Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with ...Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.展开更多
Background and Objectives: Post-operative complications (POC) are new pathological phenomena occurring in the post-operative period and worsening the previous situation through their morbidity and mortality. Our aim w...Background and Objectives: Post-operative complications (POC) are new pathological phenomena occurring in the post-operative period and worsening the previous situation through their morbidity and mortality. Our aim was to determine the prevalence and preoperative factors associated with early POC at University Clinics of Kisangani (CUKIS). Methods: This was a cross-sectional study conducted in the CUKIS, Department of Surgery from 1 January 2014 to 31 December 2023. The target population consisted of all patients who had undergone full post-operative follow-up. A logistic regression model using RStudio version 4.4.0 software was used to determine the factors predicting early postoperative complications. Results: The prevalence of early POC was estimated at 35%, with surgical site infection the most frequent POC at 45.3%. After multivariate analysis using logistic regression, the social category of widow(er)s, transfer, previous laparotomy, acute generalised peritonitis, preoperative length of stay of more than 10 days and ASA score 2 and 5 were significant risk factors associated with the occurrence of POC in the preoperative period. Conclusion: Certain factors can predict the occurrence of POC. Knowledge of these factors can help practitioners to take useful measures before each surgical operation on a patient with these factors, with a view to preventing or managing POC.展开更多
Background:Strengthening the patient safety culture is essential for improving healthcare service quality and ensuring patient safety.The study's aim was to investigate the current status of patient safety culture...Background:Strengthening the patient safety culture is essential for improving healthcare service quality and ensuring patient safety.The study's aim was to investigate the current status of patient safety culture in traditional Chinese medicine institutions and its associated factors to provide scientific recommendations for improvement.Methods:This cross‐sectional study was conducted October 14–18,2024.Four traditional Chinese medicine institutions in Zhejiang Province,China,were selected using convenience sampling,and the expected sample size was 544 participants.Data were collected using the Hospital Survey on Patient Safety Culture questionnaire,which comprises two sections:individual characteristics and patient safety culture.The latter comprises 10 dimensions with 32 items rated on a five‐point Likert scale.Dimension scores were calculated as the mean of corresponding item scores,and the overall score as the mean of all dimension scores.Descriptive statistics,t‐tests,analysis of variance,and multiple linear regression were used to analyze current status and associated factors of patient safety culture.Results:A total of 522 valid questionnaires were collected.The average patient safety culture score was 3.92.Among the dimensions,“F Communication About Error”received the highest score and“H Reporting Patient Safety Events”the lowest score.Age,monthly income,hospital grade,professional title,and weekly working hours were identified as independent factors associated with patient safety culture.Conclusion:The overall patient safety culture in the traditional Chinese medicine institutions of Zhejiang Province is relatively high but is affected by multiple factors.Further efforts are needed to implement diverse strategies aimed at strengthening patient safety culture within traditional Chinese medicine institutions.展开更多
To explore the possible explanation of the marked difference in the incidence of breast cancer between Chinese and Australian women, the authors have compared and analysed the results of two case-control studies compl...To explore the possible explanation of the marked difference in the incidence of breast cancer between Chinese and Australian women, the authors have compared and analysed the results of two case-control studies completed recently in Tianjin, China and Adelaide, Australia. Of 10 known risk factors for breast cancer 9 were significantly higher in level in Adelaide women than in Tianjin women, i.e., women in Adelaide were much taller, heavier, more obese, earlier at menarche, later at first full-term pregnancy, more nulliparous, less parity, more in history of breast cancer in first degree relatives, more educated. From the 7 risk factors analysed by use of logistic regression model 5 factors, i.e., earlier age at menarche, later age at first full-term pregnancy, less parity, history of benign disease, and history of breast cancer in first degree relatives, were associated significantly with the increased risk for breast cancer in the Tianjin study, but not in Adelaide study. These factors being not associated with breast cancer in Adelaide women were unexpected. The explanation of the indefinite findings in Adelaide study was due to the fact that the level of the risk factor is universally high, relatively uniform and lack of categories. The difference in the risk factor distribution between cases and controle would not be seen in case-control studies, and significance of the risk factor therefore may not be found. According to data on diet survey in these two cities, the calories from fat was significantly higher in Adelaide women than in Tianjin women. The marked difference in incidence in women in the two cities resulted from the summing-up effect of a number of factors. The important role of fat intake in geographical incidence difference and in the development of breast cancer was also discussed.展开更多
Background: Tenofovir (TFV) is widely used to treat patients with hepatitis B virus (HBV) infection. But kidney abnormalities are the main concern using this drug. Few studies have described the renal impairment due t...Background: Tenofovir (TFV) is widely used to treat patients with hepatitis B virus (HBV) infection. But kidney abnormalities are the main concern using this drug. Few studies have described the renal impairment due to the TFV in chronic hepatitis B (CHB) in Sub-Saharan Africa. The objective was to evaluate factors associated with renal impairment observed in patients on TFV for CHB. Method: It was a hospital based cross sectional prospective study carried out from June 2023 to July 2023 in Yaoundé (Cameroon) and included any patient treated with TFV for CHB during at least a period of 6 months. For each participant, we collected in the medical report socio-demographic data, clinical data, baseline creatinine, treatment information (type of TFV which was Disoproxil Fumarate (TDF) or Alafenamide (TAF), duration). Then, we collected blood samples to measure serum creatinine and phosphate levels and urine dipstick analysis. Factors associated with renal impairment were assessed with the Odds Ratio. A p value of Results: A total of 60 participants were included. The median age was 44 years [36-55] and median duration of TFV therapy was 17.5 months [11.7-25.7]. The prevalence of reduced eGFR (Conclusion: Kidney function was impaired in some patients receiving TFV for CHB. It should be monitored, particularly after 36 months and for those receiving TDF prodrug.展开更多
Background: Preterm birth is a primary cause of neonatal morbidity and mortality especially in low-income countries. Although understanding the preventable factors of neonatal deaths in preterm infants is required for...Background: Preterm birth is a primary cause of neonatal morbidity and mortality especially in low-income countries. Although understanding the preventable factors of neonatal deaths in preterm infants is required for timely interventions, data on those factors is lacking in Kenya. We attempted to determine mortality and its associated factors in preterm babies in Kenya. Methods and Materials: A hospital-based, prospective study was implemented from July 2019 to October 2019 involving 163 preterm neonates and their mothers admitted at Kenyatta National Hospital. A systematic random sampling method was used to recruit the study participants. Data on mortality and the associated factors in preterm neonates were collected using a pretested questionnaire for mothers and neonatal medical records. Data was analyzed using descriptive and inferential statistics. Results: The mortality rate was 18.4%. Of the neonates who died, respiratory distress syndrome (63.3%) and neonatal sepsis (20.0%) were documented as the primary causes. Neonates born of single mother (AOR = 8.006, 95% CI 2.267 to 28.272, p = 0.001), unemployed (6.960, 1.059 - 45.757, p = 0.043), self-employed (4.040, 1.067 - 15.302, p = 0.040), anemic (7.465, 2.530 - 22.023, p < 0.001) and with history of bleeding during pregnancy were more likely to have died. The neonates born before 28 weeks of gestation (126.188, 14.554 - 1094.060, p < 0.001), those who did not cry immediately at birth (54.271, 5.970 - 493.395, p < 0.001) and the resuscitated at birth (54.406, 6.807 - 434.851, p < 0.001) were likely to die. Conclusion: High mortality rates of preterm neonates are attributed to both maternal and neonatal factors. Focused antenatal care should aim at early identification of high-risk mothers for early management of bleeding during pregnancy, close monitoring of nutritional status for mothers and health education.展开更多
