Background: Kangaroo Mother Care is a simple safe method used to care for low-birth-weight babies. Low-birth-weight is a global public health issue that pose significant challenge to perinatal care systems. Globally, ...Background: Kangaroo Mother Care is a simple safe method used to care for low-birth-weight babies. Low-birth-weight is a global public health issue that pose significant challenge to perinatal care systems. Globally, complications due to low-birth-weight are the leading cause of neonatal mortality, resulting in an estimated 1 million deaths annually. Kangaroo Mother Care (KMC) is a low-cost method of care for low-birth-weight infants in areas with inadequate incubators and power outages with positive outcomes. Objectives: To assess factors influencing acceptability of Kangaroo Mother Care (KMC) in NICU at Arthur Davison Children’s Hospital in Ndola, Zambia. Methodology: A cross sectional quantitative analytical study design was used. The study was conducted at Arthur Davison Children’s Hospital (ADCH) in Ndola, Zambia. The purposive sampling method was used to select the study participants and a total of 129 mothers with Low Weight Babies A were selected to participate structured closed ended questionnaire was used to collect data from the participants using an interview. Data was analyzed using a Statistical Package for Social Scientists (SPSS) software version 26. Cross tabulations were done to determine association of variables using a Chi square (x<sup>2</sup>) test at 95% confidence interval and were assumptions where not met, fishers exact test was used. Multivariate binary logistic regression analysis was used to quantify the relationship between the dependent and independent variables. Results: Most of the respondents had male babies 77%, 69% of the babies weighed 1000 g - 1400 g, majority 79% had normal delivery, 71% of the respondents were multigravida and most of the respondents 79% were married. The study reviewed that 85% of those who attained secondary education accepted KMC, 74% of the respondents without monthly income accepted KMC, 80% of the respondents had positive attitude and accepted KMC. 82% of the respondents who had positive perception accepted KMC. Conclusion: Acceptance of Kangaroo Mother Care (KMC) among 75% of the mothers underscores its widespread favourability as a beneficial method for infant care.展开更多
Background: Poor birth outcomes are common health problems everywhere in the world. Hence institutional delivery in Ethiopia is very low, improving birth outcomes through recent evidence remained critical. The objecti...Background: Poor birth outcomes are common health problems everywhere in the world. Hence institutional delivery in Ethiopia is very low, improving birth outcomes through recent evidence remained critical. The objective of the study was to determine the prevalence of poor birth outcomes and associated factors among women who delivered in selected health facilities of North Wollo Zone. Methods: A facility based cross-sectional survey was conducted on 295 laboring mothers from May to June 2009. Interviewer administered questionnaire was used to collect the data. Patient’s chart was reviewed to retrieve medical information. Anthropometry of the neonate was taken by standard measurement tools. Data were analyzed using statistical package for social sciences (SPSS), version 15. Binary logistic regression analyses were used to identify predictors of poor birth outcomes. P-value ≤ 0.05 was considered statistically significant. Results: All the data resulted from 295 laboring mothers were made part of the analyses. A total of 266 (90.2%) laboring mothers gave live birth. A quarter, 68 (23.1%) of the laboring mothers had a poor birth outcome. The common adverse outcomes were intrauterine fetal death (IUFD, preterm, and birth defects with the proportion of 29 (42.6%), 22 (32.4%), and 3 (4.4%), respectively). Mother whose husband’s occupation was merchant (AOR = 4.4, 95% CI: 1.0-19.0), driver (AOR = 4.2, 95% CI: 1.12-15.76), & women who were illiterate (AOR = 4.0, 95% CI: 1.2-13.5), primary school completed (AOR = 4.3, 95% CI: 1.3-13.8), non-antenatal care visited (AOR = 3.4, 95% CI: 1.12-10.2), rural residence, (AOR = 2.6, 95% CI: 1.11-5.80), & mother’s HIV status, (AOR = 34.2, 95% CL 5.6, 207.0) were independent predictors of poor birth outcomes. Conclusions: Poor birth outcomes were very common in the study area where low birth weight accounted for much of all adverse pregnancy outcomes. Occupation, residence, antenatal care visit, income, maternal education and HIV status were determinants of poor birth outcomes. Accessing antenatal care in early trimester, mild physical work, maternal education to secondary level and above should be encouraged.展开更多
