Institute of Health

Effect of Attending Eight Antenatal Care Contacts on Adverse Perinatal Outcomes among Postnatal Mothers in Jimma Town Public Health Facilities Oromia, Ethiopia

Wed, 11 Jun 2025 00:00:00 GMT

Effect of Attending Eight Antenatal Care Contacts on Adverse Perinatal Outcomes among Postnatal Mothers in Jimma Town Public Health Facilities Oromia, Ethiopia Getu Tesfaye; Makeda Sinaga; Fikadu Abebe Background: Adverse perinatal outcome encompasses complications during pregnancy, labor, and delivery affecting maternal and neonatal health. While antenatal care reduces these risks by detecting and managing complications early, developing countries still face higher rates of adverse outcomes, necessitating improved interventions. Thus, WHO introduced a new eight contact antenatal care model to enhance positive pregnancy outcomes. However, research on its effectiveness in reducing adverse perinatal outcomes in in study area is lacking. Thus, this study aimed to assess its effect in Jimma Town Health Facilities. Objective: To assess the effect of eight antenatal care contacts on adverse perinatal outcomes among postnatal mothers in Jimma Town public health facilities, Oromia, Ethiopia, 2024 Methods: A facility-based retrospective cross-sectional study design was conducted from Sept 1 to 30, 2024 among 420 mothers who delivered in Jimma Town public health facilities. Data were collected through structured questionnaire and medical record reviews. Data quality checked through pre-test, training was provided to data collectors, and assigning supervisor. The data were entered, and coded into Epidata 4.2. and exported to SPSS version 27 for further analysis. Bivariable and multivariable logistic regression analyses was used and RR/OR with 95% confidence interval was used to measure strength of association. Results: The prevalence of adverse perinatal outcome among women with 8 ANC contact was 14.7% vs 23.7 in those without 8 ANC contacts. Multivariable analysis showed that having eight ANC contacts resulted a 39% reduction in the odds of adverse perinatal outcomes (AOR=0.61, 95% CI: 0.49–0.71). positive predictors like primiparity [AOR = 1.478 (95%CI: 1.224-1.872)], unplanned pregnancy [AOR= 2.39 (95%CI: 1.21-3.23], and negative predictors like college or higher education [AOR = 0.453(95% CI: 0.289-0.571)], an income of 10000 ETB or more [AOR = 0.41 (95% CI: 0.21-0.52), and place of ANC follow- up in hospital [AOR = 0.46 (0.29-0.56)] were identified. Conclusion and recommendation: Completion of eight ANC contacts significantly reduced the risk of adverse outcomes. Strengthening eight ANC contact should be prioritized by health care providers and local health authorities to enhance positive perinatal outcomes

Effect of Perceived Social Support on Neonatal Birth weight Among Mothers Who Delivered In Jimma Medical Center, Southwest Ethiopia.