Introduction: Several microorganisms cause vaginal infections. Some of them include: Trichomonas vaginalis, Gardneralla vaginalis, Bacteriodes spp., Mobilincus and Candida albicans. In pregnancy, these infections are ...Introduction: Several microorganisms cause vaginal infections. Some of them include: Trichomonas vaginalis, Gardneralla vaginalis, Bacteriodes spp., Mobilincus and Candida albicans. In pregnancy, these infections are associated with considerable discomfort and adverse pregnancy outcome including preterm delivery, low birth weight, spontaneous abortions among others. Aims: Bacterial vaginosis, vulvovaginal trichomoniasis and candidiasis in pregnant women are associated with considerable discomfort and adverse pregnancy outcome (preterm delivery and low birth weight). We attempted to determine the prevalence of these conditions in Regional Hospital Bamenda. Methods: A total of 200 vaginal swabs were collected from pregnant women after the administration of a semi-structured questionnaire. The samples were analyzed using wet mount (Trichomonas vaginalis and Candida spp.), and the Gram stain (Gardnerella vaginalis and Candida spp.). Bivariate and multivariate analyses were used to investigate association between vaginal symptoms and their risk factors. Results: The overall prevalence of vaginal infections was 49.5%, with trichomoniasis, bacterial vaginosis, and candidiasis being 2% (4), 27% (54) and 32% (64), respectively. No formal education (AOR = 0.908;95% CI: -20.72 - 35.62;p = 0.001) and practice of douching (16.93: -0.201 - 29.692;p = 0.005) were found to be independent risk factors for trichomoniasis. Malodourous greenish vagina discharges (18.52;2.96 - 60.307;p = 0.005) were associated with trichomoniasis and bacterial vaginosis. White (6.566;17.785 - 21.836;p = 0.004) and yellowish (3.404;20.127 - 23.457;p = 0.004) vaginal discharges were independent risk factors for mycotic vagina infections. Multivariate analysis revealed that the only risk factor significantly associated to VVC in this study was the use of both water cistern and pit toilet (AOR = 3.684;95% CI: 0.388 - 2.649;p = 0.010). Conclusion: There was a high prevalence of vaginal infections. Early treatment will reduce the disease burden and avoid complications associated with it.展开更多
<strong>Introduction</strong><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><strong>:</strong...<strong>Introduction</strong><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><strong>:</strong> Maternal mortality is a robust indicator of human development. Most of it occurs in developing countries.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Objectives</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: This study aims to determine the factors associated with maternal mortality in </span><span style="font-family:Tahoma;">Gynecology</span><span style="font-family:Tahoma;"> and Obstetrics Department of Borgou Departmental University Hospital Center (CHUD-B).</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Study method</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: Our study took place at Gynecology and Obstetrics Department in Borgou Departmental University Hospital Center. This was a descriptive and analytical case-control study, covering a period of 7 years from January 1, </span><span style="font-family:Tahoma;">2012</span><span style="font-family:Tahoma;"> to December 31, 2018.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Results</span></b></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">: Two hundred and twelve patients have been recruited consisting of 106 deceased women and 106 controls. The intra-hospital mortality ratio was 1100 deaths per 100,000 live births (LB). The mean age of deceased women was 27.06 ± 6.45 years with the extremes of 15 and 45 years. Direct obstetric causes were the most frequent causes of maternal death. They were dominated by immediate postpartum hemorrhage (32.93%), followed by High Blood Pressure (26.83%) and infections (17.07%). The general condition of patients on admission (p-0.000) and inadequate management (p-0.001) w</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">as</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"> associated with maternal mortality.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Conclusion</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: </span><span style="font-family:Tahoma;">Patients</span></span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">’</span></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;"> general condition on admission and inadequate management </span><span style="font-family:Tahoma;">w</span></span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">as</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"> factors associated with maternal mortality.</span></span></span>展开更多
Background: Despite WHO recommendations on the benefits of early initiation of breastfeeding for both the mother and child, only 53.5% of newborns in Tanzania are breastfed within the first hour of life. The trend for...Background: Despite WHO recommendations on the benefits of early initiation of breastfeeding for both the mother and child, only 53.5% of newborns in Tanzania are breastfed within the first hour of life. The trend for early initiation of breastfeeding shows little progress and Tanzania is still far behind reaching the global recommended rate of 70% of early initiation of breastfeeding. This study aims to determine trends and factors associated with changes in the early initiation of breastfeeding in Tanzania from 2004-2016. Methodology: This was an analytical cross-sectional study utilizing secondary data from the Tanzania Demographic and Health Surveys (TDHS) for the years 2004-2005, 2010, and 2015-2016. Data analysis was performed using Stata 15. Frequencies and proportions were used to summarize categorical variables. A Modified Poisson regression model was used to determine factors associated with the early initiation of breastfeeding. Multivariable Poisson decomposition analysis was used to assess factors associated with changes in the early initiation of breastfeeding across surveys. Results: Trends in early initiation of breastfeeding decreased from 59.53% in 2004/2005 to 46.72% in 2010, and then increased to 51.94% in 2015/2016. Only 5.9% of the overall change in early initiation of breastfeeding was contributed by the difference in characteristics such as mode of delivery and working status. The difference in coefficients contributed to a 94% decrease in early initiation of breastfeeding mostly due to a decrease in early initiation of breastfeeding among caesarean section delivery patients. Conclusion: The prevalence of early initiation of breastfeeding in Tanzania decreased between 2004 and 2016, then increased from 2010-2016. Interventions and health policies need to target factors that had significant effects on the early initiation of breastfeeding such as increasing health facility delivery and promoting the initiation of breastfeeding soon after caesarean section delivery.展开更多
Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in chi...Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.展开更多
Skin depigmentation is a worrying practice that is gaining popularity, particularly among young girls. However, this practice poses health risks. It also reflects a negative view of black skin color. This was a cross-...Skin depigmentation is a worrying practice that is gaining popularity, particularly among young girls. However, this practice poses health risks. It also reflects a negative view of black skin color. This was a cross-sectional study carried out between April and May 2023 which involved 1039 female students from schools and universities in the Collines department selected by stratified sampling. Data was collected during a face-to-face interview using a questionnaire providing information on the demographic, socio-cultural, and economic characteristics of the girls. The depigmentation products used were identified as well as the complications caused by the use of these products. Statistical analysis made it possible to calculate the frequencies and logistic regression made it possible to identify the factors associated with depigmentation. The prevalence of depigmentation among the girls surveyed was 78.2%. The main products used were soaps based on mercurial derivative and hydroquinone (21.6%) and lotions based on hydroquinone and corticosteroids (75.7%). The factors associated with the practice of depigmentation were the ethnicity of the respondents (OR = 2.52;95% CI = [0.47 - 13.33], p = 0.001);the average monthly income of the parents (OR = 3.26;95% CI = [1.71 - 6.09], p = 0.003);the opinion of the respondents on depigmentation (OR = 2.48;95% CI = [0.84 - 7.3], p < 0.001) and the value given to light skin versus black skin (OR = 3.41;95% CI = [2.32 - 5.01], p < 0.001). In conclusion, the prevalence of depigmentation among the girls surveyed is high. Consequently, reinforced awareness measures and stricter control of bleaching products are imperative to address this high prevalence of the phenomenon.展开更多