Background: It is yet a controversy subject whether low birth weight and infant death are associated to human immunodeficiency virus-1 infection. Objective: To appreciate association between low birth weights, mother ...Background: It is yet a controversy subject whether low birth weight and infant death are associated to human immunodeficiency virus-1 infection. Objective: To appreciate association between low birth weights, mother to child HIV transmission and infant mortality in HIV-1 infected pregnant women delivering between 2011 and 2016. Materials: We conducted 6 years cohort study in urban Mali. Outcome included preterm delivery, small for gestational age, infant survival status and HIV transmission. Comparison concerned women clinical WHO stage, mother viro-immunological status, and newborn anthropometric parameters. Results: HIV-1 infected women who delivered low birth weight newborn were 20.9% (111/531) versus 16.5% (1910/11.546) in HIV negative patients (p = 0.016). CD4 T cell counts low than 350 T cells count were strongly associated to LBW (p = 0.000;RR = 3.03;95% CI [1.89 - 3.16]). There is no significant association between ART that was initiated during pregnancy (p = 0.061, RR = 0.02;CI 95% (1.02 - 1.99)) or during delivery (p = 0.571;RR = 1.01;CI 95% (0.10 - 3.02)) and LBW delivery. In multivariate analysis ART regimens containing protease inhibitor (PI) were lone regimens associated with LBW ((p = 0.030;RR = 1.001;95% confidence interval [1.28 - 3.80]). Very low birth weight was statistically associated to women HIV infection (adjusted relative risk, 2.02;p = 0.000;95% confidence interval (2.17 - 4.10)). There is no significant difference between mother to child HIV transmission rate in the two HIV-infected pregnant women (10 infected children in group 2: MTCT rate 4.5%) and 3 infected children in group 1 (MTCT rate: 2.7%) (p = 0.56;RR, 0.59;CI 95% (0.18 - 4.39)). In multivariate analysis, LBW was associated with infant death (p = 0.001;RR = 2.04;CI 95% [1.04 - 5.05]). The median weight of infant at the moment of death in group 1 was 851 g (IQR: 520 - 1833 g). Significant relationship was found between infant death among LBW newborn with mother WHO stage 2 (p = 0.004;adjusted RR = 3.22;CI 95% [2.25 - 6.00]), CD4 T cells count 3 (p = 0.005;RR = 2.81;CI 95% [1.20 - 4.11]), PI regimens (p = 0.030;RR = 1.00;CI 95% [1.28 - 3.80]). Conclusion: We confirm increased risk of low birth weight and mother HIV-1 infection and we identified strongest association between mortality in infant born to HIV-1 infected mother and LBW.展开更多
Background: HIV-positive pregnant women are at an increased risk of adverse pregnancy outcomes. However, data on birth outcome among HIV-infected women are limited in Ethiopia. This study was conducted to identify the...Background: HIV-positive pregnant women are at an increased risk of adverse pregnancy outcomes. However, data on birth outcome among HIV-infected women are limited in Ethiopia. This study was conducted to identify the adverse birth outcomes and associated factors of low birth weight (LBW) and preterm delivery (PD) among HIV-infected women. Methods: A hospital based retrospective cohort study was conducted. All deliveries from HIV-infected women from September 1, 2009 to April 30, 2012 were included in the study. Multivariate logistic regression was performed to explore the potential risk factors for LBW and PD. Result: Out of 416 singleton infants born to HIV-infected mothers, the prevalence of LBW and PD was 89 (21.4%) and 69 (16.6%), respectively. The baseline maternal CD4 counts below 200 cells/mm3, maternal body mass index (BMI) below 18.5, maternal anemia and maternal exposure to Highly Active Antiretroviral Treatment (HAART) were factors significantly associated with LBW. On the other hand, a baseline maternal CD4 level below 200/ mm3, having no Prevention of Mother-to-Child Transmission (PMTCT) intervention during pregnancy, maternal BMI less than 18.5, maternal Eclamsia during pregnancy, and mothers being on HAART before pregnancy were factors associated with preterm delivery. Conclusion: There was a significant prevalence of low birth weight and preterm delivery among infants born to HIV-positive mothers. The programme for PMTCT services should maximize the need for an early identification of those mothers with predicted complications.展开更多
Background: Kangaroo mother care (KMC) is effective in preventing hypothermia, establishing breastfeeding, and reducing nosocomial infection in preterm babies in resource-limited areas. Relatively little is known abou...Background: Kangaroo mother care (KMC) is effective in preventing hypothermia, establishing breastfeeding, and reducing nosocomial infection in preterm babies in resource-limited areas. Relatively little is known about long-term morbidity and mortality outcomes among Ethiopian infants managed with KMC. Aims: To describe the follow up profiles and outcome of infants managed with KMC and discharged alive. Methods: This cross-sectional descriptive study examined outcomes among infants who were 1) managed by KMC at Black Lion Hospital, 2) discharged alive, and 3) available for follow-up. Structured, pretested questionnaires were administered to mothers. Results: Of the 110 infants included in the study, 9.1% died over the study period and 60% of the deaths occurred at home. Mortality was 100% in those babies with mothers aged less than 18 years. Thirty five percent of the deaths occurred in those from rural location. Common medical problems identified in study subjects were respiratory infections (10%), gastroenteritis (7%), rickets (7%), and anemia (6%). About 20% of infants were readmitted to hospital at least once. KMC initiation within one week was not found to be significantly associated with survival, but continued KMC after discharge significantly decreased mortality in our sample. Conclusion: Frequent follow up is very important especially those with teenage mothers and coming from a rural location. Follow up should be frequent in the first 2 months after discharge. Further research is needed to explore the determinants of mortality and morbidity after hospital discharge.展开更多