Wed, 11 Jun 2025 00:00:00 GMT

Effect of Perceived Social Support on Neonatal Birth weight Among Mothers Who Delivered In Jimma Medical Center, Southwest Ethiopia. Bacha Mulatu; Makeda Sinaga; Mahlet Million Background: Perceived social support provides a broad range of Emotional, Informational, Instrumental, and companionship support. Some evidences showed perceived social support curtails to enhance good perinatal outcome. However, its effect on birth weight has not been studied in study area. Therefore, this study aimed to assess the effect of perceived social support on neonatal birthweight among postnatal mothers in Jimma Medical Center. Objective: To assess the effect of perceived social support on neonatal birthweight among mothers who delivered in Jimma Medical Center, Jimma, southwest Ethiopia, 2024. Methods and materials: A facility-based retrospective cohort design was employed in the maternity ward of Jimma Medical Center, from March 10 to May 02, 2024. A total of 403 mothers were selected by using systematic sampling technique. The data were collected face to face by using semi-structured questionnaire. Then entered into epi info version 7.2 and exported to SPSS version 26 for data analysis was used to compare perceived social support and birth weight. Linear regression analysis was used to investigate the association between variables and at a P value of 0.05 along 95% CI was declared statistically significant. Results: The study revealed higher mean birth weights among infants of mothers with greater social support (3120g high vs 2710g for low support, p<0.001). Each unit increase in Multidimensional Scale of Perceived Social Support score was associated with 67.3g increase in birth weight (β=67.3, 95% CI: 37.5-116.7). Additionally, positive predictors like being married (β=23.2 ,95% CI :13.3-45.7), college or above education (β=14.8, 95%CI: 6.7-432.3), higher monthly income (β=31.3 ,95% CI: 10.6-73.5), planned pregnancy (β=45.2 ,95% CI: 24.7-81.6), and negative predictors drug usage during pregnancy (β=-23.9 ,95% CI: -39.4,-13.5), and primiparity (β=-4.2 ,95% CI: -8.2,-2.9) were identified. Conclusion: This study provides that maternal social support significantly influences birth weight outcomes in Ethiopia. The findings highlight that enhancing social support systems could help reduce the high prevalence of low-birth-weight infants in this population which requires focus of health workers and institution. Therefore, healthcare systems should integrate social support assessments into routine antenatal care and develop targeted interventions to strengthen support network for pregnant women.

Effectiveness of Couple-Based Violence Prevention Education on Intimate Partner Violence during Pregnancy in Rural Districts of Hadiya Zone, Central Ethiopia: A Cluster Randomized Controlled Trial

Thu, 18 Dec 2025 00:00:00 GMT

Effectiveness of Couple-Based Violence Prevention Education on Intimate Partner Violence during Pregnancy in Rural Districts of Hadiya Zone, Central Ethiopia: A Cluster Randomized Controlled Trial Zeleke Dutamo Agde; Muluemebet Abera; Nega Assefa; Jeanette H. Magnus Background: Intimate partner violence (IPV) during pregnancy is closely associated with adverse maternal and fetal outcomes. A substantial proportion of women in Ethiopia experience IPV during pregnancy. Research has consistently highlighted the importance of engaging men (perpetrators) in efforts to prevent IPV as a pivotal and effective means of addressing IPV. There is limited evidence on interventions that involve men that aimed at preventing violence during pregnancy in Ethiopia. Therefore, this study was aimed to evaluate the effectiveness of couple based violence prevention education in reducing IPV during pregnancy in rural districts of Hadiya Zone, central Ethiopia. Methods: The couple-based violence prevention education study was conducted in four rural districts (Soro, Lemo, Analemo, and Duna) of Hadiya zone, central Ethiopia region from December 5, 2022, to April 30, 2024. This study employed a mixed study design (sequential exploratory design) was employed. It consisting of 1) a qualitative exploratory study involving 77 participants (pregnant women, religious