disease in field settings. In this study, we tested the potential of fecal pH as a biomarker of gut enteropathy and investigated its relationship with fecal biomarkers of intestinal enteropathy in reproductive-age women living in resource-limited environments. METHODS Data on socio-demographic information, anthropometry, and biological samples were collected from 78 apparently healthy women aged between 20 and 27 years from November 2018 to December 2019. The association of stool pH with two fecal biomarkers of gut enteropathy (i.e., intestinal alkaline phosphatase [IAP] and fecal lipocalin-2 [LCN-2] was investigated using multiple linear regression models after adjusting for relevant covariates. RESULTS In the adjusted models, alkaline stool pH (pH > 7.2) was found to be significantly associated with a decrease in the fecal IAP level by 1.05 unit (95% CI: -1.68, -0.42; p < 0.001) in the log scale, and acidic stool pH (pH < 6) was found to be significantly associated with an increase in the fecal LCN-2 level by 0.89 units (95% CI: 0.12, 1.67; p < 0.025) in the log scale. CONCLUSIONS The study findings demonstrated an association of fecal pH with biomarkers of gut enteropathy indicating its applicability as a simple tool for understanding intestinal enteropathy among reproductive-age women living in resource-limited settings.
Collapse
Affiliation(s)
- Ishita Mostafa
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - S M Tafsir Hasan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Md Amran Gazi
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Md Ashraful Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Shah Mohammad Fahim
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Kazi Nazmus Saqeeb
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
- Office of the Executive Director, icddr,b, Dhaka, 1212, Bangladesh
- Department of Global Health, University of Washington, Seattle, WA, 98195, USA
- Department of Public Health Nutrition, James P Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh
| |
Collapse
|
8
|
Alem AZ, Yeshaw Y, Liyew AM, Tessema ZT, Worku MG, Tesema GA, Alamneh TS, Teshale AB, Chilot D, Ayalew HG. Double burden of malnutrition and its associated factors among women in low and middle income countries: findings from 52 nationally representative data. BMC Public Health 2023; 23:1479. [PMID: 37537530 PMCID: PMC10398981 DOI: 10.1186/s12889-023-16045-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 06/02/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Double burden of malnutrition (DBM) is an emerging global public health problem. The United Nations member states adopted eradicating all forms of malnutrition as an integral component of the global agenda. However, there is evidence of a high burden of undernutrition among women and rising rates of overweight and obesity, especially in low and middle income countries (LMICs). Therefore, this study aimed to investigate the prevalence and associated factors of underweight, overweight, and obesity among women of reproductive age in LMICs. METHODS Data for the study were drawn from a recent 52 Demographic and Health Surveys (DHS) conducted in LMICS. We included a sample of 1,099,187 women of reproductive age. A multilevel multinomial logistic regression model was used to identify factors associated with DBM. Adjusted relative risk ratio (RRR) with a 95% Confidence Interval (CI) was reported to show an association. RESULTS The prevalence of underweight, overweight, and obesity in LMICs among women of reproductive age was 15.2% (95% CI: 15.1-15.3), 19.0% (95% CI: 18.9- 19.1), and 9.1% (95% CI: 9.0-9.2), respectively. This study found that women aged 24-34 years, aged ≥ 35 years, with primary, secondary, and above educational level, from wealthy households, using modern contraceptives, exposed to media (radio and television), and with high parity (more than one birth) were more likely to have overweight and obesity and less likely to have underweight. Moreover, the risk of having obesity (RRR = 0.59; 95% CI = 0.58-0.60 and overweight (RRR = 0.78; 95% CI = 0.77-0.79) were lower among rural women, while the risk of being underweight was (RRR = 1.13; 95% CI = 1.11-1.15) higher among rural women compared to urban women. CONCLUSION The prevalence of underweight, overweight, and obesity was high among women of reproductive age in LMICs. Underweight, overweight, and obesity are influenced by sociodemographic, socioeconomic, and behavioral-related factors. This study shows that, in order to achieve Sustainable Development Goal 2, a multifaceted intervention approach should be considered to prevent both forms of malnutrition in women of reproductive age. This can be achieved by raising awareness and promoting healthy behaviors such as healthy eating and physical activity, especially among educated women, women from wealthy households, and women exposed to the media.
Collapse
Affiliation(s)
- Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Hiwotie Getaneh Ayalew
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| |
Collapse
|
9
|
Hailemariam T, Yimer G, Mohammed H, Bisrat H, Ajeme T, Belina M, Oljira L, Roba KT, Belay F, Andrias T, Ngadaya E, Manyazewal T. Chest X-ray predicts cases of pulmonary tuberculosis among women of reproductive age with acute respiratory symptoms: A multi-center cross-sectional study. J Clin Tuberc Other Mycobact Dis 2023; 32:100383. [PMID: 37389013 PMCID: PMC10302112 DOI: 10.1016/j.jctube.2023.100383] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
Background Tuberculosis (TB) prevalence is increasing among women of reproductive age (WRA) in sub-Saharan Africa, yet undiagnosed and untreated cases remain rather high with serious health and socio-economic consequences. We aimed to assess the prevalence and predictors of TB in WRA seeking health care for acute respiratory symptoms. Methods We consecutively enrolled outpatient WRA with acute respiratory symptoms seeking care at four healthcare facilities in Ethiopia between July 2019 and December 2020. Data on sociodemographic characteristics and clinical information were collected using a structured questionnaire administered by trained nurses. Posteroanterior chest X-ray was performed in non-pregnant WRA and interpreted independently by two radiologists. Sputum samples were collected from all patients and tested for pulmonary TB using Xpert MTB/RIF and/or smear microscopy. Predictors of bacteriologically confirmed TB cases were determined using binary logistic regression, with clinically relevant variables included in the final Firth's multivariate-penalized logistic regression model. Results We enrolled 577 participants, of whom 95 (16%) were pregnant, 67 (12%) were living with HIV, 512 (89%) had cough of less than 2 weeks, and 56 (12%) had chest-x-ray findings suggestive of TB. The Overall prevalence of TB was 3% (95% CI: 1.8%-4.7%) with no significant difference observed between patient groups categorized by duration of cough or HIV serostatus (P-value = 0.9999). In multivariable analysis, TB-suggestive CXR abnormality (AOR 18.83 [95% CI, 6.20-57.18]) and history of weight loss (AOR 3.91 [95% CI, 1.25-12.29]) were associated with bacteriologically-confirmed TB cases. Conclusions We found a high TB prevalence among low-risk women of reproductive age with acute respiratory symptoms. Routine CXR may improve early case detection and thereby TB treatment outcomes.
Collapse
Affiliation(s)
- Tesfahunegn Hailemariam
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
- Addis Ababa University, College of Health Sciences, Department of Radiology, Addis Ababa, Ethiopia
| | - Getnet Yimer
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
- Center for Global Genomics and Health Equity, Department of Genetics, Perelman School of Medicine, University of Pennsylvania, USA
| | - Hussen Mohammed
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Haileleul Bisrat
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
| | - Tigist Ajeme
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
| | - Merga Belina
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fekadu Belay
- Wachemo University, College of Medicine and Health Sciences, Department of Pediatrics and Child Health, Hossana, Ethiopia
| | | | - Esther Ngadaya
- National Institute for Medical Research, Muhimbili Research Centre, Dar es Saalam, Tanzania
| | - Tsegahun Manyazewal
- Addis Ababa University, College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa, Ethiopia
| |
Collapse
|
10
|
Yohannes K, Berhane Y, Bradby H, Herzig van Wees S, Målqvist M. Contradictions hindering the provision of mental healthcare and psychosocial services to women experiencing homelessness in Addis Ababa, Ethiopia: service providers' and programme coordinators' experiences and perspectives. BMC Health Serv Res 2023; 23:821. [PMID: 37528372 PMCID: PMC10391936 DOI: 10.1186/s12913-023-09810-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/11/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Mental health conditions are among the health issues associated with homelessness, and providing mental healthcare to people experiencing homelessness is challenging. Despite the pressing issue of homelessness in Addis Ababa, Ethiopia, there is scant research on how service providers address women's mental health and psychosocial needs. Therefore, we explored service providers' and programme coordinators' perceptions and experiences regarding mental healthcare and psychosocial services delivery to women experiencing street homelessness in the city. METHODS We conducted a descriptive qualitative study with selected healthcare and social support providers and programme coordinators. The study involved 34 participants from governmental and non-governmental organisations in Addis Ababa, Ethiopia. Data were analysed using an inductive thematic approach. RESULTS Four themes were derived from the analysis. The first of these was "divergent intentions and actions". While service providers and programme coordinators showed empathy and compassion, they also objectified and blamed people for their own homelessness. They also expressed opposing views on mental health stigma and compassion for these people. The second theme addressed "problem-solution incompatibility", which focused on the daily challenges of women experiencing homelessness and the types of services participants prioritised. Service providers and programme coordinators proposed non-comprehensive support despite the situation's complexity. The participants did not emphasise the significance of gender-sensitive and trauma-informed care for women experiencing street homelessness in the third theme, "the lack of gendered and trauma-informed care despite an acknowledgement that women face unique challenges". The fourth theme, "mismatched resources," indicated structural and systemic barriers to providing services to homeless women. CONCLUSIONS Conflicting attitudes and practices exist at the individual, organisational, and systemic levels, making it challenging to provide mental healthcare and psychosocial services to women experiencing homelessness. An integrated, gender-sensitive, and trauma-informed approach is necessary to assist women experiencing homelessness.
Collapse
Affiliation(s)
- Kalkidan Yohannes
- SWEDESD, Department of Women's and Children's Health, Uppsala University, Uppsala, SE-751 85, Sweden.
- Department of Women's and Children's Health, WoMHeR- Women's Mental Health during the Reproductive Lifespan, Uppsala University, Uppsala, Sweden.
- Department of Psychiatry, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- International Child Health and Nutrition- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Hannah Bradby
- Department of Sociology, Uppsala University, Uppsala, Sweden
| | - Sibylle Herzig van Wees
- SWEDESD, Department of Women's and Children's Health, Uppsala University, Uppsala, SE-751 85, Sweden
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Mats Målqvist
- SWEDESD, Department of Women's and Children's Health, Uppsala University, Uppsala, SE-751 85, Sweden
| |
Collapse
|
11
|
Khalili M, Jahanian Sadatmahalleh S, Nasiri M, Montazeri A. Estimation of global rating changes in quality of life and marital satisfaction among reproductive age women in Iran and Afghanistan before and after COVID-19 pandemic. BMC Womens Health 2023; 23:315. [PMID: 37328765 PMCID: PMC10324820 DOI: 10.1186/s12905-023-02467-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/09/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Quality of life and marital satisfaction are important components of reproductive-age women's health. This study aimed to compare the quality of life and marital satisfaction in women of reproductive age in Iran and Afghanistan before and after the COVID-19 pandemic. METHODS This was a cross-sectional study on a sample of Iranian and Afghan women of reproductive age. To collect the data, the 12-item short-form health survey (SF-12) and the Enrich marital satisfaction scale were used to assess the quality of life and marital satisfaction, respectively. In addition, the Global Rating of Change (GRC) was used in order to evaluate the quality of life and marital satisfaction compared to before the COVID-19 pandemic. Data were evaluated descriptively through statistics including sing t-test, and chi-square, Logistic regression was performed to assess the relationship between outcome variables and independent variables. RESULTS In all 599 reproductive-age women (300 Iranian, and 299 Afghan) were studied. After adjusting for demographic variables, no significant difference was observed between the two groups for the physical component (P = 0.05) and mental component summary scores of quality of life (P = 0.166) as measured by the SF-12. The majority of Iranian women reported that their quality of life was worsened compared to before the pandemic (57.2%), while in the Afghan group, a higher percentage declared that it was unchanged (58.9%). The mental component of quality of life had no significant relationship with any of the independent variables including nationality. In contrast, the physical component quality of life had a significant relationship with nationality (P = 0.01). Iranian women had more marital satisfaction than Afghan women (P<0.001) and marital satisfaction had a significant relationship with nationality (P<0.001). Most women in both groups (70% of Iranian and 60% of Afghan women) declared that their marital satisfaction unchanged compared to before the COVID-19 pandemic. CONCLUSION The results showed that the quality of life of Iranian and Afghan women of reproductive age was almost the same before and after the pandemic. However, Iranians scored lower on the mental component summary and Afghans reported lower scores on the physical component summary. Marital satisfaction of Afghan women was much lower than that of Iranian women. The findings suggest the need for serious attention by health care authorities. Providing a supportive environment might be considered a primary step towards a better quality of life for these populations.