文摘Background: Kangaroo Mother Care is a simple safe method used to care for low-birth-weight babies. Low-birth-weight is a global public health issue that pose significant challenge to perinatal care systems. Globally, complications due to low-birth-weight are the leading cause of neonatal mortality, resulting in an estimated 1 million deaths annually. Kangaroo Mother Care (KMC) is a low-cost method of care for low-birth-weight infants in areas with inadequate incubators and power outages with positive outcomes. Objectives: To assess factors influencing acceptability of Kangaroo Mother Care (KMC) in NICU at Arthur Davison Children’s Hospital in Ndola, Zambia. Methodology: A cross sectional quantitative analytical study design was used. The study was conducted at Arthur Davison Children’s Hospital (ADCH) in Ndola, Zambia. The purposive sampling method was used to select the study participants and a total of 129 mothers with Low Weight Babies A were selected to participate structured closed ended questionnaire was used to collect data from the participants using an interview. Data was analyzed using a Statistical Package for Social Scientists (SPSS) software version 26. Cross tabulations were done to determine association of variables using a Chi square (x<sup>2</sup>) test at 95% confidence interval and were assumptions where not met, fishers exact test was used. Multivariate binary logistic regression analysis was used to quantify the relationship between the dependent and independent variables. Results: Most of the respondents had male babies 77%, 69% of the babies weighed 1000 g - 1400 g, majority 79% had normal delivery, 71% of the respondents were multigravida and most of the respondents 79% were married. The study reviewed that 85% of those who attained secondary education accepted KMC, 74% of the respondents without monthly income accepted KMC, 80% of the respondents had positive attitude and accepted KMC. 82% of the respondents who had positive perception accepted KMC. Conclusion: Acceptance of Kangaroo Mother Care (KMC) among 75% of the mothers underscores its widespread favourability as a beneficial method for infant care.
文摘Background: Poor birth outcomes are common health problems everywhere in the world. Hence institutional delivery in Ethiopia is very low, improving birth outcomes through recent evidence remained critical. The objective of the study was to determine the prevalence of poor birth outcomes and associated factors among women who delivered in selected health facilities of North Wollo Zone. Methods: A facility based cross-sectional survey was conducted on 295 laboring mothers from May to June 2009. Interviewer administered questionnaire was used to collect the data. Patient’s chart was reviewed to retrieve medical information. Anthropometry of the neonate was taken by standard measurement tools. Data were analyzed using statistical package for social sciences (SPSS), version 15. Binary logistic regression analyses were used to identify predictors of poor birth outcomes. P-value ≤ 0.05 was considered statistically significant. Results: All the data resulted from 295 laboring mothers were made part of the analyses. A total of 266 (90.2%) laboring mothers gave live birth. A quarter, 68 (23.1%) of the laboring mothers had a poor birth outcome. The common adverse outcomes were intrauterine fetal death (IUFD, preterm, and birth defects with the proportion of 29 (42.6%), 22 (32.4%), and 3 (4.4%), respectively). Mother whose husband’s occupation was merchant (AOR = 4.4, 95% CI: 1.0-19.0), driver (AOR = 4.2, 95% CI: 1.12-15.76), & women who were illiterate (AOR = 4.0, 95% CI: 1.2-13.5), primary school completed (AOR = 4.3, 95% CI: 1.3-13.8), non-antenatal care visited (AOR = 3.4, 95% CI: 1.12-10.2), rural residence, (AOR = 2.6, 95% CI: 1.11-5.80), & mother’s HIV status, (AOR = 34.2, 95% CL 5.6, 207.0) were independent predictors of poor birth outcomes. Conclusions: Poor birth outcomes were very common in the study area where low birth weight accounted for much of all adverse pregnancy outcomes. Occupation, residence, antenatal care visit, income, maternal education and HIV status were determinants of poor birth outcomes. Accessing antenatal care in early trimester, mild physical work, maternal education to secondary level and above should be encouraged.