Objective The rate of post-operative complications has been increased with the changes in patients’age,prolonged duration,more severe and diffused lesions,and more patients with complications in recent years. We try ...Objective The rate of post-operative complications has been increased with the changes in patients’age,prolonged duration,more severe and diffused lesions,and more patients with complications in recent years. We try to identify the risk factors associated with prolonged stay in the intensive care unit (ICU) after coronary artery bypass graft surgery (CABG) . Methods 1623 patients who received CABG surgery in Beijing Anzhen Hospital展开更多
Objective To investigate the risk factors associated with early mortality of the rapid two-stage arerial switch operation,which has a significantly higher overall mortality than that of ASO procedure for D-TGA with an...Objective To investigate the risk factors associated with early mortality of the rapid two-stage arerial switch operation,which has a significantly higher overall mortality than that of ASO procedure for D-TGA with an intact ventricular septum. Methods The data we reviewed involving patients who underwent rapid two-stage switch operations from September,2002 to September,2007 in our center,13 patients were male and 8展开更多
BACKGROUND Endoscopic mucosal resection is an innovative method for treating early gastric cancer and has been widely used in clinical practice.AIM To analyze the factors associated with the development of heterochron...BACKGROUND Endoscopic mucosal resection is an innovative method for treating early gastric cancer and has been widely used in clinical practice.AIM To analyze the factors associated with the development of heterochronic gastric cancer in patients with early gastric cancer who had undergone endoscopic mucosal dissection(EMD).METHODS A cohort of patients with early gastric cancer treated using EMD was retrospectively analyzed,and patients who developed heterochronic gastric cancer after the surgery were compared with those who did not.The effects of patient age,sex,tumor size,pathological type,and surgical technique on the development of heterochronic gastric cancer were assessed using statistical analysis.RESULTS Of the 300 patients with early gastric cancer,150 patients developed heterochronic gastric cancer after EMD.Statistical analysis revealed that patient age(P value=XX),sex(P value=XX),tumor size(P value=XX),pathological type(P value=XX),and surgical technique(P value=XX)were significantly associated with the occurrence of heterochronic gastric cancer.CONCLUSION Age,sex,tumor size,pathological type,and surgical technique are key factors influencing the occurrence of heterochronic gastric cancer after EMD in patients with early gastric cancer.To address these factors,postoperative follow-up and management should be strengthened to improve the prognosis and survival rate of patients.展开更多
<strong>Background:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> Postpartum depression is the most com...<strong>Background:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> Postpartum depression is the most common psychological health problem among females;it begins after the birth of the child and can occur at any time during the first year of delivery. The COVID-19 pandemic is a novel virus that is highly infectious and has several negative psychological impacts on individuals globally. </span><b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> Coronavirus disease 2019 (COVID-19) has been reported to increase the incidence rate of depression. We investigated the prevalence rate and associated factors of postpartum depression (PPD) among women in Jeddah, Saudi Arabia, during the COVID-19 period, thereby attempting to determine whether and how COVID-19 affected PPD. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This is a cross-sectional study that was conducted on women at one week to six months postpartum using an online questionnaire. SPSS program was used for analyzing data. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> This study included 150 participated women;49.3% were in the age range of 25</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">34 years old. There were 30.7% reported being primigravida. Regarding the level of depression, there were 60.7% reported the presence of depression;the depression was affected by some demographics of females such as the education level (P = 0.021) and other factors related to the COVID-19 pandemic such as visiting the doctor during quarantine (P = 0.049), diagnosis with depression by the doctor (P = 0.006), the impact of the pandemic on depression (P = 0.035), experiencing symptoms of depression during pregnancy (P = 0.005), family history (P = 0.043), and difficulties during childbirth during the pandemic period (P = 0.03). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> There was a high prevalence of PPD among women during the COVID-19 period, and it was higher than the prevalence of PPD before the COVID-19 period.</span></span></span></span>展开更多
Background: Anaemia is one of the most common nutritional deficiency diseases observed globally and affects more than a quarter of the world’s population. Globally, 41.8% pregnant women and close to one third of non-...Background: Anaemia is one of the most common nutritional deficiency diseases observed globally and affects more than a quarter of the world’s population. Globally, 41.8% pregnant women and close to one third of non-pregnant women (30.2%) are anaemic. Anaemia during pregnancy contributes to 20% of all maternal deaths and it increases the risks of foetal, neonatal and overall infant mortality. In Kenya, according to the Ministry of Health, the prevalence of anaemia among pregnant women is 55.1%. Objective: To determine the prevalence and associated factors of anaemia among pregnant women attending antenatal clinic (ANC) at Pumwani Maternity Hospital (PMH). Methodology: A hospital based cross-sectional study design was conducted from 8<sup>th</sup> June to 18<sup>th</sup> August, 2015. Systematic random sampling method was used to select 258 pregnant women. Mothers who attended ANC during the study period and who met the inclusion criteria were interviewed and a capillary blood sample was taken. Hemoglobin level was determined by using HemoCue photometer. Data were cleaned, coded and fed into SPSS Version 20.0 for analysis. Descriptive statistics such as frequency, percentage, mean and standard deviation were used to describe selected variables. Pearson’s chi-square test and odds ratio (OR) with corresponding 95% confidence intervals (CI) computed to find association between independent and dependent variables. Multivariate analysis was done to determine factors significantly and independently predicting anaemia during pregnancy. Results: The present study revealed that the prevalence of anaemia among the pregnant women was 57%. Advanced maternal age (>31 years) (AOR = 2.71;95% CI = 1.25 - 5.88;P = 0.012) more than 18 - 24 years, government/private employed women (AOR = 2.94;95% CI = 1.47 - 5.88;P = 0.002) and self-employed women (AOR = 1.91;95% CI = 1.03 - 3.53;P = 0.039) compared to housewives, not taking iron/folic acid supplementation (IFAS) (AOR = 2.04; 95% CI = 1.14 - 3.64;P = 0.016) and mid-upper arm circumference (MUAC) less than 23 cm (AOR = 2.52;95% CI = 1.36 - 4.67;P = 0.003) were found to be predictors of anaemia. Conclusion: Anaemia among pregnant women is found to be severe public health problem based on the World Health Organization classification of anaemia. Advanced age, employment, not taking IFAS during the current pregnancy and MUAC of less than 23 cm were significantly and independently associated with anaemia during pregnancy. Thus, special attention should be given to pregnant women who are employed and advanced in age. Moreover, they should be educated on the importance of taking iron and folic acid during pregnancy.展开更多
