Anemia and Associated Factors Among Pregnant Women Attending Antenatal Care Clinic in Wolayita Sodo Town,Southern Ethiopia

Background

Anemia during pregnancy is a common problem which affects both the mother''s and her child''s health. The main aim of the study was to determine the prevalence and associated risk factors of anemia among pregnant women.

Methods

We conducted a facility based cross-sectional study on 363 pregnant women attending antenatal care clinic in Wolayita Soddo Otona Hospital from January to March 2014. Sociodemographic data were collected through questionnaire based interview. Four milliliter of venous blood and five grams of fecal samples were collected from each pregnant woman. Hematological parameters were determined using CELL DYN 1800^® (Abott, USA) Hematology analyzer. Stool samples were checked for intestinal parasites using both direct wet mount and formol-ether concentration techniques.Data were analyzed using SPSS version 20 software.

Results

Overall, the prevalence of anemia was 39.94% (95% CI: 34.7 – 45.2%), of which the majority (60%) had moderate anemia. The mean hemoglobin concentration was 11.55±2.97 g/dl. Age 15–24 years (AOR: 9.89, 95%CI:2.68–21.41), family size >5 (AOR:7.74, 95%CI:4.15–16.47), multigravida (AOR:2.66, 95%CI:1.1.31–4.53), having low income (AOR:5.81, 95%CI:2.93–14.11), current clinical illness (AOR: 6.38, 95%CI:3.13–13.00), intestinal parasitic infection (AOR:2.41, 95%CI:1.08–5.81), no history of contraceptive usage (AOR:5.02 95%CI:2.21–11.47), being in third trimesters (AOR:11.37, 95%CI:4.56–24.82), history of excess menstrual bleeding (AOR:9.82, 95%CI:3.27–21.35) and low body mass index (AOR:9.44, 95%CI:7.79–22.18) were identified as independent predictors of anemia among pregnant women.

Conclusion

Anemia prevalence was found out to be moderate public health importance. Identified risk factors should be considered for prevention and control of anemia among pregnant women.     

β-defensin Genomic Copy Number Is Associated With HIV Load and Immune Reconstitution in Sub-Saharan Africans

AIDS, caused by the retrovirus human immunodeficiency virus (HIV), is the leading cause of death of economically active people (age, 15-59 years) in sub-Saharan Africa. The host genetic variability of immune response to HIV and immune reconstitution following initiation of highly active antiretroviral therapy (HAART) is poorly understood. Here we focused on copy number variation of the β-defensin genes, which have been shown to have anti-HIV activity, and are important chemoattractants for Th17 lymphocytes via the chemokine receptor CCR6. We determined β-defensin gene copy number for 1002 Ethiopian and Tanzanian patients. We show that higher β-defensin copy number variation is associated with increased HIV load prior to HAART (P?=?.005) and poor immune reconstitution following initiation of HAART (P?=?.003). We suggest a model where variable amounts of β-defensin expression by mucosal cells, due to gene copy number variation, alters the efficacy of recruitment of Th17 lymphocytes to the site of infection, altering the dynamics of infection.     

Prevalence and determinants of anemia among pregnant women in Ethiopia; a systematic review and meta-analysis

Background

Anemia during pregnancy is one of the most common indirect obstetric cause of maternal mortality in developing countries. It is responsible for poor maternal and fetal outcomes. A limited number of studies were conducted on anemia during pregnancy in Ethiopia, and they present inconsistent findings. Therefore, this review was undertaken to summarize the findings conducted in several parts of the country and present the national level of anemia among pregnant women in Ethiopia.

Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, and African Journals Online. Search terms used were; anemia, pregnancy related anemia and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 14 software. The pooled Meta logistic regression was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence interval (CI).