Collapse
Affiliation(s)
- Masomeh Khalili
- Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
- Faculty of Humanity Sciences, University of Science and Culture, Tehran, Iran
| |
Collapse
|
12
|
Mwanja CH, Herman PZ, Millanzi WC. Prevalence, knowledge, attitude, motivators and intentional practice of female genital mutilation among women of reproductive age: a community-based analytical cross-sectional study in Tanzania. BMC Womens Health 2023; 23:226. [PMID: 37138247 PMCID: PMC10158332 DOI: 10.1186/s12905-023-02356-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/14/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND To harmonize and enhance economic growth at the individual, family, community, and national levels, healthy women embody the guardian of family health and a healthy world. They are anticipated to have the freedom to choose their identity in opposition to female genital mutilation in a thoughtful, responsible, and informed manner. Despite restrictive traditions and culture, it is unclear from the available information what exactly would be the drivers of FGM practices in Tanzania from an individual or social perspective. The purpose of this study was to evaluate female genital mutilation among women of reproductive age in terms of its frequency, knowledge, attitudes, and purposeful practice. METHODS Three hundred twenty-four randomly selected Tanzanian women of reproductive age were studied using a community-based analytical cross-sectional study design quantitatively. Structured questionnaires from earlier studies that were delivered by interviewers were utilized to gather information from the study participants. The statistical software package Statistical Packages for Social Science was used to examine the data. (SPSS v.23). A 5% significance threshold was used with a 95% confidence interval. RESULT A total of 324 women of reproductive age participated in the study with a 100% response rate with a mean age of 25 ± 7.481 years. Findings revealed that 81.8% (n = 265) of study participants were mutilated. 85.6% (n = 277) of women had inadequate knowledge about FGM, and 75.9% (n = 246) had a negative attitude toward it. However, 68.8% (n = 223) of them were willing to practice FGM. Their age (36-49 years) (AOR = 2.053; p < 0.014; 95%CI: 0.704, 4.325), single women (AOR = 2.443; p < 0.029; 95%CI: 1.376, 4.572), never go to school (AOR = 2.042; p < 0.011; 95%CI: 1.726, 4.937), housewives (AOR = 1.236; p < 0.012; 95%CI: 0.583, 3.826), extended family (AOR = 1.436; p < 0.015; 95%CI: 0.762, 3.658), inadequate knowledge (AOR = 2.041; p < 0.038; 95%CI: 0.734, 4.358) and negative attitude (AOR = 2.241; p < 0.042;95%CI: 1.008, 4.503) were significantly associated to practice female genital mutilation. CONCLUSION The study observed that the rate of female genital mutilation was significantly high and still, women demonstrated the intention to continue practicing it. However, their sociodemographic characteristic profiles, inadequate knowledge, and negative attitude towards FGM were significantly linked with the prevalence. The private agencies, local organizations, the Ministry of Health, and community health workers are alerted to the findings of the current study to design and develop interventions and awareness-raising campaigns for women of reproductive age against female genital mutilation.
Collapse
Affiliation(s)
- Charlotte H Mwanja
- School of Nursing and Public Health, Department of Nursing Management and Education, The University of Dodoma, Dodoma, Tanzania
| | - Patricia Z Herman
- School of Nursing and Public Health, Department of Nursing Management and Education, The University of Dodoma, Dodoma, Tanzania.
| | - Walter C Millanzi
- School of Nursing and Public Health, Department of Nursing Management and Education, The University of Dodoma, Dodoma, Tanzania
| |
Collapse
|
13
|
Meeker JR, Simeone RM, Shapiro-Mendoza CK, Snead MC, Hall R, Ellington SR, Galang RR. Counseling women of reproductive age about emergency preparedness - Provider attitudes and practices. Prev Med 2023; 170:107473. [PMID: 36870573 PMCID: PMC10251413 DOI: 10.1016/j.ypmed.2023.107473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023]
Abstract
We report healthcare provider attitudes and practices on emergency preparedness counseling for women of reproductive age (WRA), including pregnant, postpartum, and lactating women (PPLW), for disasters and weather emergencies. DocStyles is a web-based panel survey of primary healthcare providers in the United States. During March 17-May 17, 2021, obstetricians-gynecologists, family practitioners, internists, nurse practitioners, and physician assistants were asked about the importance of emergency preparedness counseling, level of confidence, frequency, barriers to providing counseling, and preferred resources to support counseling among WRA and PPLW. We calculated frequencies of provider attitudes and practices, and prevalence ratios with 95% CIs for questions with binary responses. Among 1503 respondents (family practitioners (33%), internists (34%), obstetrician-gynecologists (17%), nurse practitioners (8%), and physician assistants (8%)), 77% thought emergency preparedness was important, and 88% thought counseling was necessary for patient health and safety. However, 45% of respondents did not feel confident providing emergency preparedness counseling, and most (70%) had never talked to PPLW about this topic. Respondents cited not having time during clinical visits (48%) and lack of knowledge (34%) as barriers to providing counseling. Most respondents (79%) stated they would use emergency preparedness educational materials for WRA, and 60% said they were willing to take an emergency preparedness training. Healthcare providers have opportunities to provide emergency preparedness counseling; however, many have not, noting lack of time and knowledge as barriers. Emergency preparedness resources combined with training may improve healthcare provider confidence and increase delivery of emergency preparedness counseling.
Collapse
Affiliation(s)
- Jessica R Meeker
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
| | - Regina M Simeone
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Carrie K Shapiro-Mendoza
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Margaret C Snead
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Rebecca Hall
- Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Sascha R Ellington
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Romeo R Galang
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| |
Collapse
|
14
|
Nang DW, Tukirinawe H, Okello M, Tayebwa B, Theophilus P, Sikakulya FK, Fajardo Y, Afodun AM, Kajabwangu R. Prevalence of high-risk human papillomavirus infection and associated factors among women of reproductive age attending a rural teaching hospital in western Uganda. BMC Womens Health 2023; 23:209. [PMID: 37118735 PMCID: PMC10148521 DOI: 10.1186/s12905-023-02342-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 04/10/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND High-risk HPV is considered a major risk factor for the development of cervical cancer, the most common malignancy among women in Uganda. However, there is a paucity of updated epidemiological data on the extent of the burden and factors associated with hr-HPV infection among women of reproductive age. The aim of this study was to determine the prevalence and genotype distribution of hr-HPV and associated factors among women of reproductive age attending a rural teaching hospital in western Uganda. METHODS We conducted a cross-sectional study from April to June 2022. A total of 216 women of reproductive age attending the gynecological outpatient clinic were consecutively enrolled. Interviewer-administered questionnaires were used to collect participant characteristics, cervical specimens were collected by clinicians, and molecular HPV testing was performed using the Cepheid Xpert HPV DNA test. Descriptive statistics followed by binary logistic regression were conducted using SPSS version 22. RESULTS The prevalence of hr-HPV was 16.67%. Other hr-HPV types other than HPV 16 and 18 were predominant, with a prevalence of 10.6%; HPV 18/45 (2.31%), HPV 16 (0.46%), and 3.24% of the study participants had more than one hr-HPV genotype. On multivariate logistic regression, an HIV-positive status (aOR = 7.06, CI: 2.77-10.65, p = 0.007), having 3 or more sexual partners in life (aOR = 15.67, CI: 3.77-26.14, p = 0.008) and having an ongoing abnormal vaginal discharge (aOR = 5.37, CI: 2.51-11.49, p = 0.002) were found to be independently associated with hr-HPV infection. CONCLUSIONS AND RECOMMENDATIONS The magnitude of hr-HPV is still high compared to the global prevalence. HIV-positive women and those in multiple sexual relationships should be prioritized in cervical cancer screening programs. The presence of abnormal vaginal discharge in gynecology clinics should prompt HPV testing.
Collapse
Affiliation(s)
- David Wol Nang
- Department of Obstetrics and Gynecology, Kampala International University Teaching Hospital, Ishaka-Bushenyi, Uganda.
| | - Happy Tukirinawe
- Department of Obstetrics and Gynecology, Kampala International University Teaching Hospital, Ishaka-Bushenyi, Uganda
| | - Maxwell Okello
- Department of Obstetrics and Gynecology, Kampala International University Teaching Hospital, Ishaka-Bushenyi, Uganda
| | - Bekson Tayebwa
- Department of Obstetrics and Gynecology, Kampala International University Teaching Hospital, Ishaka-Bushenyi, Uganda
| | - Pius Theophilus
- Department of Medical Laboratory Science, Kampala International University Teaching Hospital, Ishaka-Bushenyi, Uganda
| | - Franck Katembo Sikakulya
- Department of Surgery, Kampala International University Teaching Hospital, Ishaka-Bushenyi, Uganda
| | - Yarine Fajardo
- Department of Obstetrics and Gynecology, Kampala International University Teaching Hospital, Ishaka-Bushenyi, Uganda
| | - Adam Moyosore Afodun
- Department of Anatomy and Cell Biology, Faculty of Health Sciences, Busitema University, Tororo, Uganda
| | - Rogers Kajabwangu
- Department of Obstetrics and Gynecology, Kampala International University Teaching Hospital, Ishaka-Bushenyi, Uganda
| |
Collapse
|
15
|
Ali SA, Razzaq S, Aziz S, Allana A, Ali AA, Naeem S, Khowaja N, Ur Rehman F. Role of iron in the reduction of anemia among women of reproductive age in low-middle income countries: insights from systematic review and meta-analysis. BMC Womens Health 2023; 23:184. [PMID: 37069552 PMCID: PMC10111688 DOI: 10.1186/s12905-023-02291-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/20/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Iron deficiency anemia is a common public health issue among women of reproductive age (WRA) because it can result in adverse maternal and birth outcomes. Although studies are undertaken to assess iron efficacy, some gaps and limitations in the existing literature need to be addressed. To fill the gaps, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the role of iron in reducing anemia among WRA in low-middle-income countries (LMICs). METHODS A comprehensive search strategy was used to search Medline through PubMed, Embase, and Science Direct for RCTs published between 2000 and 2020. The primary outcome was the mean change in hemoglobin level. We used standardized mean differences and their respective 95% CI to estimate the pooled effect. We used I2 statistics and Egger's test to assess heterogeneity and publication bias, respectively. This review was carried out in accordance with revised guidelines based on the Preferred Reporting Items for Systematic Review and Meta-analysis. RESULTS The findings showed that iron therapy improved hemoglobin and ferritin levels, though the results varied across studies. An overall pooled effect estimate for the role of iron therapy in improving the hemoglobin levels among WRA was -0.71 (95% CI: -1.27 to -0.14) (p = 0.008). Likewise, the overall pooled effect estimate for the role of iron therapy in improving the ferritin levels among WRA was -0.76 (95% CI: -1.56 to 0.04) (p = 0.04). The heterogeneity (I2) across included studies was found to be statistically significant for studies assessing hemoglobin (Q = 746.93, I2 = 97.59%, p = 0.000) and ferritin level (Q = 659.95, I2 = 97.88%, p = 0.000). CONCLUSION Iron therapy in any form may reduce anemia's burden and improve hemoglobin and ferritin levels, indicating improvement in iron-deficiency anemia. More evidence is required, however, to assess the morbidity associated with iron consumption, such as side effects, work performance, economic outcomes, mental health, and adherence to the intervention, with a particular focus on married but non-pregnant women planning a pregnancy in the near future. TRIAL REGISTRATION Registered with PROSPERO and ID is CRD42020185033.
Collapse
Affiliation(s)
- Sumera Aziz Ali
- Department of Epidemiology, Columbia University, New-York, USA.
| | - Shama Razzaq
- Divison of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong, People's Republic of China
| | - Savera Aziz
- Faculty of Nursing, University of Alberta, Alberta, Canada
| | | | | | - Shahla Naeem
- CMH Institute of Medical Sciences, Bahawalpur, Pakistan
| | - Nayab Khowaja
- Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | | |
Collapse
|
16
|
Sesay FR, Anaba EA, Manu A, Maya E, Torpey K, Adanu RMK. Determinants of induced abortion among women of reproductive age: evidence from the 2013 and 2019 Sierra Leone Demographic and Health Survey. BMC Womens Health 2023; 23:44. [PMID: 36726133 PMCID: PMC9890786 DOI: 10.1186/s12905-023-02175-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/13/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Worldwide, pregnancy termination due to unintended pregnancy is crucial in maternal health, particularly in settings where abortion laws are restrictive. Presently, there is a paucity of literature on determinants of induced abortion among women of reproductive age in Sierra Leone. The study findings could be used to improve the country's maternal mortality indices and inform health programs and reproductive health policies geared toward tackling induced abortion. METHODS We analyzed secondary data from the 2013 and 2019 Sierra Leone Demographic and Health Surveys. The surveys were nationally representative, with weighted samples comprising 16,658 (2013) and 15,574 (2019) women of reproductive age. Descriptive statistics, including frequencies and percentages, were computed, while Chi-square and Binomial Logistics Regression were employed to identify correlates of induced abortion. RESULTS The results showed that a minority (9%) of the participants had induced abortion in both surveys. Abortion was significantly associated with age, marital status, employment status, education, parity, and frequency of listening to the radio and watching television (p < 0.05). For instance, women aged 45-49 years (AOR = 7.91; 95% CI: 5.76-10.87), married women (AOR = 2.52; 95% CI: 1.95-3.26), and working women (AOR = 1.65; 95% CI: 1.45-1.87) had a higher likelihood of induced abortion compared to their counterparts. Moreover, women with primary education (AOR = 1.27; 95% CI:1.11-1.46) and those who watch television once a week (AOR = 1.29; 95% CI: 1.11-1.49) were more likely to terminate a pregnancy. Women with six or more children (AOR = 0.40; 95% CI: 0.31-0.52) were less likely to terminate a pregnancy compared to those with no child. CONCLUSION The study revealed that a minority of the women had induced abortions. The prevalence of induced abortion did not change over time. Induced abortion was influenced by age, marital status, employment status, education, parity, and exposure to mass media. Therefore, policies and programs to reduce unwanted pregnancies should focus on increasing access to modern contraceptives among women of lower socio-economic status.