<b><i><span>Background</span></i></b><span>: Achieving and maintaining glycemic targets </span><span>are</span><span> a challenge for health pract...<b><i><span>Background</span></i></b><span>: Achieving and maintaining glycemic targets </span><span>are</span><span> a challenge for health practitioners around the world. We aimed to study the factors associated with prolonged poor diabetes control in the cohort of T2DM patients monitored and treated in the Department of Internal Medicine at the Yalgado OUEDRAOGO Teaching Hospital in Ouagadougou in order to optimize therapeutic education in these patients. </span><b><i><span>Methodology</span></i></b><span>: This was a descriptive and analytical cross-sectional study combining retrospective data collection from the last year of patient follow-up and prospective collection of some information. The study included all diabetic patients, aged at least 18 years old, followed and treated in the Department of Internal Medicine at the Yalgado OUEDRAOGO Teaching Hospital between January 1, 2010 and December 31, 2018 following a systematic random sampling with a sampling step of 10. The variables collected were sociodemographic, anthropometric, lifestyle, cardiovascular risk factors and diabetes-related characteristics. To determine the risk factors associated with prolonged poor glycemic control, we performed modeling using logistic regression. All variables associated with prolonged poor glycemic control, in bivariate logistic regression with a p-value less than 0.20 were included in the full model. Later, we used a stepwise descending method to obtain the final model, which was then tested by a receiver operating characteristic (ROC) curve. The significance threshold was set at 5%. Raw and fitted Odds-Ratio (OR) and 95% confidence interval were presented. </span><b><i><span>Results</span></i></b><span>: 270 patients were included. Prolonged poor control of diabetes mellitus was observed in 73.70%. The mean age was 55.97 years (SD: ±11.52) and the sex ratio was 0.6 in favor of female. The mean time since diabetes mellitus diagnoses was 5.85 years (SD: ±5.15). A monthly gain of 92.62 USD (50.74%) for average diabetes mellitus care expenditures of 55.82 USD (SD: 28.25) was reported. An overweight (55.92%) and hypertension (41.85%) were reported. Diabetes mellitus was complicated in 68.15%. Patients were supported by their families in the management of their diabetes mellitus in 85.19%. In multivariate analysis with bivariate logistic regression, low level of formal education (OR = 8.34, 95% CI [1.97 - 35.22];</span><i><span>p</span></i><span> < 0.01), family support for diabetes mellitus management (OR = 0.65, 95% CI [0.45 - 0.94];</span><i><span>p</span></i><span> = 0.02), presence of abdominal obesity (OR = 2.27, 95% CI [1.08 - 4.77];</span><i><span>p</span></i><span> = 0.03), presence of a history of hospitalization (OR = 7.39, 95% CI [2.97 - 18.39];</span><i><span>p</span></i><span> < 0.01), poor adherence to antidiabetic treatment (OR = 2.97, 95% CI [1.42 - 6.18];</span><i><span>p</span></i><span> < 0.01), and the presence of microangiopathy (OR = 5.05, 95% CI [2.36 - 10.81];</span><i><span>p</span></i><span> < 0.01) were the factors independently associated with prolonged poor control of T2DM, with a ROC curve of 0.88, which reflects a very good sensitivity and specificity of these factors. </span><b><i><span>Conclusion</span></i></b><b><span>: </span></b><span>The imbalance of T2DM is multifactorial. Lifestyle, family environment, and compliance seem to be essential to ensure good glycemic control. Healthcare practitioners should take these elements into account in their daily patient assessment. A predictive score would be a tool to help identify patients at risk of diabetes imbalance and would contribute to improv</span><span>ing</span><span> their management.</span>展开更多
Background: In 2005, the World Health Assembly asked member states to develop effective strategies and programs to reduce the negative consequences of harmful use of alcohol. To develop effective policies, we must alr...Background: In 2005, the World Health Assembly asked member states to develop effective strategies and programs to reduce the negative consequences of harmful use of alcohol. To develop effective policies, we must already understand the phenomenon of alcohol consumption. But in Francophone west Africa, there are very few studies on the prevalence of alcohol, consumption patterns and factors associated with this consumption. The objectives of this study were to estimate the prevalence of alcohol use in schools in Burkina Faso and to identify socio-demographic factors associated with episodes of “heavy drinking”. Method: A cross-sectional study was conducted in October 2013 in six secondary schools of Bobo-Dioulasso. Three hundred and sixty-two students randomly drawn by stratified cluster sampling were interviewed by using a self-administered questionnaire adapted from the model ESPAD and WHO AUDIT questionnaire. HED (Heavy Episodic Drinking) was defined as consuming at least six local measures of alcoholic beverages around the 30 days prior investigation. The search for factors was performed using logistic regression and estimating standard errors were adjusted for clustering data. Results: The prevalence of experimentation of alcohol was estimated to 45.6% [CI 95% = 40.4 - 50.7]. This prevalence was reduced to 34.8% [CI 95% = 29.9 - 39.7], 24.3% [CI 95% = 19.9 - 28.7] and 18% [CI 95% = 14 - 21.9] if one considered the use of alcohol at least once respectively in the 12 months, 30 days and 7 days before the survey. The prevalence of HED was 16% [CI95% = 12.2 - 19.8]. Independent factors associated with the HED were alcohol use by parents or friends and father’s occupation. Episodes of “heavy drinking” were 8.3 (CI 95% = 4.9 - 14) and 2.8 (CI 95% = 1.3 - 5.8) respectively more frequent among students whose parents and friends were drinking. Neither religion nor sex nor age was not statistically associated with HED. Conclusion: This study confirms the high prevalence of alcohol consumption in schools in Burkina Faso and challenges policy makers to adopt effective policies to fight against the harmful use of alcohol especially in schools.展开更多
Introduction: Menopause is a biological phenomenon that occurs at a more or less early or late age in the life of every woman. The general objective is to study the factors associated with the age of natural menopause...Introduction: Menopause is a biological phenomenon that occurs at a more or less early or late age in the life of every woman. The general objective is to study the factors associated with the age of natural menopause in menopausal women aged between 30 and 80 years who have gone through down Keur Massar health district in 2015. Methodology: This was an observational, cross-sectional, descriptive and analytical study conducted in Keur Massar health district from December 1<sup>st</sup> to 10<sup>th</sup>, 2015. Two-stage cluster sampling was conducted. Data were collected during an individual interview at home after consent. They covered socio-economic conditions, health and nutrition status, gynecological-obstetrical history, and lifestyle. A multivariate analysis was performed using the Cox model with a 5% risk of alpha error. Results: A total of 627 postmenopausal women were surveyed. Mean age of these women was 54.5 years (±8.6 years). A proportion of 72.1% of the women was married and 46.7% was in school. Mean age of natural menopause was 47.1 years (±5.03 years). The median age of natural menopause was 47 years. Factors associated with the age of natural menopause were high parity of more than 4 children (Hra = 0.35 [0.13 - 0.92]), the existence of frequent childhood illnesses (Hra = 1.72 [1.13 - 2.64]), use of the intra-uterine device—IUD—as a modern contraceptive method (HRa = 0.39 [0.24 - 0.63]), sibling size (HRa = 0.85 [0.78 - 0.93]), family size (HRa = 1.03 [1.01 - 1.06]), and polygamy regime (HRa = 0.56 [0.37 - 0.85]). Conclusion: Many factors in childhood as well as during the period of female genital activity can impact the age of natural menopause. It is then important to improve the health status of women, children and the standard of living of the population.展开更多
Purpose: This purpose of the study was to investigate the factors both risk and protective associated with depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature sear...Purpose: This purpose of the study was to investigate the factors both risk and protective associated with depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022, through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society databases, with the keywords “COVID-19”, “pregnant women”, and “depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;and 3) description of the factors associated with depression among pregnant women during the COVID-19 pandemic. Results: Of the 213 articles extracted, 104 were excluded owing to duplication, and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 40 were excluded by title, abstract, and full-text screening. Among the 45 articles for a total of 59,329 pregnant women that met the inclusion criteria, the risk factors were “distress from COVID-19-related experiences”, “reduced/low income”, “unemployment”, “anxiety”, “history of mental illness”, “lack of social support”, and “reduced/no exercise”. The protective factors “greater/increased social support”, “higher education level”, “higher resilience”, and “healthy lifestyle behaviors” were much less frequently reported than risk factors, and none were reported to be relevant for Japanese pregnant women. Conclusion: The findings indicate that preventive interventions should begin during pregnancy with a focus on these risk factors. In addition, the protective factors need to be strengthened. Further research is required to identify the protective factors associated with depression among Japanese pregnant women.展开更多
文摘Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.