Results

Twenty studies were included in the meta-analysis with a total of 10, 281 pregnant women. The pooled prevalence of anemia among pregnant women in Ethiopia was 31.66% (95% CI (26.20, 37.11)). Based on the pooled prevalence of the subgroup analysis result, the lowest prevalence of anemia among pregnant women was observed in Amhara region, 15.89% (95% CI (8.82, 22.96)) and the highest prevalence was in Somali region, 56.80% (95% CI (52.76, 60.84)). Primigravid (RR: 0.61 (95% CI: 0.53, 0.71)) and urban women (RR: 0.73 (95% CI: 0.60, 0.88)) were less likely to develop anemia. On the other hand, mothers with short pregnancy interval (RR: 2.14 (95% CI: 1.67, 2.74)) and malaria infection during pregnancy (RR: 1.94 (95% CI: 1.33, 2.82)) had higher risk to develop anemia.

Conclusions

Almost one-third of pregnant women in Ethiopia were anemic. Statistically significant association was observed between anemia during pregnancy and residence, gravidity, pregnancy interval, and malaria infection during pregnancy. Regions with higher anemia prevalence among pregnant women should be given due emphasis. The concerned body should intervene on the identified factors to reduce the high prevalence of anemia among pregnant women.

     

Male involvement in the maternal health care system: implication towards decreasing the high burden of maternal mortality

Background

One of the essential components of antenatal care (ANC) is birth preparedness and complication readiness (BP/CR). Strengthening BP/CR measures is one of the principal strategies to reduce maternal mortality and morbidity. The current study aimed at determining the level of men’s knowledge about obstetric danger signs, and their involvement in BP/CR among community of Northwest Ethiopia.

Method

A cross-sectional community based survey was conducted in Northwest Ethiopia from May 2016 to July 2016. Data was analyzed by the Statistical Package for the Social Sciences software Version 21.0 for Windows. Participants’ socio-demographic characteristics, knowledge of obstetric danger signs, and level of involvement in BP/CR were described using frequencies and percentages. Bivariate and multivariable logistic regressions were employed to explore the associated factors and P-value of 0.05 was used as a cut-off point to declare significant association.

Result

From 856 men who were invited for the study, 824 men agreed for the interview giving a response rate of 96.2%. Half of the men stated one danger sign that may occur during pregnancy 407(49.4%); one third during delivery 271(32.9%); and 213(25.8%) during postpartum period. Among all participants, 256(31.1%) had not made any preparations; 363(44.1%) made one step; 116(14.1%) made two steps; 82(9.9%) made three steps; 5(0.6%) made four steps; 2(0.24%) made five steps; and no one made all the birth preparation steps during the birth of their last child. BP/CR was significantly association with knowledge of at least one danger sign during pregnancy (AOR?=?3.3, 95% CI: 3.1, 3.9); during delivery (AOR?=?2.2, 95% CI: 1.1, 2.8); and post partum period (AOR?=?1.8, 95% CI: 1.1, 2.4). Furthermore, BP/CR was found to be positively associated with being married, completing college education, escorting wife to antenatal care, and urban residence.

Conclusions

Men’s level of knowledge about obstetric danger signs, and their involvement in BP/CR was found to be very poor. Considering the importance of male involvement in the maternal health care, it is recommended to advocate policies and strategies that can improve awareness of men and enhance their engagement in the maternal care.

     

Health care seeking behavior for depression in Northeast Ethiopia: depression is not considered as illness by more than half of the participants

Background

Depression is one of the most disabling and chronic mental illnesses. Despite its high burden, many people suffering from depression did not perceive that they had a treatable illness and consequently most of them did not seek professional help. The aim of this study was to assess the level of professional help-seeking behavior and associated factors among individuals with depression.

Methods and materials

The community-based cross-sectional study was conducted among residents of Dessie, Northeast Ethiopia. First, 1165 residents were screened for depression using patient health questionnaire and then 226 individuals who were screened positive for probable depression were interviewed with General Help-Seeking Questionnaire to assess the professional help-seeking behavior of participants with depression. Major associated variables were identified using logistic regression with 95% confidence interval (CI), and variables with a p value less than 0.05 were considered statistically significant.

Results

Among the total participants with depressive symptoms, only 25.66% of them did seek professional help. Being female [adjusted odds ratio (AOR)?=?2.769, 95% CI (1.280, 5.99)], current alcohol drinking [AOR?=?2.74, 95% CI (1.265, 5.940)], co-morbid medical-surgical illness [AOR?=?4.49, 95% CI (1.823, 11.071)], perceiving depression as illness [AOR?=?2.44, 95% CI (1.264, 4.928)], having moderate depressive symptoms [AOR?=?2.54, 95% CI (1.086, 5.928)] and moderately severe depressive symptoms [AOR?=?7.67, 95% CI (2.699, 21.814)] were significantly associated with help seeking behavior of participants.

