Dietary Supplements Intake During Pregnancy Among Pregnant Women in Ethiopia

Introduction

Pregnant women are expected to take one or more dietary supplements (DS) like iron, folic acid, zinc, calcium, magnesium, prenatal vitamins, etc. for maternal and child health during pregnancy. Despite its growing use in Ethiopia, data concerning currently marketed maternal DS products have not been intensively investigated so far. Taking into consideration the existing problem, this study was set out to assess the prevalence and commonly used DS during pregnancy in a referral hospital in Ethiopia.

Methods

A facility based cross-sectional study was employed to conduct this study from November 2020 to January 2021. The sample size was obtained by using the single population proportion formula and participants were selected and approached by using a systematic random sampling technique. Data were collected through a semi-structured interviewer-administered questionnaire. Descriptive statistics including frequencies and percentages were used to describe continuous and categorical variables and multivariate logistic regression was used to observe the association of the independent variables to the dependent variable.

Results

The overall prevalence of DS use was 84.2% and the most used product was Fefol (iron and folate supplement) (62.4%). A majority (87.8%) of DS products were obtained by prescription. In multivariate regression analysis, DS use during pregnancy was significant among nulliparous women and women who went to college and above [adjusted odds ratio (AOR): 8.142, 95% confidence interval (CI) (1.298-51.070)] and [AOR: 9.259, 95% CI (1.998-42.906)], respectively.

Conclusion

Even though the prevalence of DS practice showed improvement among the study participants, the duration of the DS intake is less than that recommended by the WHO. Pregnant women who did not have birth before and who went to college or above showed significant association with the use of DS.

Pelvic Floor Disorders and Pelvic Floor Muscle Exercise: A Survey on Knowledge, Attitude, and Practice among Pregnant Women in Northwest Ethiopia

The purpose of the study was to investigate 1: overall knowledge of pelvic organ prolapse (POP) and urinary incontinence (UI) as well as knowledge, attitudes, and practice of pelvic floor muscle exercise (PFME); and 2: the association of these factors with parity in pregnant women in Gondar, Ethiopia. A facility-based cross-sectional study was performed in the Central Gondar zone, northwest Ethiopia between February and April 2021. The associations between parity and knowledge of POP and UI, and knowledge, attitude, and practice towards PFME were estimated using logistics regression models and presented as crude and adjusted odds ratios with 95% confidence intervals. Nulliparous women were used as the reference. Adjustments were made for maternal age, antenatal care visits, and level of education. The study sample comprised 502 pregnant women: 133 nulliparous, and 369 multiparous. We found no association between parity and knowledge of POP, UI, or knowledge, attitude, and practice toward PFME. The sum score indicated poor knowledge about both POP, UI, and PFME in the study population, and poor attitude and practice of PFME. Despite a high attendance in antenatal care services, knowledge, attitude, and practice were poor, indicating a need for quality improvement of the services.

Prevalence of sexual violence and associated factors among women attending antenatal care in Debre Markos at public health institutions in north-west Ethiopia, 2021

Background

Sexual violence refers to being forced to perform any unwanted sexual act. Due to the negative effects on both the mother and the fetus, sexual assault during pregnancy is a public health concern. Knowing the prevalence of sexual violence during pregnancy helps policymakers understand the extent of the problem and can be considered the first step toward implementing interventions for prevention and treatment. This study was done to determine the prevalence of sexual violence and its associated factors during pregnancy in public hospitals in Debre Markos.

Methods

An institution-based cross-sectional study was conducted among 306 pregnant women in Debre Markos, north west Ethiopia from May 1 to June 30, 2021, 2021. A systematic random sampling procedure was used to select study participants. Data were collected using a structured and interviewer-administered questionnaire, and a pre-test was done. Both bi-variable and multivariable logistic regression analyses were undertaken to identify significantly associated variables with sexual violence. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a p-value of ≤ 0.05 was used to claim statistical association.

Results

There were 304 interviewed respondents with a response rate of 99.3%. In this study, the overall prevalence of sexual violence among pregnant mothers during the current pregnancy was 19.4%. A husband who had no formal education {AOR = 3.48; 95% CI: 1.06, 11.39}, pregnant mothers who had no formal education {AOR =  6.1; 95% CI: 1.50-18.11}, pregnant mothers who had secondary education {AOR = 2.80, 95% CI: 1.15, 6.81}, being a housewife {AOR = 3.87, 95 CI:1.21, 12.37}, and being a governmental employee {AOR = 4.49, 95% CI: 1.22, 16.40} were factors associated with sexual violence at the value of p ≤ 0.05.

Conclusions and recommendations

In this study, approximately one-fifth of the study participants experienced sexual violence during their current pregnancy. To reduce this, interventions should focus on the education of women as well as their partner about violence against women and on initiatives to economically empower women.

COVID-19 vaccine acceptance and associated factors among women attending antenatal and postnatal cares in Central Gondar Zone public hospitals, Northwest Ethiopia

Introduction

The Coronavirus disease 2019 pandemic is a public health problem, which caused a major impact on morbidity and mortality around the world. Even though an effective vaccine is the most awaited resolution for the pandemic, little is known about COVID-19 vaccine acceptance in Ethiopia. This study aimed to assess vaccine acceptance and its associated factors among pregnant and postnatal mothers.