文摘Background and Objectives: Post-operative complications (POC) are new pathological phenomena occurring in the post-operative period and worsening the previous situation through their morbidity and mortality. Our aim was to determine the prevalence and preoperative factors associated with early POC at University Clinics of Kisangani (CUKIS). Methods: This was a cross-sectional study conducted in the CUKIS, Department of Surgery from 1 January 2014 to 31 December 2023. The target population consisted of all patients who had undergone full post-operative follow-up. A logistic regression model using RStudio version 4.4.0 software was used to determine the factors predicting early postoperative complications. Results: The prevalence of early POC was estimated at 35%, with surgical site infection the most frequent POC at 45.3%. After multivariate analysis using logistic regression, the social category of widow(er)s, transfer, previous laparotomy, acute generalised peritonitis, preoperative length of stay of more than 10 days and ASA score 2 and 5 were significant risk factors associated with the occurrence of POC in the preoperative period. Conclusion: Certain factors can predict the occurrence of POC. Knowledge of these factors can help practitioners to take useful measures before each surgical operation on a patient with these factors, with a view to preventing or managing POC.
基金supported by two funding sources:(1)The Youth Program of the Humanities and Social Sciences Research Fund,Ministry of Education of China(Grant 18YJC630064)(2)Peking Union Medical College Hospital Talent Cultivation Program(Category C)(Grant UBJ12930).
文摘Background:Strengthening the patient safety culture is essential for improving healthcare service quality and ensuring patient safety.The study's aim was to investigate the current status of patient safety culture in traditional Chinese medicine institutions and its associated factors to provide scientific recommendations for improvement.Methods:This cross‐sectional study was conducted October 14–18,2024.Four traditional Chinese medicine institutions in Zhejiang Province,China,were selected using convenience sampling,and the expected sample size was 544 participants.Data were collected using the Hospital Survey on Patient Safety Culture questionnaire,which comprises two sections:individual characteristics and patient safety culture.The latter comprises 10 dimensions with 32 items rated on a five‐point Likert scale.Dimension scores were calculated as the mean of corresponding item scores,and the overall score as the mean of all dimension scores.Descriptive statistics,t‐tests,analysis of variance,and multiple linear regression were used to analyze current status and associated factors of patient safety culture.Results:A total of 522 valid questionnaires were collected.The average patient safety culture score was 3.92.Among the dimensions,“F Communication About Error”received the highest score and“H Reporting Patient Safety Events”the lowest score.Age,monthly income,hospital grade,professional title,and weekly working hours were identified as independent factors associated with patient safety culture.Conclusion:The overall patient safety culture in the traditional Chinese medicine institutions of Zhejiang Province is relatively high but is affected by multiple factors.Further efforts are needed to implement diverse strategies aimed at strengthening patient safety culture within traditional Chinese medicine institutions.
文摘To explore the possible explanation of the marked difference in the incidence of breast cancer between Chinese and Australian women, the authors have compared and analysed the results of two case-control studies completed recently in Tianjin, China and Adelaide, Australia. Of 10 known risk factors for breast cancer 9 were significantly higher in level in Adelaide women than in Tianjin women, i.e., women in Adelaide were much taller, heavier, more obese, earlier at menarche, later at first full-term pregnancy, more nulliparous, less parity, more in history of breast cancer in first degree relatives, more educated. From the 7 risk factors analysed by use of logistic regression model 5 factors, i.e., earlier age at menarche, later age at first full-term pregnancy, less parity, history of benign disease, and history of breast cancer in first degree relatives, were associated significantly with the increased risk for breast cancer in the Tianjin study, but not in Adelaide study. These factors being not associated with breast cancer in Adelaide women were unexpected. The explanation of the indefinite findings in Adelaide study was due to the fact that the level of the risk factor is universally high, relatively uniform and lack of categories. The difference in the risk factor distribution between cases and controle would not be seen in case-control studies, and significance of the risk factor therefore may not be found. According to data on diet survey in these two cities, the calories from fat was significantly higher in Adelaide women than in Tianjin women. The marked difference in incidence in women in the two cities resulted from the summing-up effect of a number of factors. The important role of fat intake in geographical incidence difference and in the development of breast cancer was also discussed.
文摘Background: Tenofovir (TFV) is widely used to treat patients with hepatitis B virus (HBV) infection. But kidney abnormalities are the main concern using this drug. Few studies have described the renal impairment due to the TFV in chronic hepatitis B (CHB) in Sub-Saharan Africa. The objective was to evaluate factors associated with renal impairment observed in patients on TFV for CHB. Method: It was a hospital based cross sectional prospective study carried out from June 2023 to July 2023 in Yaoundé (Cameroon) and included any patient treated with TFV for CHB during at least a period of 6 months. For each participant, we collected in the medical report socio-demographic data, clinical data, baseline creatinine, treatment information (type of TFV which was Disoproxil Fumarate (TDF) or Alafenamide (TAF), duration). Then, we collected blood samples to measure serum creatinine and phosphate levels and urine dipstick analysis. Factors associated with renal impairment were assessed with the Odds Ratio. A p value of Results: A total of 60 participants were included. The median age was 44 years [36-55] and median duration of TFV therapy was 17.5 months [11.7-25.7]. The prevalence of reduced eGFR (Conclusion: Kidney function was impaired in some patients receiving TFV for CHB. It should be monitored, particularly after 36 months and for those receiving TDF prodrug.