Collapse
Affiliation(s)
- Foday Robert Sesay
- grid.8652.90000 0004 1937 1485Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Emmanuel Anongeba Anaba
- grid.8652.90000 0004 1937 1485Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Adom Manu
- grid.8652.90000 0004 1937 1485Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Ernest Maya
- grid.8652.90000 0004 1937 1485Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Kwasi Torpey
- grid.8652.90000 0004 1937 1485Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Richard M. K. Adanu
- grid.8652.90000 0004 1937 1485Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| |
Collapse
|
17
|
Sow D, Sylla K, Dieng NM, Senghor B, Gaye PM, Fall CB, Goumballa N, Diallo A, Ndiaye JLA, Parola P, Sokhna C, Doucouré S, Faye B. Molecular diagnosis of urogenital schistosomiasis in pre-school children, school-aged children and women of reproductive age at community level in central Senegal. Parasit Vectors 2023; 16:43. [PMID: 36717835 PMCID: PMC9887789 DOI: 10.1186/s13071-023-05671-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Urogenital schistosomiasis is a major public health concern in sub-Saharan Africa. In Senegal, the disease is endemic in all regions of the country. Recently, WHO strongly recommended including pre-school children and women of reproductive age during a mass drug administration campaign. It is important to describe the burden of the disease in these group at risk using innovative diagnostic tools. This study aimed to assess the use of real-time PCR in the detection of schistosomiasis cases at the community level in a seasonal transmission area. METHODS A cross-sectional survey was carried out in Niakhar located in the centre of Senegal. Pre-schoolchildren, school-aged children and female adolescents and adults were invited to participate in the study in April 2018. Urine samples were collected and examined using Hemastix reagent strips, filtration technique and real-time PCR. Schistosoma haematobium was detected, identified by targeting the Dra1 gene. The prevalence of urogenital schistosomiasis was determined for each group and the performance of the real-time PCR was compared with the conventional techniques. RESULTS A total of 428 participants were enrolled in this study including 87 (20.4%) pre-school children (1-5 years), 262 (61.3%) school-aged children between (5-14 years), 17 (3.9%) adolescents (15-17 years) and 62 (14.4%) female adults. The comparison of the diagnostic techniques has shown that the prevalence of urogenital schistosomiasis is higher using molecular technique (34.6%) compared to microscopy (20.3%). The percentage rate of haematuria using Hemastix was 23.1%. School-aged children between 5 and 14 years old were the most affected with 29.0% and 43.1% under microscopy and RT-PCR, respectively. In female participants, microscopic prevalence decreases with age, from 21.4% in school-aged children to 17.6% in adolescents and 9.7% in adults. There was good correlation between the number of eggs per 10 ml and the cycle threshold range. CONCLUSION These results show the importance of using molecular tools in the surveillance of schistosomiasis particularly in pre-school children and women of reproductive age.
Collapse
Affiliation(s)
- Doudou Sow
- grid.442784.90000 0001 2295 6052Service de Parasitologie-Mycologie, UFR Sciences de la Santé, Université Gaston Berger, Saint-Louis, Sénégal
| | - Khadime Sylla
- grid.8191.10000 0001 2186 9619Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Ndeye Marème Dieng
- grid.8191.10000 0001 2186 9619Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Bruno Senghor
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Papa Mouhamadou Gaye
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Cheikh B. Fall
- grid.8191.10000 0001 2186 9619Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Ndiaw Goumballa
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Aldiouma Diallo
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Jean Louis A. Ndiaye
- Service de Parasitologie-Mycologie, UFR Sciences de la Santé, Université Iba Der Thiam, Thies, Sénégal
| | - Philippe Parola
- Unité VITROME, IHU Méditérannée Infection, Marseille, France
| | - Cheikh Sokhna
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Souleymane Doucouré
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Babacar Faye
- grid.8191.10000 0001 2186 9619Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| |
Collapse
|
18
|
Vrijlandt WAL, de Jong MFC, Prins JR, Bramham K, Vrijlandt PJWS, Janse RJ, Mazhar F, Carrero JJ. Prevalence of chronic kidney disease in women of reproductive age and observed birth rates. J Nephrol 2023. [PMID: 36652169 DOI: 10.1007/s40620-022-01546-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/01/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Women of reproductive age with chronic kidney disease (CKD) are recognised to have decreased fertility and a higher risk of adverse pregnancy outcomes. How often CKD afflicts women of reproductive age is not well known. This study aimed to evaluate the burden of CKD and associated birth rates in an entire region. METHODS This was a retrospective cohort study including women of childbearing age in Stockholm during 2006-2015. We estimated the prevalence of "probable CKD" by the presence of an ICD-10 diagnosis of CKD, a single estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or history of maintenance dialysis. By linkage with the Swedish Medical Birth Register we identified births during the subsequent three years from study inclusion and evaluated birth rates. RESULTS We identified 817,730 women in our region, of whom 55% had at least one creatinine measurement. A total of 3938 women were identified as having probable CKD, providing an age-averaged CKD prevalence of 0.50%. Women with probable CKD showed a lower birth rate 3 years after the index date (35.7 children per 1000 person years) than the remaining women free from CKD (46.5 children per 1000 person years). CONCLUSION As many as 0.50% of individuals in this cohort had probable CKD, defined on the basis of at least one eGFR<60 ml/min1.73 m2 test result, dialysis treatment (i.e. CKD stages 3-5) or an ICD-10 diagnosis of CKD. This prevalence is lower than previous estimates. Women with probable CKD, according to a study mainly capturing CKD 3-5, had a lower birth rate than those without CKD, illustrating the challenges of this population to successfully conceive.
Collapse
|
19
|
Maasoumi R, Jamali B, Zarei F, Tavousi M. Prerequisites of sexual health literacy promoting service: a qualitative study in Iran. BMC Health Serv Res 2023; 23:3. [PMID: 36597059 PMCID: PMC9809051 DOI: 10.1186/s12913-022-09018-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Sexual health literacy is one of the determinants of the rate, factors, and outcomes of problems associated with sexual health and reproductive. The prerequisite of having and promoting this type of literacy is the appropriate organization and access to sexual health services. The current study was conducted with the objective of describing the perceptions and experiences of health care providers and recipients of sexual health literacy promoting services. METHODS The current qualitative study was conducted on 37 individuals in the form of 3 individual in-depth and semi-structured interviews and 4 focus group discussions (26 individuals) with service recipients (women of reproductive age), and 8 in-depth and semi-structured interviews with service providers in Amol from September 2019 to March 2020. The recorded interviews were transcribed and analyzed through content analysis. RESULTS Data analysis resulted in the extraction of the theme titled "prerequisites of sexual health literacy promoting service" which consisted of two subthemes 'client-oriented service' and 'efficient service'. In the client-oriented service attention must be paid to the client's age, sex, needs and socio-cultural background. Efficient service is a service which is based on continuing sexual education, can reconstruct sexual attitudes, is professional, team-based, integrated into other services, and has a follow-up structure. CONCLUSIONS The results outline the requirements for sexual health literacy promoting services which should be taken into consideration during the policymaking, planning and design of relevant health programs.
Collapse
Affiliation(s)
- Raziyeh Maasoumi
- grid.411705.60000 0001 0166 0922Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran ,grid.411705.60000 0001 0166 0922Nursing and Midwifery Research Care Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Jamali
- grid.467532.10000 0004 4912 2930Department of Nursing and Midwifery, Comprehensive Health Research Center, Babol Branch, Islamic Azad University, Babol, Iran
| | - Fatemeh Zarei
- grid.412266.50000 0001 1781 3962Department of Health Education and Health Promotion, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mahmood Tavousi
- grid.417689.5Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| |
Collapse
|
20
|
Etuk I, Iwuala A, Njoku K, Olagbegi B, Ogboye A, Akpakli JK, Okoli U, Hill K, Adetiloye O, Imosemi D, Omoera V, Oludara F, Ekong I, Alabi O, Mobisson N. Barriers to health in women of reproductive age living with or at risk of non-communicable diseases in Nigeria: a Photovoice study. BMC Womens Health 2023; 23:3. [PMID: 36593476 PMCID: PMC9808961 DOI: 10.1186/s12905-022-02146-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 12/26/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Nigeria has one of the highest maternal mortality ratios (MMR) globally with an MMR of 512 (per 100,000 live births) and the proportion of maternal deaths due to non-communicable diseases (NCDs) is increasing. While evidence shows that many of these deaths are preventable, limited attention is being paid to the unique vulnerabilities and experiences of women of reproductive age (WRA) with NCDs and their risk factors, as well as the barriers to the screening, diagnosis, and management of these diseases in Nigeria. METHODS This study explored the lives of WRA in Lagos and Federal Capital Territory in Nigeria from May to June 2019 using a community-based participatory research (CBPR) methodology called Photovoice which is aligned with CBPR as it includes procedures such as the identification of important community issues, discussion of photo assignments and data analysis. Twenty-four women of reproductive age were provided with digital cameras and trained on how to capture photos that conveyed their current health, healthcare utilization and engagement, and experience journeys. Individual interviews with the women were held for an in-depth exploration of the photographs. The data was then analysed thematically. RESULTS Six distinct themes were identified across the barriers highlighted by the women: food and nutrition, home and family, neighborhood-built environment, economic instability, religion and spirituality and low prioritization of self-care. These themes captured the challenge of reduced agency, limited contribution and participation, and a complex relationship between visible and invisible illness. CONCLUSION The perspectives of WRA in Nigeria obtained through this qualitative research provided a strong substratum for understanding the environmental barriers that predispose WRA to NCDs in Nigeria. The results of the study are useful for the improvement of woman-centred services of prevention, diagnosis, and management of NCD risk factors across the maternal and reproductive health care continuum in Nigeria.
Collapse
Affiliation(s)
- Imo Etuk
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| | - Amira Iwuala
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| | - Kendra Njoku
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| | - Bosoye Olagbegi
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| | - Ayoposi Ogboye
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria.
| | - Jonas Kofi Akpakli
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| | | | | | | | | | | | - Folashade Oludara
- Federal Capital Territory Health & Human Services Secretariat, Abuja, Nigeria
| | - Iniobong Ekong
- Federal Capital Territory Health & Human Services Secretariat, Abuja, Nigeria
| | - Olubunmi Alabi
- Federal Capital Territory Health & Human Services Secretariat, Abuja, Nigeria
| | - Nneka Mobisson
- mDoc Healthcare, 1a Hakeem Dickson Drive, Off T.F. Kuboye Street, Lekki Phase 1, Lagos, Nigeria
| |
Collapse
|
21
|
Ganjoo R, Rimal RN, Talegawkar SA, Sedlander E, Pant I, Bingenheimer JB, Chandarana S, Aluc A, Jin Y, Yilma H, Panda B. Improving iron folic acid consumption through interpersonal communication: Findings from the Reduction in Anemia through Normative Innovations (RANI) project. Patient Educ Couns 2022; 105:81-87. [PMID: 33980397 PMCID: PMC8710582 DOI: 10.1016/j.pec.2021.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/09/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE More than half of Indian women of reproductive age are anemic. Regular iron folic acid uptake can prevent and treat anemia. This study investigated the effect of interpersonal communication on improving IFA use among women of reproductive age. METHODS The Reduction in Anemia through Normative Innovations (RANI) Project is a cluster randomized trial that collected longitudinal data from control (n = 1896) and intervention (n = 1898) communities in Odisha, India at Time 1 and six months later at Time 2. Structural equation models assessed the effect of the intervention on iron folic acid use via multiple interpersonal communication pathways. RESULTS Compared to the control arm, iron folic acid use significantly increased in the intervention arm. Both, general health interpersonal communication and anemia-specific interpersonal communication were augmented in the intervention communities. The impact of the intervention on iron folic acid use was mediated through anemia-specific interpersonal communication. CONCLUSION The RANI Project increased interpersonal communication among participants, resulting in increased iron folic acid use for anemia reduction. PRACTICE IMPLICATIONS Strategic use of targeted interpersonal communication to promote behavior change appears to be a viable strategy to increase iron folic acid use to reduce anemia.
Collapse
Affiliation(s)
- Rohini Ganjoo
- Department of Biomedical Laboratory Sciences, School of Medicine and Health Sciences, The George Washington University, Ashburn, VA, United States.
| | - Rajiv N Rimal
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States; Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Erica Sedlander
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States; Department of Family and Community Medicine, University of California, San Francisco, United States
| | - Ichhya Pant
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Jeffrey B Bingenheimer
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Shikha Chandarana
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Aika Aluc
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Yichen Jin
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Hagere Yilma
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | | |
Collapse
|
22
|
Munthali M, Chiumia IK, Mandiwa C, Mwale S. Knowledge and perceptions of preconception care among health workers and women of reproductive age in Mzuzu City, Malawi: a cross-sectional study. Reprod Health 2021; 18:229. [PMID: 34775983 DOI: 10.1186/s12978-021-01282-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 11/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background Preconception care is one of the preventive strategies in maternal and new-born health as recommended by WHO. However, in sub-Saharan Africa there is poor preconception care practices. This study examined knowledge and perceptions of preconception care among health workers and women of reproductive age group in Mzuzu City, Malawi. Methods A descriptive cross-sectional study was conducted using a mixed methods approach. Selection of respondents was done through a multistage and purposive sampling techniques respectively. A total of 253 women of reproductive age from nine townships of Mzuzu City responded to the questionnaire and 20 health workers were interviewed. Results A total of 136 (54%) respondents had heard of preconception care. About 57.7% (n = 146) demonstrated a good level of knowledge of preconception care while 42.3% (n = 107) had poor knowledge. About 72% (n = 105) of those with good of knowledge of preconception care, lacked awareness on possibilities of talking to a health care provider on intentions of getting pregnant. About 74.7% (n = 189) of women had a positive perception towards preconception care. Knowledge of preconception care was a good predictor of positive perception (AOR = 2.5; 95% CI 1.2–5.0), however its predictability was influenced by the academic level attained. Those with secondary (AOR = 10.2; 95% CI 3.2–26.2) and tertiary (AOR = 2.3; 95% CI 1.1–4.9) were more likely to have good knowledge of preconception care than those with primary school education level. About 95% (n = 19) of health workers lacked details about preconception care but they admitted their role in preconception care. Conclusion Preconception care practice among health workers and women of reproductive age in Mzuzu City was low. However there was positive perception towards preconception care in both parties. There is an opportunity in existing platforms for implementation of interventions targeting identified predictors for increased knowledge and uptake of preconception care. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01282-w. World health organization defines preconception care as the provision of biomedical, behavioral and social interventions to women and couples before the occurrence of conception. In sub-Saharan Africa, there is poor preconception care practices which has resulted into high infant and maternal mortalities. This study examined the knowledge and perceptions of preconception care among health workers and women of reproductive age in order to provide evidence based outcomes for tailored interventions and policy direction. A semi-structured questionnaire and structured interviews were used to assess the knowledge level and perceptions of preconception care among women of reproductive age and health workers respectively. Of the 253 women, 57.7% showed good level of knowledge of preconception care while 42.3% had poor knowledge. Most (72%) women with good knowledge level lacked awareness that they can talk to a health worker before getting pregnant. Most (74.7%) women showed a positive perception towards preconception care which was strongly linked to having good knowledge based on the academic level attained. Those with secondary and tertiary backgrounds were more likely to have good knowledge than those with primary school level education. The majority (95%) of health workers were unable to explain well about preconception care but they admitted their role in preconception care.