Method

Institution-based cross-sectional study was conducted on 527 pregnant and postnatal mothers from August 15 to September 15, 2021. Data were collected using an interviewer-administered structured questionnaire. A systematic random sampling technique was used to select the study participants. Epi-Data version 4.6 and Stata 16 software were used for data entry and analysis respectively. Participant characteristics and rate of vaccine acceptance were presented using descriptive statistics. Multi-variable logistic regression was performed to identify statistically significant variables. Adjusted odds ratio with 95% confidence interval was used to declare statistical significance based on p < 0.05 in the multivariable logistic regression model.

Result

The overall prevalence of intent to accept COVID-19 vaccine was 62.04% (95% CI: 57.65, 66.25). Of those 40.08% were pregnant mothers and 21.97% of them were postpartum mothers. Urban residence (AOR = 2.03, 95% CI: 1.09–3.77), respondents who were worry about COVID-19 disease (AOR = 3.46, 95% CI: 2.16–5.52), and participants who had favorable attitude towards vaccine (AOR = 8.54, 95% CI: 5.18–14.08) were significantly associated with COVID-19 vaccine acceptance.

Conclusion

Our findings showed that the willingness to accept COVID-19 vaccination was low. Residence, worry about COVID-19 disease, and attitudes towards vaccine were factors significantly associated with COVID-19 vaccine acceptance. Evidence-based and clear information on COVID-19 vaccines should be provided to pregnant and postnatal mothers for both rural and urban residences to improve attitude towards the COVID-19 vaccine and increase vaccination rates.

Prevalence and associated factors of pelvic organ prolapse among women attending gynecologic clinic in referral hospitals of Amhara Regional State, Ethiopia

INTRODUCTION AND HYPOTHESIS

While pelvic organ prolapse is common in clinical observation, there is a lack of evidence regarding its actual proportion and associated factors in the study area. Understanding the prevalence and risk factors could potentially help with prevention. Thus, this study aimed to determine the prevalence and associated factors related to pelvic organ prolapse in the Amhara region, northwest Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted among 424 women, recruited by the systematic random sampling technique. Data were collected in a face-to-face interview using a structured and pre-tested questionnaire to assess the symptoms of pelvic organ prolapse and the socio-demographic, obstetric, gynecologic, medical and surgical characteristics. The stage of prolapse was determined by pelvic examination using the Simplified Pelvic Organ Prolapse Quantification staging system. Descriptive statistics and logistic regression analyses were employed.

RESULTS

The overall prevalence of pelvic organ prolapse (stage I-IV) was found to be 37.6% when determined by pelvic examination and 9.2% as assessed by prolapse symptoms. Age ≥ 40 years [AOR 2.46 (1.320, 5.314)], age at first delivery ≤ 20 years [AOR 4.719 (2.44, 9.11)], carrying heavy objects for ≥ 5 hours a day [AOR 12.724 (4.89, 33.07)], parity ≥ 4 [AOR 3.739 (1.693, 8.208)], prolonged labor [AOR 3.487 (1.699, 7.159)], constipation [AOR 2.835 (1.273, 6.317)] and anemia [AOR 2.22 (1.049, 4.694)] were significantly associated with pelvic organ prolapse.

CONCLUSION

Prevalence of pelvic organ prolapse is high in the area; thus, developing information and education programs on avoiding risk factors is advisable to reduce the problem.

Risk factors of precancerous cervical lesions: The role of women's socio-demographic, sexual behavior and body mass index in Amhara region referral hospitals; case-control study

BACKGROUND

Cervical cancer remains one of the major public health challenges in low and middle-income countries including Ethiopia. There was a scarce of evidence regarding the effect of woman's socio-demographic characteristics and body mass index on the development of precancerous cervical lesions in Ethiopia. Therefore, the current study aimed at identifying the risk factors of precancerous cervical lesions among women visiting referral hospitals for cervical cancer screening in Amhara national regional state.

METHODS

A hospital-based case-control study was conducted from 22 December 2019 to 8 April 2020 among 200 women including 67 visual inspections with acetic acid (VIA) positive women (i.e., cases) and 133 visual inspections with acetic acid (VIA) negative women (i.e., controls). The study was conducted at randomly selected referral hospitals in Amhara national regional state. Data were collected mainly through face to face interview and chart review using structured questionnaire and checklist respectively. Data were then entered to EpiData version 4.6 and exported to SPSS version 25 for analysis. Binary logistic regression model was fitted and variables with p-value of < 0.2 at bivariable logistic regression analysis were candidates for the multivariable analysis. Level of significance was claimed based on adjusted odds ratio (AOR) with 95% confidence interval (CI) at p-value of ≤ 0.05.

RESULTS

This study illustrates that the odds of being positive for precancerous cervical lesion (PCL) were higher among women who had body mass index (BMI) of <18.5 kg/m2 (AOR = 3.83; 95% CI: 1.26, 8.76), early coitarche (AOR = 3.15; 95% CI: 1.50, 11.49, history of using oral contraceptive pills (AOR = 2.74; 95% CI: 1.6, 7.4), lifetime sexual transmitted infections (AOR = 3.73; 95% CI: 2.5, 12.28) and multiple sexual partners (AOR = 3.23; 95% CI: 1.82, 9.29). On the other hand, participants' BMI of ≥25 kg/m2 (AOR = 0.46; 95% CI: 0.36, 0.75) and level of education of college and above (AOR = 0.29; 95% CI: 0.23, 0.77) were identified to be protective factors of PCL.

CONCLUSION

Most of the determinants of precancerous cervical lesions were modifiable and mainly related to women's socio-demographic characteristics, sexual behaviors and body mass index. Therefore, strengthening awareness on safe sexual practices and healthy life styles through information, education and communication (IEC), and behavioral change communication (BCC) would decrease the incidence of precancerous cervical lesions.