文摘Background: Preterm birth is a primary cause of neonatal morbidity and mortality especially in low-income countries. Although understanding the preventable factors of neonatal deaths in preterm infants is required for timely interventions, data on those factors is lacking in Kenya. We attempted to determine mortality and its associated factors in preterm babies in Kenya. Methods and Materials: A hospital-based, prospective study was implemented from July 2019 to October 2019 involving 163 preterm neonates and their mothers admitted at Kenyatta National Hospital. A systematic random sampling method was used to recruit the study participants. Data on mortality and the associated factors in preterm neonates were collected using a pretested questionnaire for mothers and neonatal medical records. Data was analyzed using descriptive and inferential statistics. Results: The mortality rate was 18.4%. Of the neonates who died, respiratory distress syndrome (63.3%) and neonatal sepsis (20.0%) were documented as the primary causes. Neonates born of single mother (AOR = 8.006, 95% CI 2.267 to 28.272, p = 0.001), unemployed (6.960, 1.059 - 45.757, p = 0.043), self-employed (4.040, 1.067 - 15.302, p = 0.040), anemic (7.465, 2.530 - 22.023, p < 0.001) and with history of bleeding during pregnancy were more likely to have died. The neonates born before 28 weeks of gestation (126.188, 14.554 - 1094.060, p < 0.001), those who did not cry immediately at birth (54.271, 5.970 - 493.395, p < 0.001) and the resuscitated at birth (54.406, 6.807 - 434.851, p < 0.001) were likely to die. Conclusion: High mortality rates of preterm neonates are attributed to both maternal and neonatal factors. Focused antenatal care should aim at early identification of high-risk mothers for early management of bleeding during pregnancy, close monitoring of nutritional status for mothers and health education.
文摘Introduction: Several microorganisms cause vaginal infections. Some of them include: Trichomonas vaginalis, Gardneralla vaginalis, Bacteriodes spp., Mobilincus and Candida albicans. In pregnancy, these infections are associated with considerable discomfort and adverse pregnancy outcome including preterm delivery, low birth weight, spontaneous abortions among others. Aims: Bacterial vaginosis, vulvovaginal trichomoniasis and candidiasis in pregnant women are associated with considerable discomfort and adverse pregnancy outcome (preterm delivery and low birth weight). We attempted to determine the prevalence of these conditions in Regional Hospital Bamenda. Methods: A total of 200 vaginal swabs were collected from pregnant women after the administration of a semi-structured questionnaire. The samples were analyzed using wet mount (Trichomonas vaginalis and Candida spp.), and the Gram stain (Gardnerella vaginalis and Candida spp.). Bivariate and multivariate analyses were used to investigate association between vaginal symptoms and their risk factors. Results: The overall prevalence of vaginal infections was 49.5%, with trichomoniasis, bacterial vaginosis, and candidiasis being 2% (4), 27% (54) and 32% (64), respectively. No formal education (AOR = 0.908;95% CI: -20.72 - 35.62;p = 0.001) and practice of douching (16.93: -0.201 - 29.692;p = 0.005) were found to be independent risk factors for trichomoniasis. Malodourous greenish vagina discharges (18.52;2.96 - 60.307;p = 0.005) were associated with trichomoniasis and bacterial vaginosis. White (6.566;17.785 - 21.836;p = 0.004) and yellowish (3.404;20.127 - 23.457;p = 0.004) vaginal discharges were independent risk factors for mycotic vagina infections. Multivariate analysis revealed that the only risk factor significantly associated to VVC in this study was the use of both water cistern and pit toilet (AOR = 3.684;95% CI: 0.388 - 2.649;p = 0.010). Conclusion: There was a high prevalence of vaginal infections. Early treatment will reduce the disease burden and avoid complications associated with it.
文摘<strong>Introduction</strong><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><strong>:</strong> Maternal mortality is a robust indicator of human development. Most of it occurs in developing countries.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Objectives</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: This study aims to determine the factors associated with maternal mortality in </span><span style="font-family:Tahoma;">Gynecology</span><span style="font-family:Tahoma;"> and Obstetrics Department of Borgou Departmental University Hospital Center (CHUD-B).</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Study method</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: Our study took place at Gynecology and Obstetrics Department in Borgou Departmental University Hospital Center. This was a descriptive and analytical case-control study, covering a period of 7 years from January 1, </span><span style="font-family:Tahoma;">2012</span><span style="font-family:Tahoma;"> to December 31, 2018.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Results</span></b></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">: Two hundred and twelve patients have been recruited consisting of 106 deceased women and 106 controls. The intra-hospital mortality ratio was 1100 deaths per 100,000 live births (LB). The mean age of deceased women was 27.06 ± 6.45 years with the extremes of 15 and 45 years. Direct obstetric causes were the most frequent causes of maternal death. They were dominated by immediate postpartum hemorrhage (32.93%), followed by High Blood Pressure (26.83%) and infections (17.07%). The general condition of patients on admission (p-0.000) and inadequate management (p-0.001) w</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">as</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"> associated with maternal mortality.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><b><span style="font-family:Tahoma;">Conclusion</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;">: </span><span style="font-family:Tahoma;">Patients</span></span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">’</span></span></span><span><span><span style="font-family:""><span style="font-family:Tahoma;"> general condition on admission and inadequate management </span><span style="font-family:Tahoma;">w</span></span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;">as</span></span></span><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"><span style="font-family:Tahoma;"> factors associated with maternal mortality.</span></span></span>
文摘Background: Despite WHO recommendations on the benefits of early initiation of breastfeeding for both the mother and child, only 53.5% of newborns in Tanzania are breastfed within the first hour of life. The trend for early initiation of breastfeeding shows little progress and Tanzania is still far behind reaching the global recommended rate of 70% of early initiation of breastfeeding. This study aims to determine trends and factors associated with changes in the early initiation of breastfeeding in Tanzania from 2004-2016. Methodology: This was an analytical cross-sectional study utilizing secondary data from the Tanzania Demographic and Health Surveys (TDHS) for the years 2004-2005, 2010, and 2015-2016. Data analysis was performed using Stata 15. Frequencies and proportions were used to summarize categorical variables. A Modified Poisson regression model was used to determine factors associated with the early initiation of breastfeeding. Multivariable Poisson decomposition analysis was used to assess factors associated with changes in the early initiation of breastfeeding across surveys. Results: Trends in early initiation of breastfeeding decreased from 59.53% in 2004/2005 to 46.72% in 2010, and then increased to 51.94% in 2015/2016. Only 5.9% of the overall change in early initiation of breastfeeding was contributed by the difference in characteristics such as mode of delivery and working status. The difference in coefficients contributed to a 94% decrease in early initiation of breastfeeding mostly due to a decrease in early initiation of breastfeeding among caesarean section delivery patients. Conclusion: The prevalence of early initiation of breastfeeding in Tanzania decreased between 2004 and 2016, then increased from 2010-2016. Interventions and health policies need to target factors that had significant effects on the early initiation of breastfeeding such as increasing health facility delivery and promoting the initiation of breastfeeding soon after caesarean section delivery.
文摘Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.
文摘Skin depigmentation is a worrying practice that is gaining popularity, particularly among young girls. However, this practice poses health risks. It also reflects a negative view of black skin color. This was a cross-sectional study carried out between April and May 2023 which involved 1039 female students from schools and universities in the Collines department selected by stratified sampling. Data was collected during a face-to-face interview using a questionnaire providing information on the demographic, socio-cultural, and economic characteristics of the girls. The depigmentation products used were identified as well as the complications caused by the use of these products. Statistical analysis made it possible to calculate the frequencies and logistic regression made it possible to identify the factors associated with depigmentation. The prevalence of depigmentation among the girls surveyed was 78.2%. The main products used were soaps based on mercurial derivative and hydroquinone (21.6%) and lotions based on hydroquinone and corticosteroids (75.7%). The factors associated with the practice of depigmentation were the ethnicity of the respondents (OR = 2.52;95% CI = [0.47 - 13.33], p = 0.001);the average monthly income of the parents (OR = 3.26;95% CI = [1.71 - 6.09], p = 0.003);the opinion of the respondents on depigmentation (OR = 2.48;95% CI = [0.84 - 7.3], p < 0.001) and the value given to light skin versus black skin (OR = 3.41;95% CI = [2.32 - 5.01], p < 0.001). In conclusion, the prevalence of depigmentation among the girls surveyed is high. Consequently, reinforced awareness measures and stricter control of bleaching products are imperative to address this high prevalence of the phenomenon.