Collapse
|
23
|
Coleman SRM, Bunn JY, Nighbor TD, Kurti AN, Bolívar HA, Tyndale RF, Higgins ST. Use of electronic nicotine delivery systems (ENDS) among U.S. women of reproductive age: Prevalence, reported reasons for use, and toxin exposure. Prev Med 2021; 152:106582. [PMID: 33930436 PMCID: PMC8545704 DOI: 10.1016/j.ypmed.2021.106582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
Given the rapidly expanding marketplace for Electronic Nicotine Delivery Systems (ENDS), it is important to monitor patterns of use, particularly among vulnerable populations. This study examined ENDS prevalence, reasons for use (i.e., to help quit smoking and for appealing flavors), and toxin exposure among U.S. women of reproductive age using data from the Population Assessment of Tobacco and Health (PATH) Study (2013-17). Exclusive ENDS users, dual users of ENDS and cigarettes, and exclusive cigarette smokers were compared within and between pregnant and not-pregnant women. Among pregnant women, prevalence of exclusive ENDS and dual use was similar (0.8%; 95%CI = 0.4-1.2% vs. 1.4%; 95%CI = 0.9-2.0%, respectively), but exclusive ENDS use was less prevalent than dual use among not-pregnant women (1.1%; 95%CI = 0.9-1.4% vs. 3.7%; 95%CI = 3.3-4.0%, respectively). Most women reported ENDs were used to help quit smoking (66.5-90.0%) and for appealing flavors (57.6-87.4%), and endorsement rates did not differ by use pattern or pregnancy status. Except for metals, toxin exposure was substantially lower for exclusive ENDS users relative to dual users and exclusive cigarette smokers regardless of pregnancy status. Pregnant and not-pregnant U.S. women regularly report using ENDS for help with quitting smoking and for appealing flavors. Although no type or pattern of tobacco/nicotine use is safe, especially during pregnancy, using ENDS exclusively is consistent with lower overall toxin exposure for pregnant and not-pregnant women. This study advances understanding of ENDS use and toxin exposure in women of reproductive age, a population highly vulnerable to the effects of nicotine/tobacco consumption.
Collapse
Affiliation(s)
- Sulamunn R M Coleman
- Vermont Center on Behavior and Health, University of Vermont, United States of America; Department of Psychiatry, University of Vermont, United States of America.
| | - Janice Y Bunn
- Vermont Center on Behavior and Health, University of Vermont, United States of America; Department of Medical Biostatistics, University of Vermont, United States of America
| | - Tyler D Nighbor
- Vermont Center on Behavior and Health, University of Vermont, United States of America
| | - Allison N Kurti
- Vermont Center on Behavior and Health, University of Vermont, United States of America
| | - Hypatia A Bolívar
- Department of Psychology, University of Illinois Springfield, United States of America
| | - Rachel F Tyndale
- Centre for Addiction and Mental Health, Departments of Pharmacology & Toxicology, and Psychiatry, University of Toronto, Canada
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, University of Vermont, United States of America; Department of Psychiatry, University of Vermont, United States of America; Department of Psychological Science, University of Vermont, United States of America
| |
Collapse
|
24
|
Bliznashka L, Blakstad MM, Berhane Y, Tadesse AW, Assefa N, Danaei G, Canavan CR, Hemler EC, Fawzi WW. Household-level double burden of malnutrition in Ethiopia: a comparison of Addis Ababa and the rural district of Kersa. Public Health Nutr 2021; 24:6354-68. [PMID: 34446127 DOI: 10.1017/S1368980021003700] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the prevalence of and factors associated with different forms of household-level double burden of malnutrition (DBM) in Ethiopia. DESIGN We defined DBM using anthropometric measures for adult overweight (BMI ≥ 25 kg/m2), child stunting (height-for-age Z-score <-2 sd) and overweight (weight-for-height Z-score ≥2 sd). We considered sixteen biological, environmental, behavioural and socio-demographic factors. Their association with DBM forms was assessed using generalised linear models. SETTING We used data from two cross-sectional studies in an urban (Addis Ababa, January-February 2018), and rural setting (Kersa District, June-September 2019). PARTICIPANTS Five hundred ninety-two urban and 862 rural households with an adult man, adult woman and child <5 years. RESULTS In Addis Ababa, overweight adult and stunted child was the most prevalent DBM form (9 % (95 % CI 7, 12)). Duration of residence in Addis Ababa (adjusted OR (aOR) 1·03 (95 % CI 1·00, 1·06)), Orthodox Christianity (aOR 1·97 (95 % CI 1·01, 3·85)) and household size (aOR 1·24 (95 % CI 1·01, 1·54)) were associated factors. In Kersa, concurrent child overweight and stunting was the most prevalent DBM form (11 % (95 % CI 9, 14)). Housing quality (aOR 0·33 (95 % CI 0·20, 0·53)), household wealth (aOR 1·92 (95 % CI 1·18, 3·11) and sanitation (aOR 2·08 (95 % CI 1·07, 4·04)) were associated factors. After adjusting for multiple comparisons, only housing quality remained a significant factor. CONCLUSIONS DBM prevalence was low among urban and rural Ethiopian households. Environmental, socio-economic and demographic factors emerged as potential associated factors. However, we observed no common associated factors among urban and rural households.
Collapse
|
25
|
Sunguya BF, Ge Y, Mlunde L, Mpembeni R, Leyna G, Huang J. High burden of anemia among pregnant women in Tanzania: a call to address its determinants. Nutr J 2021; 20:65. [PMID: 34238307 PMCID: PMC8268339 DOI: 10.1186/s12937-021-00726-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/03/2021] [Indexed: 11/24/2022] Open
Abstract
Background Anemia in pregnancy is behind a significant burden of maternal mortality and poor birth outcomes globally. Efforts to address it need evidence on trends and its pertinent factors as they vary from one area to another. Methods We pooled data of 23,203 women of reproductive age whose hemoglobin levels were measured from two Tanzania Demographic and Health Surveys (TDHS). Of them, 2,194 women were pregnant. Analyses employed descriptive analyses to determine the burden of anemia, its characteristics, and severity; GIS mapping to determine the regional changes of anemia between 2005 and 2015; and logistic regression to determine the remaining determinants of anemia among pregnant women using Stata 15. Results The burden of anemia among pregnant women in Tanzania has remained unprecedently high, and varies between regions. There was no significant decline of anemia in general between the two periods after adjusting for individual, households, reproductive, and child characteristics [AOR = 0.964, 95% CI = 0.774–1.202, p = 0.747). Anemia is currently prevalent in 57% of pregnant women in Tanzania. The prevalence is more likely to be higher among women aged 15–19 years than those aged between 20–34 years. It is more likely to be prevalent among those within large families, with no formal education, food insecurity, lack of health insurance, had no antimalaria during pregnancy, and had low frequency of ANC attendance. On the other hand, delivery in a health facility may be potentially protective against anemia. Conclusions Anemia in pregnancy remained persistently high and prevalent among 57% of pregnant women in Tanzania. Efforts to address anemia are crucial and need to be focused in regions with increasing burden of anemia among pregnant women. It is imperative to address important risk factors such as food insecurity, strengthening universal health coverage, empowering women of reproductive age with education and especially nutritional knowledge and advocating for early antenatal booking, attendance, and facility delivery. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00726-0.
Collapse
Affiliation(s)
- Bruno F Sunguya
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Yue Ge
- Global Health Institute, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory of Health Technology Assessment, National Health Commission, Shanghai, China
| | - Linda Mlunde
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Implementation Science Tanzania, Dar es Salaam, Tanzania
| | - Rose Mpembeni
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Germana Leyna
- Tanzania Food and Nutrition Center, Dar es Salaam, Tanzania
| | - Jiayan Huang
- Global Health Institute, School of Public Health, Fudan University, Shanghai, China. .,Key Laboratory of Health Technology Assessment, National Health Commission, Shanghai, China.
| |
Collapse
|
26
|
Gahungu J, Vahdaninia M, Regmi PR. The unmet needs for modern family planning methods among postpartum women in Sub-Saharan Africa: a systematic review of the literature. Reprod Health 2021; 18:35. [PMID: 33568180 PMCID: PMC7877117 DOI: 10.1186/s12978-021-01089-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 01/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa has the highest fertility rate in the world, with the highest unmet need for family planning (FP). Yet, there is a lack of knowledge about the determinants for non-utilisation of modern contraceptive methods among women of reproductive age. This systematic review of literature assessed factors affecting the unmet need and reasons for non-utilisation of modern contraceptive methods during the postpartum period in Sub-Saharan African women. METHODS An online literature search was conducted in several databases: MEDLINE, Cochrane Review, PubMed, Elsevier's Science Direct and Web of Science. The search was completed by hand searching. Data were extracted and summarised using the Arksey and O'Malley methodology. RESULTS In total, 19 studies were included; one qualitative study, seventeen quantitative, and one used a mixed-methods approach. Studies were conducted in Ethiopia (n = 11), Nigeria (n = 3), Kenya (n = 2), Malawi (n = 2) and Uganda (n = 1). Factors affecting the unmet need for modern contraceptive methods were described at three levels: (a) individual; (b) household; and (c) healthcare facility level. Reasons for non-use of FP included: fear of side effects; husband's disapproval; the absence of menses; abstinence; and low perception of risk of pregnancy. CONCLUSION Unmet needs in postpartum FP in women from Sub-Saharan Africa were associated with health-system and socio-demographic determinants. We suggest that there is a need to improve the awareness of modern contraceptive methods through effective interventions. Further research is needed for under-studied countries in this continent.
Collapse
Affiliation(s)
| | - Mariam Vahdaninia
- Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Pramod R Regmi
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth Gateway Building, 10 St Paul's Ln, BH8 8AJ, Bournemouth, UK
| |
Collapse
|
27
|
Menon S, Benova L, Mabeya H. Epilepsy management in pregnant HIV+ women in sub-Saharan Africa, clinical aspects to consider: a scoping review. BMC Med 2020; 18:341. [PMID: 33198766 PMCID: PMC7670685 DOI: 10.1186/s12916-020-01799-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/25/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Since the introduction of highly active antiretroviral therapy (HAART), acquired immune deficiency syndrome (AIDS) related mortality has markedly declined. As HAART is becoming increasingly available, the infection with human immunodeficiency virus (HIV+) in sub-Saharan Africa (SSA) is becoming a chronic condition. While pregnancy in HIV+ women in SSA has always been considered a challenging event for the mother and the fetus, for pregnant HIV+ women also diagnosed with epilepsy (WWE), there are additional risks as HIV increases the odds of developing seizures due to the vulnerability of the central nervous system to other infections, immune dysfunction, and overall metabolic disturbances. In light of a growing proportion of HIV+ WWE on HAART and an increasing number of pregnant women accessing mother-to-child transmission of HIV programs through provision of HAART in SSA, there is a need to develop contextualized and evidenced-based clinical strategies for the management of epilepsy in this population. In this study, we conduct a literature scoping review to identify issues that warrant consideration for clinical management. RESULT Twenty-three articles were retained after screening, which covered six overarching clinical aspects: status epilepticus (SE), Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), dyslipidemia, congenital malformation (CM), chronic kidney disease (CKD), and neurological development. No studies for our population of interest were identified, highlighting the need for a cautionary approach to be employed when extrapolating findings. CONCLUSION High risks of CM and drug interactions with first-line antiepileptic drugs (AEDs) warrant measures to increase the accessibility and choices of safer second-line AEDs. To ensure evidence-based management of epilepsy within this population, the potential high prevalence of SE, CKD, dyslipidemia, and SJS/TEN and the cumulative effect of drug-drug interactions should be considered. Further understanding of the intersections between pregnancy and drug-drug interactions in SSA is needed to ensure evidenced-based management of epilepsy in pregnant HIV+ WWE. To prevent SE, the barriers for AED treatment adherence in pregnant HIV+ women should be explored. Our review underscores the need to conduct cohort studies of HIV+ WWE in reproductive age over time and across pregnancies to capture the cumulative effect of HAART and AED to inform clinical management.