文摘Background: It is yet a controversy subject whether low birth weight and infant death are associated to human immunodeficiency virus-1 infection. Objective: To appreciate association between low birth weights, mother to child HIV transmission and infant mortality in HIV-1 infected pregnant women delivering between 2011 and 2016. Materials: We conducted 6 years cohort study in urban Mali. Outcome included preterm delivery, small for gestational age, infant survival status and HIV transmission. Comparison concerned women clinical WHO stage, mother viro-immunological status, and newborn anthropometric parameters. Results: HIV-1 infected women who delivered low birth weight newborn were 20.9% (111/531) versus 16.5% (1910/11.546) in HIV negative patients (p = 0.016). CD4 T cell counts low than 350 T cells count were strongly associated to LBW (p = 0.000;RR = 3.03;95% CI [1.89 - 3.16]). There is no significant association between ART that was initiated during pregnancy (p = 0.061, RR = 0.02;CI 95% (1.02 - 1.99)) or during delivery (p = 0.571;RR = 1.01;CI 95% (0.10 - 3.02)) and LBW delivery. In multivariate analysis ART regimens containing protease inhibitor (PI) were lone regimens associated with LBW ((p = 0.030;RR = 1.001;95% confidence interval [1.28 - 3.80]). Very low birth weight was statistically associated to women HIV infection (adjusted relative risk, 2.02;p = 0.000;95% confidence interval (2.17 - 4.10)). There is no significant difference between mother to child HIV transmission rate in the two HIV-infected pregnant women (10 infected children in group 2: MTCT rate 4.5%) and 3 infected children in group 1 (MTCT rate: 2.7%) (p = 0.56;RR, 0.59;CI 95% (0.18 - 4.39)). In multivariate analysis, LBW was associated with infant death (p = 0.001;RR = 2.04;CI 95% [1.04 - 5.05]). The median weight of infant at the moment of death in group 1 was 851 g (IQR: 520 - 1833 g). Significant relationship was found between infant death among LBW newborn with mother WHO stage 2 (p = 0.004;adjusted RR = 3.22;CI 95% [2.25 - 6.00]), CD4 T cells count 3 (p = 0.005;RR = 2.81;CI 95% [1.20 - 4.11]), PI regimens (p = 0.030;RR = 1.00;CI 95% [1.28 - 3.80]). Conclusion: We confirm increased risk of low birth weight and mother HIV-1 infection and we identified strongest association between mortality in infant born to HIV-1 infected mother and LBW.
文摘Background: HIV-positive pregnant women are at an increased risk of adverse pregnancy outcomes. However, data on birth outcome among HIV-infected women are limited in Ethiopia. This study was conducted to identify the adverse birth outcomes and associated factors of low birth weight (LBW) and preterm delivery (PD) among HIV-infected women. Methods: A hospital based retrospective cohort study was conducted. All deliveries from HIV-infected women from September 1, 2009 to April 30, 2012 were included in the study. Multivariate logistic regression was performed to explore the potential risk factors for LBW and PD. Result: Out of 416 singleton infants born to HIV-infected mothers, the prevalence of LBW and PD was 89 (21.4%) and 69 (16.6%), respectively. The baseline maternal CD4 counts below 200 cells/mm3, maternal body mass index (BMI) below 18.5, maternal anemia and maternal exposure to Highly Active Antiretroviral Treatment (HAART) were factors significantly associated with LBW. On the other hand, a baseline maternal CD4 level below 200/ mm3, having no Prevention of Mother-to-Child Transmission (PMTCT) intervention during pregnancy, maternal BMI less than 18.5, maternal Eclamsia during pregnancy, and mothers being on HAART before pregnancy were factors associated with preterm delivery. Conclusion: There was a significant prevalence of low birth weight and preterm delivery among infants born to HIV-positive mothers. The programme for PMTCT services should maximize the need for an early identification of those mothers with predicted complications.
文摘Background: Kangaroo mother care (KMC) is effective in preventing hypothermia, establishing breastfeeding, and reducing nosocomial infection in preterm babies in resource-limited areas. Relatively little is known about long-term morbidity and mortality outcomes among Ethiopian infants managed with KMC. Aims: To describe the follow up profiles and outcome of infants managed with KMC and discharged alive. Methods: This cross-sectional descriptive study examined outcomes among infants who were 1) managed by KMC at Black Lion Hospital, 2) discharged alive, and 3) available for follow-up. Structured, pretested questionnaires were administered to mothers. Results: Of the 110 infants included in the study, 9.1% died over the study period and 60% of the deaths occurred at home. Mortality was 100% in those babies with mothers aged less than 18 years. Thirty five percent of the deaths occurred in those from rural location. Common medical problems identified in study subjects were respiratory infections (10%), gastroenteritis (7%), rickets (7%), and anemia (6%). About 20% of infants were readmitted to hospital at least once. KMC initiation within one week was not found to be significantly associated with survival, but continued KMC after discharge significantly decreased mortality in our sample. Conclusion: Frequent follow up is very important especially those with teenage mothers and coming from a rural location. Follow up should be frequent in the first 2 months after discharge. Further research is needed to explore the determinants of mortality and morbidity after hospital discharge.