文摘Objective The rate of post-operative complications has been increased with the changes in patients’age,prolonged duration,more severe and diffused lesions,and more patients with complications in recent years. We try to identify the risk factors associated with prolonged stay in the intensive care unit (ICU) after coronary artery bypass graft surgery (CABG) . Methods 1623 patients who received CABG surgery in Beijing Anzhen Hospital
文摘Objective To investigate the risk factors associated with early mortality of the rapid two-stage arerial switch operation,which has a significantly higher overall mortality than that of ASO procedure for D-TGA with an intact ventricular septum. Methods The data we reviewed involving patients who underwent rapid two-stage switch operations from September,2002 to September,2007 in our center,13 patients were male and 8
文摘BACKGROUND Endoscopic mucosal resection is an innovative method for treating early gastric cancer and has been widely used in clinical practice.AIM To analyze the factors associated with the development of heterochronic gastric cancer in patients with early gastric cancer who had undergone endoscopic mucosal dissection(EMD).METHODS A cohort of patients with early gastric cancer treated using EMD was retrospectively analyzed,and patients who developed heterochronic gastric cancer after the surgery were compared with those who did not.The effects of patient age,sex,tumor size,pathological type,and surgical technique on the development of heterochronic gastric cancer were assessed using statistical analysis.RESULTS Of the 300 patients with early gastric cancer,150 patients developed heterochronic gastric cancer after EMD.Statistical analysis revealed that patient age(P value=XX),sex(P value=XX),tumor size(P value=XX),pathological type(P value=XX),and surgical technique(P value=XX)were significantly associated with the occurrence of heterochronic gastric cancer.CONCLUSION Age,sex,tumor size,pathological type,and surgical technique are key factors influencing the occurrence of heterochronic gastric cancer after EMD in patients with early gastric cancer.To address these factors,postoperative follow-up and management should be strengthened to improve the prognosis and survival rate of patients.
文摘<strong>Background:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> Postpartum depression is the most common psychological health problem among females;it begins after the birth of the child and can occur at any time during the first year of delivery. The COVID-19 pandemic is a novel virus that is highly infectious and has several negative psychological impacts on individuals globally. </span><b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> Coronavirus disease 2019 (COVID-19) has been reported to increase the incidence rate of depression. We investigated the prevalence rate and associated factors of postpartum depression (PPD) among women in Jeddah, Saudi Arabia, during the COVID-19 period, thereby attempting to determine whether and how COVID-19 affected PPD. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This is a cross-sectional study that was conducted on women at one week to six months postpartum using an online questionnaire. SPSS program was used for analyzing data. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> This study included 150 participated women;49.3% were in the age range of 25</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">34 years old. There were 30.7% reported being primigravida. Regarding the level of depression, there were 60.7% reported the presence of depression;the depression was affected by some demographics of females such as the education level (P = 0.021) and other factors related to the COVID-19 pandemic such as visiting the doctor during quarantine (P = 0.049), diagnosis with depression by the doctor (P = 0.006), the impact of the pandemic on depression (P = 0.035), experiencing symptoms of depression during pregnancy (P = 0.005), family history (P = 0.043), and difficulties during childbirth during the pandemic period (P = 0.03). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> There was a high prevalence of PPD among women during the COVID-19 period, and it was higher than the prevalence of PPD before the COVID-19 period.</span></span></span></span>
文摘Background: Anaemia is one of the most common nutritional deficiency diseases observed globally and affects more than a quarter of the world’s population. Globally, 41.8% pregnant women and close to one third of non-pregnant women (30.2%) are anaemic. Anaemia during pregnancy contributes to 20% of all maternal deaths and it increases the risks of foetal, neonatal and overall infant mortality. In Kenya, according to the Ministry of Health, the prevalence of anaemia among pregnant women is 55.1%. Objective: To determine the prevalence and associated factors of anaemia among pregnant women attending antenatal clinic (ANC) at Pumwani Maternity Hospital (PMH). Methodology: A hospital based cross-sectional study design was conducted from 8<sup>th</sup> June to 18<sup>th</sup> August, 2015. Systematic random sampling method was used to select 258 pregnant women. Mothers who attended ANC during the study period and who met the inclusion criteria were interviewed and a capillary blood sample was taken. Hemoglobin level was determined by using HemoCue photometer. Data were cleaned, coded and fed into SPSS Version 20.0 for analysis. Descriptive statistics such as frequency, percentage, mean and standard deviation were used to describe selected variables. Pearson’s chi-square test and odds ratio (OR) with corresponding 95% confidence intervals (CI) computed to find association between independent and dependent variables. Multivariate analysis was done to determine factors significantly and independently predicting anaemia during pregnancy. Results: The present study revealed that the prevalence of anaemia among the pregnant women was 57%. Advanced maternal age (>31 years) (AOR = 2.71;95% CI = 1.25 - 5.88;P = 0.012) more than 18 - 24 years, government/private employed women (AOR = 2.94;95% CI = 1.47 - 5.88;P = 0.002) and self-employed women (AOR = 1.91;95% CI = 1.03 - 3.53;P = 0.039) compared to housewives, not taking iron/folic acid supplementation (IFAS) (AOR = 2.04; 95% CI = 1.14 - 3.64;P = 0.016) and mid-upper arm circumference (MUAC) less than 23 cm (AOR = 2.52;95% CI = 1.36 - 4.67;P = 0.003) were found to be predictors of anaemia. Conclusion: Anaemia among pregnant women is found to be severe public health problem based on the World Health Organization classification of anaemia. Advanced age, employment, not taking IFAS during the current pregnancy and MUAC of less than 23 cm were significantly and independently associated with anaemia during pregnancy. Thus, special attention should be given to pregnant women who are employed and advanced in age. Moreover, they should be educated on the importance of taking iron and folic acid during pregnancy.