Collapse
Affiliation(s)
- Sonia Menon
- Instiute of Tropical Medicine Antwerp, Antwerp, Belgium.
| | - Lenka Benova
- Instiute of Tropical Medicine Antwerp, Antwerp, Belgium
| | | |
Collapse
|
28
|
Yiga P, Ogwok P, Achieng J, Auma MD, Seghers J, Matthys C. Determinants of dietary and physical activity behaviours among women of reproductive age in urban Uganda, a qualitative study. Public Health Nutr 2021; 24:3624-36. [PMID: 33000718 DOI: 10.1017/S1368980020003432] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To explore determinants of dietary and physical activity behaviours among women of reproductive age. DESIGN Data were collected through focus group discussions (FGD). The FGD guide was based on a modified theoretical framework; theory of planned behaviour was incorporated with constructs of health belief model, precaution adoption process model, social cognitive and social support theory. Discussions were audio recorded, transcribed verbatim and analysed thematically. SETTING Kampala, Uganda. PARTICIPANTS Women were categorised into young adults; 18-34 years and adults; 35-45 years. RESULTS Separate FGD with independent participants were conducted for dietary and physical activity behaviours until data saturation was achieved. Six FGD were conducted per behaviour. Determinants of dietary behaviours at intra-individual level included gaps in food skills, knowledge and self-efficacy, food safety concerns, convenience, finances and physiological satisfaction. The social-cultural norms were relationship between vegetable consumption and low social status, consideration of fruits as a snack for children and not food and habitual orientation towards carbohydrate foods. At environment level, social networks and increased availability of energy-dense, nutrient poor, street and processed foods influence dietary behaviour. For physical activity, intra-individual determinants were knowledge gaps and self-efficacy, while socio-cultural norms included gender stereotypes. Home (limited space and sedentary entertainment like social media and TV) and physical environment (cheap motorised transportation) influence physical activity. CONCLUSION The existing cultural beliefs promote dietary and physical activity behaviours which are divergent from healthy recommendations. Therefore, a comprehensive intervention is needed to address socio-cultural misconceptions, financial and time limitations in urban Uganda.
Collapse
|
29
|
Hanley-Cook GT, Argaw AA, de Kok BP, Vanslambrouck KW, Toe LC, Kolsteren PW, Jones AD, Lachat CK. EAT- Lancet diet score requires minimum intake values to predict higher micronutrient adequacy of diets in rural women of reproductive age from five low- and middle-income countries. Br J Nutr 2021; 126:92-100. [PMID: 32993824 DOI: 10.1017/S0007114520003864] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The EAT-Lancet Commission promulgated a universal reference diet. Subsequently, researchers constructed an EAT-Lancet diet score (0-14 points), with minimum intake values for various dietary components set at 0 g/d, and reported inverse associations with risks of major health outcomes in a high-income population. We assessed associations between EAT-Lancet diet scores, without or with lower bound values, and the mean probability of micronutrient adequacy (MPA) among nutrition-insecure women of reproductive age (WRA) from low- and middle-income countries (LMIC). We analysed single 24-h diet recall data (n 1950) from studies in rural DRC, Ecuador, Kenya, Sri Lanka and Vietnam. Associations between EAT-Lancet diet scores and MPA were assessed by fitting linear mixed-effects models. Mean EAT-Lancet diet scores were 8·8 (SD 1·3) and 1·9 (SD 1·1) without or with minimum intake values, respectively. Pooled MPA was 0·58 (SD 0·22) and energy intake was 10·5 (SD 4·6) MJ/d. A one-point increase in the EAT-Lancet diet score, without minimum intake values, was associated with a 2·6 (SD 0·7) percentage points decrease in MPA (P < 0·001). In contrast, the EAT-Lancet diet score, with minimum intake values, was associated with a 2·4 (SD 1·3) percentage points increase in MPA (P = 0·07). Further analysis indicated positive associations between EAT-Lancet diet scores and MPA adjusted for energy intake (P < 0·05). Our findings indicate that the EAT-Lancet diet score requires minimum intake values for nutrient-dense dietary components to avoid positively scoring non-consumption of food groups and subsequently predicting lower MPA of diets, when applied to rural WRA in LMIC.
Collapse
|
30
|
Megersa BS, Ojengbede OA, Deckert A, Fawole OI. Factors associated with induced abortion among women of reproductive age attending selected health facilities in Addis Ababa, Ethiopia: a case control study. BMC Womens Health 2020; 20:188. [PMID: 32883263 PMCID: PMC7469090 DOI: 10.1186/s12905-020-01023-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 07/16/2020] [Indexed: 11/28/2022]
Abstract
Background There has been a significant reduction of abortion rates in high-income countries, while the rates remain unchanged in low- and middle-income countries. In Ethiopia, for example, the number of women of reproductive age seeking an induced abortion is increasing. However, there is limited information concerning the reasons why the occurrence of this procedure is increasing. Thus, this study aimed to identify factors associated with having induced abortion in Addis Ababa, Ethiopia. Methods An unmatched case-control study was conducted using a semi-structured, interviewer-administered questionnaire from October to December 2017. The cases were 147 women of reproductive age who underwent abortion in a health facility or presented with complications due to induced abortion conducted outside the health facility. The controls were 295 women who came for antenatal care and who reported never having had an induced abortion. The cases were selected by consecutive sampling from nine health facilities, whereas the controls were selected by systematic sampling from the same health facilities. Bivariate and multivariate logistic regression models were employed using STATA version 14 to identify factors associated with induced abortion. Results The mean age of cases was 26.5 ± 5.7 years, while for the controls it was 28.1 ± 4.8 years. Being unmarried (AOR = 9.6; 95% CI: 1.5–61.7), having primary (AOR = 5.3; 95% CI: 1.5–18.3) and tertiary (AOR = 5.7; 95% CI: 1.6–21.1) education, earning monthly income 100–300 USD (AOR = 0.2; 95% CI: 0.1–0.4) and > 300 USD (AOR = 0.1; 95% CI: 0.0–0.2), initiating first intercourse between ages of 15 and 19 (AOR = 4.7; 95% CI: 1.4–15.6), marrying before the age of 18 (AOR = 2.9; 95% CI: 1.3–6.7), and having two children (AOR = 4.7; 95% CI: 1.8–12.7) were independent predictors of induced abortion. Conclusion Family planning programs hoping to reduce the occurrence of induced abortion should specifically target unmarried women, low income, and those who have two children. The government should also work on preventing early marriage and providing sexual and reproductive health education to help adolescents delay age at first sexual experience.
Collapse
Affiliation(s)
- Bikila Soboka Megersa
- Pan Africa University Institute of Life and Earth Sciences (Including Health and Agriculture), University of Ibadan, Ibadan, Nigeria. .,Arba Minch University, Arba Minch, Ethiopia.
| | - Oladosu Akanbi Ojengbede
- Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Andreas Deckert
- Institute of Global Health Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Olufunmilayo Ibitola Fawole
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
31
|
Abstract
OBJECTIVES Frequent sugar-sweetened beverage (SSB) intake is associated with weight gain in women, and pre-pregnancy overweight and excessive gestational weight gain are linked to adverse pregnancy outcomes. SSB intake information for women of reproductive age (WRA) is limited. We described SSB intake among non-pregnant and pregnant WRA and identified correlates of daily intake. METHODS Using 2017 Behavioral Risk Factor Surveillance System data, we analyzed SSB intake (regular soda, fruit drinks, sweet tea, sports/energy drinks) for 11,321 non-pregnant and 392 pregnant WRA (18-49 years) in 12 states and D.C. Adjusted odds ratios (aOR) for daily (≥ 1 time/day) SSB intake (reference: < 1 time/day) by characteristics were estimated using multivariable logistic regression. RESULTS Overall, 27.3% of non-pregnant and 21.9% of pregnant women reported consuming SSBs ≥ 1 time/day; 12.6% and 9.7%, respectively, consumed SSBs ≥ 2 times/day. Among non-pregnant women, odds of daily SSB intake were higher for women who were non-Hispanic black (aOR 2.04, 95% CI 1.55-2.69) vs. non-Hispanic white; had ≤ high school education (aOR 2.79, CI 2.26-3.44) or some college (aOR 1.85, CI 1.50-2.27) vs. college graduates; lived in nonmetropolitan counties (aOR 1.35, CI 1.11-1.63) vs. metropolitan; had no physical activity (aOR 1.72, CI 1.43-2.07) vs. some; were former (aOR 1.51, CI 1.17-1.94) or current (aOR 3.48, CI 2.82-4.28) smokers vs. nonsmokers. Among pregnant women, those not married had higher odds (aOR 2.81, CI 1.05-7.51) for daily SSB intake than married women. CONCLUSIONS One in five pregnant women and one in four non-pregnant women of reproductive age consumed SSBs at least once per day. Sociodemographic and behavioral correlates of daily SSB intake were identified.
Collapse
Affiliation(s)
- Elizabeth A Lundeen
- Division of Nutrition, Physical Activity and Obesity (DNPAO), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, Mail Stop F77, Atlanta, GA, 30341, USA.
| | - Sohyun Park
- Division of Nutrition, Physical Activity and Obesity (DNPAO), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, Mail Stop F77, Atlanta, GA, 30341, USA
| | - Jennifer A Woo Baidal
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, 622 W. 168th Street, PH-17, New York, NY, 10032, USA
| | - Andrea J Sharma
- Division of Nutrition, Physical Activity and Obesity (DNPAO), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, Mail Stop F77, Atlanta, GA, 30341, USA
- U.S. Public Health Service Commissioned Corps, Rockville, MD, USA
| | - Heidi M Blanck
- Division of Nutrition, Physical Activity and Obesity (DNPAO), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, Mail Stop F77, Atlanta, GA, 30341, USA
- U.S. Public Health Service Commissioned Corps, Rockville, MD, USA
| |
Collapse
|
32
|
Bliznashka L, Danaei G, Fink G, Flax VL, Thakwalakwa C, Jaacks LM. Cross-country comparison of dietary patterns and overweight and obesity among adult women in urban Sub-Saharan Africa. Public Health Nutr 2021; 24:1393-403. [PMID: 32390577 DOI: 10.1017/S1368980019005202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To derive dietary patterns (DP) among women of reproductive age (WRA) and older women in urban Sub-Saharan Africa (SSA), and to examine their association with body mass index (BMI), overweight and obesity. DESIGN We used principal component analysis to derive DP. Their association with BMI, overweight and obesity was assessed using linear and multinomial logistic regression models controlling for age, marital status, education and wealth. SETTING Cross-sectional data from prospective studies in Accra, Ghana (2008-2009), Dar es Salaam, Tanzania (2014) and Lilongwe and Kasungu, Malawi (2017-2018) were used. PARTICIPANTS We compared WRA in Ghana (18-54 years, n 1762) and Malawi (19-48 years, n 137), and older women in Ghana (≥55 years, n 514) and Tanzania (≥50 years, n 134). RESULTS Among WRA, protein and healthy DP were identified in both Ghana and Malawi. In Ghana, the protein DP was associated with higher odds of overweight or obesity (adjusted OR 1·82, 95 % CI 1·27, 2·60 for quintile 2). Among older women, three DP were identified in Ghana (cereal, protein and healthy) and two DP in Tanzania (protein and healthy). The protein DP was associated with higher BMI in Ghana (adjusted mean difference 2·83, 95 % CI 0·95, 4·71 for quartile 3). CONCLUSIONS Higher quintiles of the protein DP were associated with higher BMI and odds of overweight or obesity among women in urban Ghana, but not in Malawi or Tanzania. Further research is needed to understand how DP influence overweight and obesity among adult women in urban SSA.
Collapse
|
33
|
Lee J, Jeong Y, Mok S, Choi K, Park J, Moon HB, Choi G, Kim HJ, Kim SY, Choi SR, Kim S. Associations of exposure to phthalates and environmental phenols with gynecological disorders. Reprod Toxicol 2020; 95:19-28. [PMID: 32360183 DOI: 10.1016/j.reprotox.2020.04.076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 04/18/2020] [Accepted: 04/23/2020] [Indexed: 02/06/2023]
Abstract
Phthalates and environmental phenols might be associated with some benign diseases that have been found to be hormone-sensitive. Current knowledge on adverse effects of these chemicals among reproductive women is limited and often controversial. Therefore, the purpose of this study was to investigate the association between the urinary concentration of phthalates and environmental phenols and gynecological disorders from 512 women of reproductive age. The association between chemical concentration and disease in the control and case groups was statistically determined with the questionnaire survey data and measurements using the LC-MS/MS. The results have shown that DEHP metabolites, ethyl paraben and 3,4-DHB showed significant direct associations with leiomyoma and benign ovarian tumors (p < 0.05). We found statistically significant positive relationships between exposure to chemicals (some DEHP metabolites, DHB) and prevalence of gynecologic disorders (p < 0.05). Furthermore, the ORs for leiomyoma associated with these compounds in always user for personal care products (PCPs) was higher than those of sometimes user. High levels of urinary concentrations of these compounds such as DEHP metabolites and parabens and their metabolites showed significant associations with leiomyoma and benign ovarian tumors.