Conclusions

Level of professional help-seeking behavior is as low as previous studies in different countries. The severity of depressive symptoms, co-morbidity of medical–surgical illness, current drinking of alcohol, being female, and perceiving depression as illness were significantly associated with professional help-seeking behavior for depressive symptoms. Working on mental health literacy in the community is important to increase help-seeking behavior.

     

Comfort Evaluation of Wearable Functional Textiles

Wearable E-textile systems should be comfortable so that highest efficiency of their functionality can be achieved. The development of electronic textiles (functional textiles) as a wearable technology for various applications has intensified the use of flexible wearable functional textiles instead of wearable electronics. However, the wearable functional textiles still bring comfort complications during wear. The purpose of this review paper is to sightsee and recap recent developments in the field of functional textile comfort evaluation systems. For textile-based materials which have close contact to the skin, clothing comfort is a fundamental necessity. In this paper, the effects of functional finishing on the comfort of the textile material were reviewed. A brief review of clothing comfort evaluations for textile fabrics based on subjective and objective techniques was conducted. The reasons behind the necessity for sensory evaluation for smart and functional clothing have been presented. The existing works of literature on comfort evaluation techniques applied to functional fabrics have been reviewed. Statistical and soft computing/artificial intelligence presentations from selected fabric comfort studies were also reviewed. Challenges of smart textiles and its future highlighted. Some experimental results were presented to support the review. From the aforementioned reviews, it is noted that the electronics clothing comfort evaluation of smart/functional fabrics needs more focus.     

Development of Stainless Steel Yarn with Embedded Surface Mounted Light Emitting Diodes

The integration of electronic components in/onto conductive textile yarns without compromising textile qualities such as flexibility, conformability, heat and moisture transfer, and wash resistance is essential to ensuring acceptance of electronic textiles. One solution is creating flexible and stretchable conductive yarns that contain tiny surface-mounted electronic elements embedded at the fiber level. The purpose of this work was to manufacture and subsequently evaluate the physical features and electromechanical properties of stainless steel yarn with light-emitting surface mounted devices (SMDs) embedded in it. The SMDs were successfully integrated into a conductive stainless steel yarn (SS) by inserting crimp beads and creating a bond through hot air soldering machines, resulting in what we call an E-yarn. The relationship curves between gauge length and electrical resistance, and the relationship curves between conductive yarn elongation and electrical resistance, were explored experimentally. The results of the analysis demonstrated that E-yarn had a lower tensile strength than the original electrically-conductive SS yarn. The effects of the washing cycle on the conductivity of the E-yarn were also investigated and studied. The results showed that E-yarns encapsulated at the solder pad by heat shrink tube still functioned well after ten machine wash cycles, after which they degraded greatly.     

Role of PD-1 and its ligand, B7-H1, in early fate decisions of CD8 T cells

Expression of the PD-1 receptor on T cells has been shown to provide an important inhibitory signal that down-modulates peripheral effector responses in normal tissues and tumors. Furthermore, PD-1 up-regulation on chronically activated T cells can maintain them in a partially reversible inactive state. The function of PD-1 in the very early stages of T-cell response to antigen in vivo has not been fully explored. In this study, we evaluate the role of PD-1 and its 2 B7 family ligands, B7-H1 (PD-L1) and B7-DC (PD-L2), in early fate decisions of CD8 T cells. We show that CD8 T cells specific for influenza hemagglutinin (HA) expressed as a self-antigen become functionally tolerized and express high levels of surface PD-1 by the time of their first cell division. Blockade of PD-1 or B7-H1, but not B7-DC, at the time of self-antigen encounter mitigates tolerance induction and results in CD8 T-cell differentiation into functional cytolytic T lymphocytes (CTLs). These findings demonstrate that, in addition to modulating effector functions in the periphery, B7-H1:PD-1 interactions regulate early T-cell-fate decisions.