leaders, community leaders, male partners, and women‘s development army); 2) a baseline cross-sectional study with 432 couples; and 3) a cluster randomized controlled trial, which included a total of 432 couples (216 couples in the intervention group and 216 couples in the control group). A cluster random sampling was employed to select study participants in the quantitative study, while a purposive sampling method was used to select study participants for the qualitative study. The intervention, couple based violence prevention education was implemented for six months for the intervention groups. Pre-tested interview questionnaires were used to collect quantitative data at baseline and endline assessments. Topic guides were used to collect data in in-depth interviews (IDIs) and focus group discussions (FGDs). The SPSS version 25 and ATLAS.ti 7.1 were used for quantitative and qualitative data analysis, respectively. For the experimental study, the chi-square test and sample t-test were used to test the statistical significance at baseline in the intervention and control groups for the categorical and continuous variables, respectively. Moreover, the McNemar test was then employed to compare the outcomes of interest between the intervention and control groups, both before and after the intervention. Intention-to-treat (ITT) analysis approach was employed to analyze data. xiii A difference-in-difference (DiD) analysis was conducted to determine the net effect of the intervention while Generalized Estimating Equation (GEE) model to determine the odds of the outcomes between the intervention and control groups. Finally, the qualitative data were analyzed thematically, with codes, categories, and themes emerging from the data. Results: A total of 58 codes, 22 categories, and four themes emerged from the qualitative data of community perspectives towards IPV during pregnancy. The themes include: threats to the health of the mother and the fetus, contributing factors of IPV during pregnancy, coping strategies for IPV during pregnancy, and the need for intervention. The baseline cross-sectional assessment revealed that early marriage, being uneducated, lower autonomy, partners‘ cigarette smoking and alcohol consumption, male partners‘ poor knowledge of IPV, and partners‘ non involvement in antenatal care (ANC) were found to be the predictors of IPV during pregnancy. It was also shown that 53.0% of women and 58.4% of men had good knowledge of IPV. A significant proportion of pregnant women (56.0%) and male partners (65.6%) held supportive attitude towards IPV. Moreover, it was revealed that couple-based violence prevention education was effective in improving male partners‘ knowledge and changing their attitude and controlling behavior related to IPV. Knowledge of IPV nearly quadrupled among male partners in the intervention groups (AOR = 3.7; 95% CI 2.6-5.4). Moreover, the intervention reduced the male partners' attitude and controlling behavior related to IPV by 67.6% (AOR = 0.324; 95% CI 0.229-0.459) and 56.4% (AOR = 0.436; 95% CI 0.317-0.600), respectively. Subsequently, the intervention led to a substantial and statistically significant reduction in the proportion of IPV and its different forms (psychological, physical, and sexual) among mothers in the intervention group. The intervention led to a net reduction of 23.6% in any IPV during pregnancy and a 74.1% decrease in the likelihood of experiencing any IPV (AOR = 0.259; 95% CI: 0.161–0.417). Conclusion and recommendation: The couple-based violence prevention education led to a significant improvement in knowledge of IPV and a reduction of supportive attitudes towards wife beating and controlling behavior among male partners. Overall, the intervemtion was effective in reducing any IPV among the study participants in the study area. Tailoring the couple-based violence prevention education that address healthy communication in marital relationships, promoting mutual respect among couples, challenging harmful gender norms and xiv power imbalances, and promoting joint decision-making that are crucial in preventing IPV in pregnancy. Therefore, scale-up the intervention and adaptation to similar settings are recommended.