Collapse
Affiliation(s)
- Jangwoo Lee
- School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Yunsun Jeong
- Department of Marine Science and Convergence Engineering, Hanyang University, Ansan, Republic of Korea
| | - Sori Mok
- Department of Marine Science and Convergence Engineering, Hanyang University, Ansan, Republic of Korea
| | - Kyungho Choi
- School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jeongim Park
- College of Natural Sciences, Soonchunhyang University, Asan, Republic of Korea
| | - Hyo-Bang Moon
- Department of Marine Science and Convergence Engineering, Hanyang University, Ansan, Republic of Korea
| | - Gyuyeon Choi
- College of Medicine, Soonchunhyang University, Seoul, Republic of Korea
| | - Hai-Joong Kim
- College of Medicine, Korea University, Seoul, Republic of Korea
| | - Su Young Kim
- College of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Soo Ran Choi
- College of Medicine, Inha University, Incheon, Republic of Korea
| | - Sungkyoon Kim
- School of Public Health, Seoul National University, Seoul, Republic of Korea.
| |
Collapse
|
34
|
He YR, Li Y, Ma L, Wei SS, Wu HY, Huang J. [Effects of LNG-IUS on sexual function and sexual quality in women of childbearing age]. Zhonghua Yi Xue Za Zhi 2020; 100:1255-1259. [PMID: 32344499 DOI: 10.3760/cma.j.cn112137-20190821-01790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Objective: To investigate the effects of levonorgestrel releasing intrauterine system (LNG-IUS) on sexual function and sexual quality in women of childbearing age. Methods: A total of 203 healthy women who were using IUD for long-term contraception were enrolled in the study. Among them, 130 were placed LNG-IUS as the study group and 73 were placed the copper intrauterine devices (Cu-IUDs) as the control group. The two groups were further divided into three subgroups by age. The basic information and questionnaires were adopted before and 2 years after using IUDs, including age, the time of using IUD, side-effects after using IUD, frequency and satisfaction of sex after using IUD. The Female Sexual Function Index (FSFI) was evaluated on 2 years after. Results: In the 30-39 age subgroup, the frequency of sex was significantly decreased after using LNG-IUS (P<0.05). Rests of the subgroup shows no significantly different in the frequency of sex (P>0.05). The sexual satisfaction in all subgroups also shows no significantly different before and after using IUDs (P>0.05). There was no significant difference in the individual score and total scores of FSFI between the study group and control group (P>0.05). Conclusion: The LNG-IUS has no adverse effects on female sexual function and sexual quality in the reproductive age.
Collapse
Affiliation(s)
- Y R He
- Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016 China
| | - Y Li
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, 310016 China
| | - L Ma
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, 310016 China
| | - S S Wei
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, 310016 China
| | - H Y Wu
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, 310016 China
| | - J Huang
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, 310016 China
| |
Collapse
|
35
|
Mwandelile IF, Mpembeni R, Abade A, Rumisha SF, Massaga JJ, Kishimba R. Awareness and factors associated with reported intake of folic acid-fortified flour among women of reproductive age in Ifakara, Morogoro region, Tanzania: a cross-sectional study. BMC Nutr 2020; 5:55. [PMID: 32153968 PMCID: PMC7050702 DOI: 10.1186/s40795-019-0324-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 11/11/2019] [Indexed: 11/16/2022] Open
Abstract
Background Folic acid fortification of staple foods has been in place in many countries for over two decades. Studies have shown that folic acid fortification can significantly reduce incidence of neural tube defects. Tanzania adopted a mandatory fortification policy for commercially-produced wheat and maize flour in 2011. We determined factors influencing intake of folic acid-fortified flour among women of reproductive age (WRA). Methods We conducted a cross-sectional study among WRA during March–April 2017 in Ifakara Town Council, Morogoro region. Multistage cluster sampling was used to select study participants. We used a questionnaire to capture information on demographics, awareness of folic acid, awareness of existence of folic acid fortified flour in community and intake of folic acid fortified flour. Intake was defined as reported consumption of folic acid fortified flour products at least once within 7 days before interview. Univariate, bivariate, and multivariable logistic analyses were done to evaluate factors associated with intake of folic acid fortified flour. Results The median age of the 698 participating WRA was 30 years (range: 18–49). Awareness of folic acid and folic acid fortified flour was 6.9% (95% CI: 5.2–9.0%) and 7.5% (95% CI: 5.7–9.6%), respectively. Consumption of folic acid fortified flour was 63.3% (95% CI: 59.7–66.8%). Independent factors associated with intake included being employed (aOR = 1.91; 95% CI: 1.19–3.06), having no children (nulliparity) (aOR = 2.59; 95% CI: 1.36–4.95) or having 1–4 children (aOR = 1.98; 95% CI: 1.17–3.33) (vs. 5 or more children), and folic acid awareness (aOR = 2.53; 95% CI: 1.30–4.92). Conclusion Folic acid fortified flour was used by most respondents in our study despite low awareness of existence of folic acid fortified flour in the community. Being employed, having fewer than five children, and folic acid awareness were independent factors associated with intake. We recommend scaling up of mandatory flour fortification program and doing further studies on blood folate level among women of reproductive age in Ifakara to assess fortification program effectiveness.
Collapse
Affiliation(s)
- Ipyana Frank Mwandelile
- 1Muhimbili University of Health and Allied Sciences (MUHAS), P.O.Box 65015, Dar es- salaam, Tanzania.,Field Epidemiology and Laboratory Training Programme (FELTP), P.O.Box 71286, Dar es- salaam, Tanzania
| | - Rose Mpembeni
- 1Muhimbili University of Health and Allied Sciences (MUHAS), P.O.Box 65015, Dar es- salaam, Tanzania
| | - Ahmed Abade
- Field Epidemiology and Laboratory Training Programme (FELTP), P.O.Box 71286, Dar es- salaam, Tanzania
| | - Susan F Rumisha
- 3National Institute for Medical Research, P.O.Box 9653, 3 Barack Obama Drive, 11101 Dar es Salaam, Tanzania
| | - Julius J Massaga
- 3National Institute for Medical Research, P.O.Box 9653, 3 Barack Obama Drive, 11101 Dar es Salaam, Tanzania
| | - Rogath Kishimba
- Field Epidemiology and Laboratory Training Programme (FELTP), P.O.Box 71286, Dar es- salaam, Tanzania
| |
Collapse
|
36
|
Abstract
BACKGROUND Food insecurity is widely prevalent in certain sections of society in low and middle-income countries. The United Nations has challenged all member countries to eliminate hunger for all people by 2030. This study examines the prevalence and correlates of household food insecurity among women, especially Dalit women of reproductive age in Nepal. METHODS Data came from 2016 Nepal Demographic Health Survey, a cross-sectional, nationally representative survey that included 12,862 women between 15 and 49 years of age of which 12% were Dalit. Descriptive analysis was used to assess the prevalence of household food insecurity while logistic regression examined the relationship between women's ethnicity and the risk of food insecurity after accounting for demographic, economic, cultural, and geo-ecological characteristics. RESULTS About 56% of all women and 76% of Dalit women had experienced food insecurity. Ethnicity is strongly related to food insecurity. Dalit women were most likely to be food insecure, even after accounting for factors such as education and wealth. They were 82, 85, 89 and 92% more vulnerable to food insecurity than Muslims, Brahmin/Chhetri, Terai Indigenous, and Hill Indigenous populations, respectively. Education was a protective factor-women with secondary education (6th to 10th grade) were 39% less likely to be food insecure compared to their counterparts without education. With a more than 10th grade education, women were 2.27 times more likely to be food secure compared to their counterparts without education. Marriage was also protective. Economically, household wealth is inversely correlated with food insecurity. Finally, residence in the Mid-Western, Far-Western and Central Development regions was correlated with food insecurity. CONCLUSION To reduce food insecurity in Nepal, interventions should focus on improving women's education and wealth, especially among Dalit and those residing in the Far- and Mid-Western regions.
Collapse
Affiliation(s)
- Shanta Pandey
- Boston College School of Social Work, McGuinn Hall, Room 311, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
| | - Vincent Fusaro
- Boston College School of Social Work, McGuinn Hall, Room 311, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA
| |
Collapse
|
37
|
Kurti AN, Bunn JY, Tang K, Nighbor T, Gaalema DE, Coleman-Cowger V, Coleman SRM, Higgins ST. Impact of electronic nicotine delivery systems and other respondent characteristics on tobacco use transitions among a U.S. national sample of women of reproductive age. Drug Alcohol Depend 2020; 207:107801. [PMID: 31855658 PMCID: PMC6981035 DOI: 10.1016/j.drugalcdep.2019.107801] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 11/26/2019] [Accepted: 11/26/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Identifying predictors of tobacco use patterns that differ in harm among reproductive-aged women may inform efforts to protect women and children against adverse health impacts of tobacco use. METHODS Changes in tobacco use patterns were examined among women (18-49 years) who completed Wave 1 (W1) and Wave 2 (W2), or W2 and Wave 3 (W3) of the U.S. Population Assessment of Tobacco and Health (PATH, 2013-2016) study, and were using cigarettes, filtered cigars and/or cigarillos in the first wave over which data were included for that respondent (Time 1; T1). We examined the proportion of respondents whose tobacco use transitions from T1 to Time 2 (T2) were harm-maintaining (continued using combusted tobacco), harm-reducing (transitioned to electronic nicotine delivery systems (ENDS), or harm-eliminating (quit tobacco). Multinomial logistic regressions (with harm-maintaining as the baseline category) were conducted to examine associations between ENDS use, demographic, and psychosocial characteristics with each transition. RESULTS A majority of women (83 %) exhibited harm-maintaining transitions, followed by harm-eliminating (14.7 %) and harm-reducing (2.3 %) transitions. Use of ENDS at T1 was associated with increased odds of harm reduction and decreased odds of harm elimination. Younger women were more likely to make both harm-reducing and harm-eliminating transitions. Increased educational attainment, identifying as Black or Hispanic, increased psychiatric symptoms, and pregnancy were associated with harm elimination, whereas living at or above poverty was associated with harm reduction. CONCLUSIONS Study results contribute new information on the impact of ENDS, sociodemographic characteristics, psychiatric symptoms, and pregnancy on tobacco use transitions among reproductive-aged women.
Collapse
Affiliation(s)
- Allison N Kurti
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA; Department of Psychological Science, University of Vermont, Burlington, VT, USA.
| | - Janice Y Bunn
- Department of Medical Biostatistics, University of Vermont, Burlington, VT, USA
| | - Katherine Tang
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Tyler Nighbor
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA; Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | | | - Sulamunn R M Coleman
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA; Department of Psychological Science, University of Vermont, Burlington, VT, USA
| |
Collapse
|
38
|
Nankinga O, Aguta D. Determinants of Anemia among women in Uganda: further analysis of the Uganda demographic and health surveys. BMC Public Health 2019; 19:1757. [PMID: 31888579 PMCID: PMC6937990 DOI: 10.1186/s12889-019-8114-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 12/19/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Anemia is a public health problem in many developing countries. It affects a sizable proportion of women of reproductive age. Anemia increases the risk of morbidity and mortality from infectious diseases, and can lead to poor fetal outcomes, and low productivity. This study examined the trends and determinants of anemia among women of reproductive age in Uganda. METHODS This study analyzed data from the Uganda Demographic and Health Surveys conducted in 2006, 2011, and 2016. The study was based on 10,956 weighted cases of women age 15-49. Bivariate analysis and multiple logistic regression analysis examined the association between the outcome variable and the determinants. Potential determinants of anemia in women were selected based on literature. RESULTS The results of the analysis show that anemia decreased in Uganda between 2006 and 2016, but with an increase between 2011 and 2016. The overall prevalence of anemia among women was 50, 23, and 32% respectively in 2006, 2011, and 2016. Women who were pregnant at the time of the survey had higher odds of being anemic across the surveys (OR 2.00, 95% CI 1.49-2.67; OR 1.47, 95% CI 1.02-2.10; OR 1.33, 95% CI 1.07-1.65). Women in households with nonimproved sources of drinking water also had higher odds for anemia (OR 1.32, 95% CI 1.09-1.61) in 2016. Wealth index, region and age were also significantly associated with anemia in women. CONCLUSION In order to reduce anemia in women, there is need to target pregnant women during antenatal and postpartum visits, and ensure that nutrition education during such visits is supported. There is also need to ensure sustainable household access to safe water. This should be combined with interventions aimed at enhancing household wealth.
Collapse
Affiliation(s)
- Olivia Nankinga
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda.
| | - Danstan Aguta
- Uganda Bureau of Statistics, Statistics House, Kampala, Uganda
| |
Collapse
|
39
|
Shatilwe JT, Mashamba-Thompson TP. Mapping evidence on access to healthcare information by women of reproductive age in low-and-middle-income countries: scoping review protocol. Syst Rev 2019; 8:328. [PMID: 31843003 PMCID: PMC6913006 DOI: 10.1186/s13643-019-1203-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/16/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Research shows that there are inadequate interventions in resource-limited settings that could enable women of reproductive age to access and use health services in those settings. The main objective of this scoping review is to map the evidence on access to healthcare information by women of reproductive age in LMICs. METHOD AND ANALYSIS The primary search will include Google Scholar, Science Direct, PubMed, EBSCOhost (Academic search complete, CINAHL with full text, MEDLINE with full text, MEDLINE), Emerald, Embase, CDSR, PsycINFO, published and peer review journals, organisational projects, conference papers, reference list, grey literature sources, as well as reports related to this objective will be included in the study. Identified keywords will be used to search articles from the studies. The articles and abstracts will be screened by two independent reviewers (JS and TPMT). Inclusion and exclusion criteria will be considered to guide the screening. A thematic content analysis will be used to present the narrative account of the reviews, using NVivo computer software (version 11). DISCUSSIONS The scoping review will focus on women of reproductive age in LMICs. We anticipate finding relevant literature on the interventions aimed at accessing health care services in LMICs. The study findings will help reveal research gaps to guide future research. SCOPING REVIEW REGISTRATION Not registered with PROSPERO (not needed). PROTOCOL AND REGISTRATION This scoping review was not registered.