文摘<b><i><span>Background</span></i></b><span>: Achieving and maintaining glycemic targets </span><span>are</span><span> a challenge for health practitioners around the world. We aimed to study the factors associated with prolonged poor diabetes control in the cohort of T2DM patients monitored and treated in the Department of Internal Medicine at the Yalgado OUEDRAOGO Teaching Hospital in Ouagadougou in order to optimize therapeutic education in these patients. </span><b><i><span>Methodology</span></i></b><span>: This was a descriptive and analytical cross-sectional study combining retrospective data collection from the last year of patient follow-up and prospective collection of some information. The study included all diabetic patients, aged at least 18 years old, followed and treated in the Department of Internal Medicine at the Yalgado OUEDRAOGO Teaching Hospital between January 1, 2010 and December 31, 2018 following a systematic random sampling with a sampling step of 10. The variables collected were sociodemographic, anthropometric, lifestyle, cardiovascular risk factors and diabetes-related characteristics. To determine the risk factors associated with prolonged poor glycemic control, we performed modeling using logistic regression. All variables associated with prolonged poor glycemic control, in bivariate logistic regression with a p-value less than 0.20 were included in the full model. Later, we used a stepwise descending method to obtain the final model, which was then tested by a receiver operating characteristic (ROC) curve. The significance threshold was set at 5%. Raw and fitted Odds-Ratio (OR) and 95% confidence interval were presented. </span><b><i><span>Results</span></i></b><span>: 270 patients were included. Prolonged poor control of diabetes mellitus was observed in 73.70%. The mean age was 55.97 years (SD: ±11.52) and the sex ratio was 0.6 in favor of female. The mean time since diabetes mellitus diagnoses was 5.85 years (SD: ±5.15). A monthly gain of 92.62 USD (50.74%) for average diabetes mellitus care expenditures of 55.82 USD (SD: 28.25) was reported. An overweight (55.92%) and hypertension (41.85%) were reported. Diabetes mellitus was complicated in 68.15%. Patients were supported by their families in the management of their diabetes mellitus in 85.19%. In multivariate analysis with bivariate logistic regression, low level of formal education (OR = 8.34, 95% CI [1.97 - 35.22];</span><i><span>p</span></i><span> < 0.01), family support for diabetes mellitus management (OR = 0.65, 95% CI [0.45 - 0.94];</span><i><span>p</span></i><span> = 0.02), presence of abdominal obesity (OR = 2.27, 95% CI [1.08 - 4.77];</span><i><span>p</span></i><span> = 0.03), presence of a history of hospitalization (OR = 7.39, 95% CI [2.97 - 18.39];</span><i><span>p</span></i><span> < 0.01), poor adherence to antidiabetic treatment (OR = 2.97, 95% CI [1.42 - 6.18];</span><i><span>p</span></i><span> < 0.01), and the presence of microangiopathy (OR = 5.05, 95% CI [2.36 - 10.81];</span><i><span>p</span></i><span> < 0.01) were the factors independently associated with prolonged poor control of T2DM, with a ROC curve of 0.88, which reflects a very good sensitivity and specificity of these factors. </span><b><i><span>Conclusion</span></i></b><b><span>: </span></b><span>The imbalance of T2DM is multifactorial. Lifestyle, family environment, and compliance seem to be essential to ensure good glycemic control. Healthcare practitioners should take these elements into account in their daily patient assessment. A predictive score would be a tool to help identify patients at risk of diabetes imbalance and would contribute to improv</span><span>ing</span><span> their management.</span>
文摘Background: In 2005, the World Health Assembly asked member states to develop effective strategies and programs to reduce the negative consequences of harmful use of alcohol. To develop effective policies, we must already understand the phenomenon of alcohol consumption. But in Francophone west Africa, there are very few studies on the prevalence of alcohol, consumption patterns and factors associated with this consumption. The objectives of this study were to estimate the prevalence of alcohol use in schools in Burkina Faso and to identify socio-demographic factors associated with episodes of “heavy drinking”. Method: A cross-sectional study was conducted in October 2013 in six secondary schools of Bobo-Dioulasso. Three hundred and sixty-two students randomly drawn by stratified cluster sampling were interviewed by using a self-administered questionnaire adapted from the model ESPAD and WHO AUDIT questionnaire. HED (Heavy Episodic Drinking) was defined as consuming at least six local measures of alcoholic beverages around the 30 days prior investigation. The search for factors was performed using logistic regression and estimating standard errors were adjusted for clustering data. Results: The prevalence of experimentation of alcohol was estimated to 45.6% [CI 95% = 40.4 - 50.7]. This prevalence was reduced to 34.8% [CI 95% = 29.9 - 39.7], 24.3% [CI 95% = 19.9 - 28.7] and 18% [CI 95% = 14 - 21.9] if one considered the use of alcohol at least once respectively in the 12 months, 30 days and 7 days before the survey. The prevalence of HED was 16% [CI95% = 12.2 - 19.8]. Independent factors associated with the HED were alcohol use by parents or friends and father’s occupation. Episodes of “heavy drinking” were 8.3 (CI 95% = 4.9 - 14) and 2.8 (CI 95% = 1.3 - 5.8) respectively more frequent among students whose parents and friends were drinking. Neither religion nor sex nor age was not statistically associated with HED. Conclusion: This study confirms the high prevalence of alcohol consumption in schools in Burkina Faso and challenges policy makers to adopt effective policies to fight against the harmful use of alcohol especially in schools.
文摘Introduction: Menopause is a biological phenomenon that occurs at a more or less early or late age in the life of every woman. The general objective is to study the factors associated with the age of natural menopause in menopausal women aged between 30 and 80 years who have gone through down Keur Massar health district in 2015. Methodology: This was an observational, cross-sectional, descriptive and analytical study conducted in Keur Massar health district from December 1<sup>st</sup> to 10<sup>th</sup>, 2015. Two-stage cluster sampling was conducted. Data were collected during an individual interview at home after consent. They covered socio-economic conditions, health and nutrition status, gynecological-obstetrical history, and lifestyle. A multivariate analysis was performed using the Cox model with a 5% risk of alpha error. Results: A total of 627 postmenopausal women were surveyed. Mean age of these women was 54.5 years (±8.6 years). A proportion of 72.1% of the women was married and 46.7% was in school. Mean age of natural menopause was 47.1 years (±5.03 years). The median age of natural menopause was 47 years. Factors associated with the age of natural menopause were high parity of more than 4 children (Hra = 0.35 [0.13 - 0.92]), the existence of frequent childhood illnesses (Hra = 1.72 [1.13 - 2.64]), use of the intra-uterine device—IUD—as a modern contraceptive method (HRa = 0.39 [0.24 - 0.63]), sibling size (HRa = 0.85 [0.78 - 0.93]), family size (HRa = 1.03 [1.01 - 1.06]), and polygamy regime (HRa = 0.56 [0.37 - 0.85]). Conclusion: Many factors in childhood as well as during the period of female genital activity can impact the age of natural menopause. It is then important to improve the health status of women, children and the standard of living of the population.
文摘Purpose: This purpose of the study was to investigate the factors both risk and protective associated with depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022, through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society databases, with the keywords “COVID-19”, “pregnant women”, and “depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;and 3) description of the factors associated with depression among pregnant women during the COVID-19 pandemic. Results: Of the 213 articles extracted, 104 were excluded owing to duplication, and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 40 were excluded by title, abstract, and full-text screening. Among the 45 articles for a total of 59,329 pregnant women that met the inclusion criteria, the risk factors were “distress from COVID-19-related experiences”, “reduced/low income”, “unemployment”, “anxiety”, “history of mental illness”, “lack of social support”, and “reduced/no exercise”. The protective factors “greater/increased social support”, “higher education level”, “higher resilience”, and “healthy lifestyle behaviors” were much less frequently reported than risk factors, and none were reported to be relevant for Japanese pregnant women. Conclusion: The findings indicate that preventive interventions should begin during pregnancy with a focus on these risk factors. In addition, the protective factors need to be strengthened. Further research is required to identify the protective factors associated with depression among Japanese pregnant women.