Genomic diversity and antimicrobial resistance profiles of Shigella species in under-five children with acute diarrhea in Addis Ababa, Ethiopia

Sun, 11 Jan 2026 00:00:00 GMT

Genomic diversity and antimicrobial resistance profiles of Shigella species in under-five children with acute diarrhea in Addis Ababa, Ethiopia Basha Ayele; Getenet Beyene; Zeleke Mekonnen Background: Shigella species exhibit considerable genetic diversity, reflecting distinct genomic traits and epidemiological trends. In Ethiopia, infections caused by Shigella species, along with rising antimicrobial resistance (AMR), pose a major public health threat, especially among children under five. To our knowledge, there are few studies on the genetic diversity and antimicrobial susceptibility of Shigella species in this vulnerable age group. Figuring this out could help treat cases better and control outbreaks more effectively. Objective: This study aimed to characterize Shigella species' genomic diversity and AMR profiles in under five children with acute diarrhea in Addis Ababa, Ethiopia. Methods: Between June 2021 and April 2022, we conducted a cross-sectional study. Freshly passed stool specimens were collected and transported in Cary Blair media to the Ethiopian Public Health Institute (EPHI) laboratory for Shigella isolation and identification using standard bacteriological methods. Serogrouping was performed using polyvalent antisera, and antimicrobial susceptibility testing (AST) was conducted using the disk diffusion method. Additionally, a systematic review and meta-analysis were conducted to assess the prevalence and AMR patterns of Shigella species in East Africa. Molecular characterization was performed using whole-genome sequencing (WGS) analysis. Sequencing was conducted using the Illumina NextSeq550 (Illumina, Singapore) with a 300-cycle kit, generating paired-end reads of 149bp. Raw reads were quality-filtered and trimmed to a minimum length of 50 bp before being taxonomically classified using MiniKraken version 1. The whole genome data were aligned with Antibiotic Resistance Gene (ARG) sequences from the Comprehensive Antibiotic Resistance Database (CARD) using the Resistance Gene Identifier (RGI). Plasmid analysis was performed using the Mykrobe PlasmidFinder tool. Additionally, AMR and virulence genes were screened using the Centre for Genomic Epidemiology (CGE) web-based platform. Data were analyzed using descriptive statistical tools. The association of independent and dependent variables was evaluated with logistic regression. A P-value < 0.05 was considered statistically significant. Results: Among the 534 stool-cultured specimens in the prospective study, 47 (8.8%) were positive for Shigella species. Of these, 31 were serologically identified as S. sonnei and 16 as S. flexneri. Of 37 isolates analyzed by WGS, all 28 S. sonnei strains identified xiii serologically were confirmed as S. sonnei. However, all nine isolates initially identified as S. flexneri were found to be E. coli O37:H10. The phylogenetic tree showed that both S. sonnei and E. coli O37:H10 isolates had multiple evolutionary origins, suggesting that their phenotypic features evolved convergently. Plasmids Col156 and Col (BS512) were identified in all S. sonnei isolates, while IncFII and Col (MG828) plasmids were found only in one isolate. In contrast to S. sonnei, the most common plasmid type in E. coli O37:H10 isolates was IncFII, and virulence genes such as gad were frequently detected. Discrepancies were observed between phenotypic and genotypic AMR results. The systematic review estimated the pooled prevalence of Shigella species in East Africa was 6.2%. Despite variations in study sites and periods, the meta-analysis study further revealed an increased rate of resistance of Shigella species to tetracycline, ampicillin, amoxicillin, chloramphenicol, and co-trimoxazole. In the prospective study, AST showed that 100, 93.6, 80.9, 72.3, and 57.5% were sensitive to norfloxacin, nalidixic acid, ciprofloxacin, gentamicin, and cefoxitin, respectively. However, 100% of the isolates were resistant to amoxicillin. All isolates were resistant to three or more antimicrobials that exhibited multidrug resistance (MDR). None of the risk factors assessed showed a statistically significant association with Shigella infection. All S. sonnei isolates in our study contained genes encoding blaEC-8 and blaZEG-1. About 60.7% of the isolates were phenotypically sensitive to cefoxitin among the blaEC-8 genes detected in the genotyping analysis, whereas all isolates were completely resistant to amoxicillin phenotypically. The study also identified genes that conferred resistance to trimethoprim (dfrA1). Extended-spectrum beta lactamase (ESBL) blaEC-15 for cephalosporins, blaMIX-2, and blaMIX-6 for penicillins were detected in E. coli O37:H10. All E. coli O37:H10 isolates possessed a gene associated with trimethoprim resistance, and eight E. coli O37:H10 isolates exhibited consistent results for trimethoprim when comparing phenotype and genotype. The dominant AMR mechanism among the identified ARGs was antibiotic efflux, followed by antibiotic target alteration. Conclusion: There was no significant heterogeneity among East African studies, the majority of which were conducted in Ethiopia. Both the systematic review and the prospective phenotypic study revealed alarmingly increased levels of AMR to commonly administered antibiotics. The genotyping study revealed that the most prevalent resistant genes were associated with beta-lactam and trimethoprim drugs. The IncFII plasmid, which primarily encodes ESBL, was more frequently identified in E. coli O37:H10 isolates than xiv in S. sonnei. The study also highlighted a significant discrepancy between phenotypic and genotypic drug resistance, as well as variations in serotypes and phylogenetic relationships with global isolates. Recommendation: The study highlighted significant discrepancies between phenotypic and genotypic results. Molecular studies integrating WGS for AMR determination and strain identification into active surveillance could enhance monitoring of AMR spread and detection of potential emerging variations. Therefore, public health and clinical laboratories in Ethiopia should implement WGS to address inconsistencies in conventional analyses, enhance treatment efficacy, and inform targeted interventions.