Collapse
Affiliation(s)
- Joyce T Shatilwe
- Displine of Public Health Medicine and School of Nursing, University of KwaZulu-Natal, Durban, South Africa.
| | - Tivani P Mashamba-Thompson
- Displine of Public Health Medicine and School of Nursing, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
40
|
Hakizimana D, Nisingizwe MP, Logan J, Wong R. Identifying risk factors of anemia among women of reproductive age in Rwanda - a cross-sectional study using secondary data from the Rwanda demographic and health survey 2014/2015. BMC Public Health 2019; 19:1662. [PMID: 31829161 PMCID: PMC6907339 DOI: 10.1186/s12889-019-8019-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/29/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Anemia among Women of Reproductive Age (WRA) continues to be among the major public health problems in many developing countries, including Rwanda, where it increased in prevalence between the 2015 and 2010 Rwanda Demographic and Health Survey (RDHS) reports. A thorough understanding of its risk factors is necessary to design better interventions. However, to the best of our knowledge, no study has been conducted in Rwanda on a nationally representative sample to assess factors associated with anemia among WRA. Accordingly, this study was conducted to address such gap. METHODS A quantitative, cross-sectional study was conducted using data from the RDHS 2014-2015. The study population consisted of 6680 WRA who were tested for anemia during the survey. Anemia was defined as having a hemoglobin level equal to or below 10.9 g/dl for a pregnant woman, and hemoglobin level equal to or below 11.9 g/dl for a non-pregnant woman. Pearson's chi-squared test and multiple logistic regression were conducted for bivariate and multivariable analysis, respectively. RESULTS The prevalence of anemia among WRA was 19.2% (95% CI: 18.0-20.5). Four factors were found to be associated with lower odds of anemia, including being obese (OR: 0.61, 95% CI: 0.40-0.91), being in the rich category (OR: 0.74, 95% CI: 0.63-0.87), sleeping under a mosquito net (OR: 0.85, 95% CI: 0.74-0.98), and using hormonal contraceptives (OR: 0.61, 95% CI: 0.50-0.73). Five factors were associated with higher odds of anemia, including being underweight (OR: 1.39, 95% CI: 1.09-1.78), using an intrauterine device (OR: 1.98, 95% CI: 1.05-3.75), being separated or widowed (OR: 1.35, 95% CI: 1.09-1.67), and living in the Southern province (OR: 1.45, 95% CI: 1.11-1.89) or in the Eastern province (OR: 1.41, 95% CI: 1.06-1.88). CONCLUSION Anemia continues to pose public health challenges; novel public health interventions should consider geographic variations in anemia risk, seek to improve women's economic statuses, and strengthen iron supplementation especially for Intrauterine device users. Additionally, given the association between anemia and malaria, interventions to prevent malaria should be enhanced.
Collapse
Affiliation(s)
- Dieudonne Hakizimana
- Department of Global Health Delivery, University of Global Health Equity, Kigali, Rwanda.
| | - Marie Paul Nisingizwe
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jenae Logan
- Department of Global Health Delivery, University of Global Health Equity, Kigali, Rwanda
| | - Rex Wong
- Department of Global Health Delivery, University of Global Health Equity, Kigali, Rwanda.,School of Public Health, Yale University, New Haven, CT, USA
| |
Collapse
|
41
|
Abubakari SW, Bawah AA, Nettey EO, Apraku EA, Zandoh C, Amenga-Etego S, Asante KP, Owusu-Agyei S, Badasu DM. Potential gains in reproductive-aged life expectancy if maternal mortality were eradicated from the Kintampo districts of Central Ghana. BMC Pregnancy Childbirth 2019; 19:374. [PMID: 31646980 DOI: 10.1186/s12884-019-2515-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/20/2019] [Indexed: 11/30/2022] Open
Abstract
Background Almost 99% of pregnancy or childbirth-related complications globally is estimated to occur in developing regions. Yet, little is known about the demographic impact of maternal causes of death (COD) in low-and middle-income countries. Assuming that critical interventions were implemented such that maternal mortality is eradicated as a major cause of death, how would it translate to improved longevity for reproductive-aged women in the Kintampo districts of Ghana? Methods The study used longitudinal health and demographic surveillance data from the Kintampo districts to assess the effect of hypothetically eradicating maternal COD on reproductive-aged life expectancy by applying multiple decrement and associated single decrement life table techniques. Results According to the results, on the average, women would have lived an additional 4.4 years in their reproductive age if maternal mortality were eradicated as a cause of death, rising from an average of 28.7 years lived during the 2005-2014 period to 33.1 years assuming that maternal mortality was eradicated. The age patterns of maternal-related mortality and all-cause mortality depict that the maternal-related mortality is different from the all-cause mortality for women of reproductive age. Conclusion This observation suggests that other COD are competing with maternal mortality among the WRA in the study area and during the study period.
Collapse
|
42
|
Lu J, Cai J, Ren T, Wu J, Mao D, Li W, Zhang Y, Piao J, Wang J, Yang L, Yang X, Ma Y. Physiological requirements for iron in women of reproductive age assessed by the stable isotope tracer technique. Nutr Metab (Lond) 2019; 16:55. [PMID: 31452667 PMCID: PMC6701013 DOI: 10.1186/s12986-019-0384-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/12/2019] [Indexed: 12/03/2022] Open
Abstract
Background Iron nutrition is important for the health of women of reproductive age, and defining the physiologic requirement for iron can help them accurately plan the iron intake. However, research on the physiologic requirement for iron in women is insufficient worldwide. This study aimed to further improve the methodology and get more precise data for the physiological requirements for iron in women of reproductive age on the basis of our previous study. Method Sixty-one women of reproductive age who had not been pregnant before and during the whole study were included from Hebei province, China in 2015. Each subject participated in a 2-week metabolic trial with consuming 50 mg of the stable isotope 58Fe, and were then followed for ~ 800 days. The abundance of 58Fe and the total iron concentration in the circulation were measured using multi-collector inductively-coupled plasma mass spectrometry and atomic absorption spectroscopy. The physiologic requirement for iron in women of reproductive age was then calculated. Results The average iron circulation rate was 80.4%, and the steady period started from about 1 year. The average physiological requirement for iron of 21 subjects obtained by formula calculation was 1.55 mg/d and 23.63 μg.kg− 1.d− 1 after adjustment for body mass, and that of 33 subjects obtained by linear regression was 1.29 mg/d, 20.98 μg.kg− 1.d− 1 after adjustment for body mass. The results by two methods showed no significant difference. The EAR and RNI calculated from this results was 11–13 mg/d and 15–18 mg/d, respectively, both of which were slightly lower than the recommended value in Chinese Dietary Reference Intake (2013). Conclusion The physiological requirements for iron in women of reproductive age were in accordance with other studies, while the EAR and RNI calculated from which were slightly lower than Chinese present recommended value. Trial registration ChiCTR, ChiCTR-OCH-14004302. Registered 14 February 2014, http://www.chictr.org.cn/enindex.aspx Electronic supplementary material The online version of this article (10.1186/s12986-019-0384-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Jiaxi Lu
- 1The Key Laboratory of Trace Element Nutrition of The Ministry of Health, National Institute for Nutrition and Health, Chinese center for disease control and prevention, 29 Nan Wei Road, Xicheng District, Beijing, 100050 People's Republic of China
| | - Jie Cai
- 2Hospital Management Institute, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, Hubei 430071 People's Republic of China
| | - Tongxiang Ren
- National Institute of Metrology, National Research Center for Certified Reference Material, No.18, Bei San Huan Dong Lu, Chaoyang District, Beijing, 10050 People's Republic of China
| | - Jinghuan Wu
- 1The Key Laboratory of Trace Element Nutrition of The Ministry of Health, National Institute for Nutrition and Health, Chinese center for disease control and prevention, 29 Nan Wei Road, Xicheng District, Beijing, 100050 People's Republic of China
| | - Deqian Mao
- 1The Key Laboratory of Trace Element Nutrition of The Ministry of Health, National Institute for Nutrition and Health, Chinese center for disease control and prevention, 29 Nan Wei Road, Xicheng District, Beijing, 100050 People's Republic of China
| | - Weidong Li
- 1The Key Laboratory of Trace Element Nutrition of The Ministry of Health, National Institute for Nutrition and Health, Chinese center for disease control and prevention, 29 Nan Wei Road, Xicheng District, Beijing, 100050 People's Republic of China
| | - Yu Zhang
- 1The Key Laboratory of Trace Element Nutrition of The Ministry of Health, National Institute for Nutrition and Health, Chinese center for disease control and prevention, 29 Nan Wei Road, Xicheng District, Beijing, 100050 People's Republic of China
| | - Jianhua Piao
- 1The Key Laboratory of Trace Element Nutrition of The Ministry of Health, National Institute for Nutrition and Health, Chinese center for disease control and prevention, 29 Nan Wei Road, Xicheng District, Beijing, 100050 People's Republic of China
| | - Jun Wang
- National Institute of Metrology, National Research Center for Certified Reference Material, No.18, Bei San Huan Dong Lu, Chaoyang District, Beijing, 10050 People's Republic of China
| | - Lichen Yang
- 1The Key Laboratory of Trace Element Nutrition of The Ministry of Health, National Institute for Nutrition and Health, Chinese center for disease control and prevention, 29 Nan Wei Road, Xicheng District, Beijing, 100050 People's Republic of China
| | - Xiaoguang Yang
- 1The Key Laboratory of Trace Element Nutrition of The Ministry of Health, National Institute for Nutrition and Health, Chinese center for disease control and prevention, 29 Nan Wei Road, Xicheng District, Beijing, 100050 People's Republic of China
| | - Yuxia Ma
- 4Hebei Medical University, 361 Zhongshan East Road, Shijiazhuang, Hebei 050017 People's Republic of China
| |
Collapse
|
43
|
Vijayakumar TM, Priyadharshini A, Ahalya SP, Lakshmi KS, Muthunarayanan L, Rama S. Effect of Hemocare Syrup and Hemocare XT Tablets on Hemoglobin levels in iron deficiency anemia among women of reproductive age: A randomized, placebo controlled, open label trial. Contemp Clin Trials Commun 2019; 15:100425. [PMID: 31384693 DOI: 10.1016/j.conctc.2019.100425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/03/2019] [Accepted: 07/22/2019] [Indexed: 11/24/2022] Open
Abstract
Background Iron deficiency anemia is one of the important public health problems in developing countries among the women of reproductive age group. Hemocare formulation plays a significant role in Iron deficiency anemia because of its Iron content. The present study aimed to investigate the effect of Hemocare Syrup and Hemocare XT Tablets compared with placebo on Hemoglobin Levels in Iron Deficiency Anemia among Women of Reproductive Age. Methods A prospective, interventional, randomized, open label, placebo controlled trial has been conducted with 126 patients. Eligible patients randomly received either Placebo 100 mg or Hemocare XT Tablet 100 mg or 10 ml of Hemocare Syrup once daily in the same manner for 4 weeks. Hemoglobin values were documented at the end of 15th day, 21st day and 30th day. Results The baseline hemoglobin values were compared with each follow up and statistically significant difference was found at the end of 30th day of Hemocare Syrup and Hemocare XT treatment (P < 0.05) but there was no significant difference observed in the placebo group. The study results revealed that 30 days treatment of Hemocare Syrup and Hemocare XT Tablets increases the Hemoglobin levels to 12.46 ± 0.44 g/dl and 12.90 ± 0.98 g/dl from 9.08 ± 2.54 g/dl and 9.68 ± 2.04 g/dl respectively. Conclusion Hemocare Syrup and Hemocare XT Tablets treatment showed clinically significant improvement in hemoglobin levels from the baseline and placebo group.
Collapse
|
44
|
Yaya S, Ghose B. Trend in overweight and obesity among women of reproductive age in Uganda: 1995-2016. Obes Sci Pract 2019; 5:312-323. [PMID: 31452916 PMCID: PMC6700515 DOI: 10.1002/osp4.351] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 12/28/2022] Open
Abstract
Countries in Sub-Saharan Africa (SSA) are experiencing rising burdens of overweight/obesity and associated non-communicable diseases. As in other developing regions, this epidemiological transition in African countries is believed to be resulting from changes in dietary, sociodemographic structure and lifestyle factors. To date, not much is known about the prevalence and sociodemographic patterns of overweight/obesity in Uganda, especially among women of reproductive age. Therefore, this study aimed to address this research gap by using nationally representative data on women of this age group in Uganda. METHODS This study involved analysis of cross-sectional data on 19,395 women aged between 15 and 49 years from Uganda Demographic and Health Survey for the years 1995-2016. Overweight/obesity was measured using body mass index as per World Health Organization guidelines, and logistic regression methods were used to identify the sociodemographic predictors. RESULTS There has a been significant rise in the prevalence of overweight (9.77% in 1995 vs. 16.21% in 2016) and obesity (1.99% in 1995 vs. 6.21% in 2016) since the first survey in 1995, with the most noticeable increase occurring in the central region that accounted for a combined prevalence of 17.22% in 1995 compared with 37. 21% in 2016. Multivariate analysis showed an increased likelihood of having overweight/obesity among women who live in the urban areas, have primary and above primary education, from non-poor households and users of radio and TV. CONCLUSION During the last two decades, there has been a slow but steady rise in the prevalence of overweight and obesity among women of reproductive age in Uganda. The present findings highlight the need for an enhanced attention on growing overweight/obesity within the broader goal improving maternal and child health in the country.
Collapse
Affiliation(s)
- S. Yaya
- Faculté de MédecineUniversité de ParakouParakouBenin
| | - B. Ghose
- Institute of Nutrition and Food ScienceUniversity of DhakaDhakaBangladesh
| |
Collapse
|
45
|
Abstract
Objective To examine changes in the prevalence and odds of unmet healthcare needs and healthcare utilization among low-income women of reproductive age (WRA) after Ohio's 2014, ACA-associated Medicaid expansion, which extended coverage to non-senior adults with a family income ≤ 138% of the federal poverty level. Methods We analyzed publically available data from the 2012 and 2015 Ohio Medicaid Assessment Survey (OMAS), a cross-sectional telephone survey of Ohio's non-institutionalized adult population. The study included 489 low-income women in 2012 and 1273 in 2015 aged 19-44 years who were newly eligible for Medicaid after expansion in January 2014. Four unmet healthcare need and three healthcare utilization measures were examined. We fit survey-weighted logistic regression models adjusted for race/ethnicity, working status, and educational attainment to determine whether the odds of each measure differed between 2012 and 2015. Results In 2015, low-income WRA had a significantly lower odds of reporting an unmet dental care need (ORadj = 0.72, 95% CI 0.54, 0.95), unmet vision care need (ORadj = 0.68, 95% CI 0.50, 0.93), unmet mental health need (ORadj = 0.57, 95% CI 0.39, 0.83), and unmet prescription need (ORadj = 0.39, 95% CI 0.45, 0.80) compared to 2012. There were no significant differences in the odds of seeing a doctor or dentist in the past year or of having a usual source of care for low-income WRA in 2012 and 2015. Conclusions for Practice After Ohio's 2014 Medicaid expansion the odds of low-income WRA having unmet healthcare needs was reduced. Future research should examine outcomes after a longer period of follow-up and include additional measures, such as self-rated health status.
Collapse
Affiliation(s)
- Thalia P Farietta
- Center for Outcomes Research and Evaluation, Yale University, 1 Church Street #200, New Haven, CT, 06510, USA
| | - Bo Lu
- The Ohio State University College of Public Health, 244 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43210, USA
| | - Rachel Tumin
- Ohio Colleges of Medicine Government Resource Center, 150 Pressey Hall, 1070 Carmack Road, Columbus, OH, 43210, USA.
| |
Collapse
|
46
|
Dijkhuizen MA, Greffeille V, Roos N, Berger J, Wieringa FT. Interventions to Improve Micronutrient Status of Women of Reproductive Age in Southeast Asia: A Narrative Review on What Works, What Might Work, and What Doesn't Work. Matern Child Health J 2019; 23:18-28. [PMID: 30357535 DOI: 10.1007/s10995-018-2637-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives To provide an overview of nutrition-specific and nutrition-sensitive interventions that could improve micronutrient status of women of reproductive age. Methods This narrative review has a special focus on Southeast Asia, as the work was undertaken within the framework of the SMILING (Sustainable Micronutrient Interventions to controL deficiencies and Improve Nutrition status and General health in Southeast Asia) project. Results In order for new interventions to become accepted, comprehension and interpretation of potential impact of different strategies by policymakers and non-nutritionists is needed. By presenting a wide overview of strategies, and discussing the context and current consensus on these strategies, the review aims to help with the formulation of new recommendations for national programs in Southeast Asia. Conclusions Current policies in Southeast Asia to improve micronutrient status of women of reproductive age are focused too much on single micronutrient supplementation for pregnant women (iron and folic acid supplements). A more holistic approach, including both nutrition-specific and nutrition-sensitive interventions, is needed.
Collapse
|
47
|
Aziz Ali S, Abbasi Z, Feroz A, Hambidge KM, Krebs NF, Westcott JE, Saleem S. Factors associated with anemia among women of the reproductive age group in Thatta district: study protocol. Reprod Health 2019; 16:34. [PMID: 30885226 PMCID: PMC6423857 DOI: 10.1186/s12978-019-0688-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 02/15/2019] [Indexed: 01/01/2023] Open
Abstract
Background Maternal anemia is a leading public health issue placing pregnant women at higher risk of low birth weight, preterm birth, perinatal mortality, and neonatal mortality. Women in developing countries are at higher risk of anemia which could be either due to micronutrient deficiencies, hemoglobinopathies, infections or other socio-demographic factors. Thus, it is highly essential to explore the factors of anemia among women of the reproductive age group in order to design suitable interventions. The primary objective of this study is to assess the biological and socio-demographic factors that are associated with anemia among the women of the reproductive age group in Thatta district. Methods An exploratory mixed method study using quantitative and qualitative approaches will be conducted in district Thatta Pakistan from September 2018 to January 2019. In the qualitative phase, data will be collected through focus group discussions and key informant interviews to understand the perceptions of women, their husbands and healthcare providers about anemia. In addition, a quantitative approach using cross-sectional study will be conducted to determine biological and socio-demographic factors associated with anemia. Approximately 150 non-pregnant women and their spouses will be included in the quantitative component of the study. In addition to thematic analysis for the qualitative component, Logistic regression will be done to calculate adjusted Odds ratios with their respective 95% CIs to assess the factors associated with anemia. Discussion The better understanding of biological, socio-demographic factors and community perceptions of anemia will help us to design strategies and interventions to better address anemia during the reproductive cycle in rural areas of Pakistan. This will help the researchers and policymakers to take the appropriate action accordingly by designing suitable approaches to address the specific type of anemia in the rural population of Pakistan. This will, in turn, reduce the chances of adverse maternal and fetal outcomes associated with anemia.
Collapse
Affiliation(s)
- Sumera Aziz Ali
- Department of Community Health Sciences, The Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan
| | - Zahid Abbasi
- Department of Community Health Sciences, The Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan
| | - Anam Feroz
- Department of Community Health Sciences, The Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan.
| | - K Michael Hambidge
- University of Colorado School of Medicine, 12700 E 19th Ave.; Research Complex 2, Rm 5025, Box C225, Aurora, CO, 80045, USA
| | - Nancy F Krebs
- University of Colorado School of Medicine, 12700 E 19th Ave.; Research Complex 2, Rm 5025, Box C225, Aurora, CO, 80045, USA
| | - Jamie E Westcott
- University of Colorado School of Medicine, 12700 E 19th Ave.; Research Complex 2, Rm 5025, Box C225, Aurora, CO, 80045, USA
| | - Sarah Saleem
- Department of Community Health Sciences, The Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan
| |
Collapse
|
48
|
Abstract
Iodine, an essential micronutrient, is required to produce thyroid hormones. Iodine deficiency disorders (IDD) comprise a range of adverse maternal and fetal outcomes, with the most significant irreversible effect resulting from neurodevelopmental deficits in fetal brain caused by deficient iodine status during early pregnancy. The objective of this scoping review was to summarize the studies that assessed iodine status of women of reproductive age in the USA. A systematic review of literature using the PRISMA Extension for Scoping Reviews (PRISMA-ScR) statement was conducted. PubMed, Medline, CINAHL, EMBASE, EBSCOHost, Cochrane, ERIC, Google Scholar, and Web of Science databases were searched, 1652 records were identified. One thousand six hundred forty-one records that did not satisfy the inclusion/exclusion criteria and quality review were excluded, and 11 peer-reviewed articles were determined to be eligible for this scoping review. Despite the USA being considered iodine sufficient for the general population, the US dietary iodine intakes have decreased drastically since the 1970s, with iodine deficiency reemerging in vulnerable groups such as women of reproductive age. Although data to conduct a scoping review of iodine status among women of reproductive age in the USA was scarce, majority of the articles reviewed demonstrate emergent iodine deficiency in this population of women of reproductive age, indicating alarm for a public health concern needing immediate attention.
Collapse
Affiliation(s)
- Pallavi Panth
- Department of Nutrition and Food Sciences, College of Health Sciences, Texas Woman's University, P.O. Box 425888, Denton, TX, 76204-5876, USA.
- Institute for Women's Health, College of Health Sciences, Texas Woman's University, Denton, TX, 76204-5876, USA.
| | - Gena Guerin
- Department of Kinesiology, College of Health Sciences, Texas Woman's University, Denton, TX, 76204-5876, USA
| | - Nancy M DiMarco
- Department of Nutrition and Food Sciences, College of Health Sciences, Texas Woman's University, P.O. Box 425888, Denton, TX, 76204-5876, USA.
- Institute for Women's Health, College of Health Sciences, Texas Woman's University, Denton, TX, 76204-5876, USA.
| |
Collapse
|
49
|
Houngbe F, Tonguet-Papucci A, Nago E, Gauny J, Ait-Aïssa M, Huneau JF, Kolsteren P, Huybregts L. Effects of multiannual, seasonal unconditional cash transfers on food security and dietary diversity in rural Burkina Faso: the Moderate Acute Malnutrition Out (MAM'Out) cluster-randomized controlled trial. Public Health Nutr 2019; 22:1089-99. [PMID: 30561287 DOI: 10.1017/S1368980018003452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the impact of multiannual, seasonal unconditional cash transfers (UCT) provided within the Moderate Acute Malnutrition Out (MAM'Out) research project on households' food security and children's and caregivers' dietary diversity. DESIGN A two-arm cluster-randomized controlled trial with sixteen villages in the intervention group and sixteen others in the control group. A monthly allowance of 10 000 XOF was transferred to caregivers of eligible children via a personal mobile phone account from July to November 2013 and 2014. SETTING Tapoa province in the eastern region of Burkina Faso. PARTICIPANTS Data on household food access (monthly adequate household food provisioning (MAHFP); household food insecurity access scale (HFIAS)) and maternal and child dietary diversity were analysed for 1143 households, 1219 caregivers of reproductive age (15-49 years) and 1247 under-5 children from both intervention and control groups. RESULTS The mean women dietary diversity score in intervention caregivers and the mean dietary diversity score (DDS) in intervention children with inadequate minimum DDS at baseline were respectively 7 % (95 % CI 2, 11 %; P = 0·002) and 17 % (95 % CI 11, 23 %; P <0·001) higher compared with the control group. However, no difference was found in the intervention effect on household food security measured with HFIAS (relative risk = 1·03; 95 % CI 0·92, 1·15; P = 0·565) and MAHFP (relative risk = 0·98; 95 % CI 0·96, 1·01; P = 0·426). CONCLUSIONS Multiannual, seasonalUCT increased dietary diversity in children and their caregivers. They can be recommended in actions aiming to improve maternal and child diet diversity.
Collapse
|
50
|
Mochache V, Lakhani A, El-Busaidy H, Temmerman M, Gichangi P. Correlates of facility-based delivery among women of reproductive age from the Digo community residing in Kwale, Kenya. BMC Res Notes 2018; 11:715. [PMID: 30305159 PMCID: PMC6180567 DOI: 10.1186/s13104-018-3818-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/03/2018] [Indexed: 11/10/2022] Open
Abstract
Objective This study sought to describe factors associated with facility-based delivery among women of reproductive age in Kwale County, Kenya. Results Between March and December 2015, 745 women from 15 villages were interviewed through a cross-sectional household survey. Respondents were selected using stratified, systematic sampling and completed a sexual and reproductive health questionnaire. Of 632 (85%) women who had a previous birth, 619 (98%) reported antenatal care attendance. Of these, 491 (79%) subsequently had a facility-based delivery. Factors associated with increased likelihood of facility delivery included respondent’s education (odds ratio, OR = 2.0, 95% confidence interval, CI 1.2–3.2, P = 0.004), ideal antenatal care attendance (OR = 2.3, 95% CI 1.4–3.7, P = 0.001) and pregnancy intention (OR = 1.5, 95% CI 1.0–2.2, P = 0.040). Being in a polygamous relationship (OR = 0.6, 95% CI 0.3–0.9, P = 0.024) and having a husband ≥ 40 years (OR = 0.5, 95% CI 0.3–0.9, P = 0.013) were associated with reduced likelihood of facility delivery. Respondent’s education (aOR = 1.9, 95% CI 1.1–3.3, P = 0.030) as well as ideal ANC attendance (aOR = 2.0, 95% CI 1.0–3.8, P = 0.040) remained significantly associated with facility delivery in multivariate analyses. Electronic supplementary material The online version of this article (10.1186/s13104-018-3818-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Vernon Mochache
- International Centre for Reproductive Health, P.O. Box 91109-80103, Mombasa, Kenya. .,University of Ghent, Ghent, Belgium.
| | - Amyn Lakhani
- Community Health Department, Aga Khan University, Mombasa, Kenya
| | | | - Marleen Temmerman
- International Centre for Reproductive Health, P.O. Box 91109-80103, Mombasa, Kenya.,University of Ghent, Ghent, Belgium.,Community Health Department, Aga Khan University, Mombasa, Kenya
| | - Peter Gichangi
- International Centre for Reproductive Health, P.O. Box 91109-80103, Mombasa, Kenya.,University of Ghent, Ghent, Belgium.,University of Nairobi, Nairobi, Kenya
| |
Collapse
|