East African Journal of Health and Biomedical Sciences

Adverse Birth Outcomes and Associated Factors among Iron-Folic Acid Supplements User and Non-user Women in Public Hospitals, Harari Region, Eastern, Ethiopia: A Comparative Cross-Sectional Study

Kebede Eleni Tesfaye — 2023-04-09

Background: Iron folic acid supplementation is a routine component of prenatal care that is an effective strategy for preventing adverse birth outcomes. However, its relationship with adverse birth outcomes is poorly understood, particularly in developing countries such as Ethiopia. Therefore, this study aimed to determine adverse birth outcomes and associated factors among iron-folic acid supplement users and non-user women in public hospitals in Eastern Ethiopia.

Methods: A comparative cross-sectional study was conducted on 512 (341 iron folic acid users and 171 non-users) consecutively selected women who gave birth in two public hospitals in the Harari region. Data were collected through interviews and complemented by reviewing medical records. Data was analyzed using the statistical package for social science version 24. Factors associated with adverse birth outcomes were identified using the multivariable binary logistic regression model. A P-value less than 0.05 is taken as a cut-off to determine statistical significance.

Results: The adverse birth outcomes among non-iron folic acid users and users were 53% (95% CI: 45.0, 61.0) and 16% (95% CI: 12.0, 20.0), respectively. Oligohydramnios (AOR=5.76; 95%CI: 1.56,21.25), spontaneous onset of labor (AOR=0.06; 95%CI: 0.04, 0.68), and induction of labor (AOR=0.20, 95%CI 0.05-0.90) were adverse birth outcomes among iron folic acid users, whereas anemia (AOR=3.38; 95%CI: 1.43, 7.98), pregnancy-induced hypertension (AOR=4.50; 95%CI: 1.61, 12.58), and maternal long working hours (AOR=1.27; 95%CI: 1.07, 1.50) were associated with adverse birth outcomes among non-iron folic acid users.

Conclusions: In this study, adverse birth outcomes are higher among non-iron folic acid users. Anemia, pregnancy-induced hypertension, and long working hours were significant associations with adverse birth outcomes among non-iron folic acid users. Early screening and treatment of pregnancy-related complications and health education regarding iron-folic acid supplements during antenatal care should be strengthened.

Hypoglycemia and Associated Factors among Neonates Admitted to Neonatal Intensive Care Unit in Eastern Ethiopia

Shafi Ibsa — 2023-04-09

Background: Neonatal hypoglycemia is the most frequent metabolic disease in newborn infants worldwide; yet, published data on the magnitude of neonatal hypoglycemia and associated factors in Ethiopia is sparse. As a result, the purpose of this study was to investigate the severity of hypoglycemia and associated factors in neonates admitted to Hiwot Fana Comprehensive Specialized University Hospital in Eastern Ethiopia.

Methods: A cross-sectional study was conducted among 316 newborns admitted to the neonatal intensive care unit from November 2021 to February 2022. Data were collected using pretested, structured questionnaires and random blood glucose measurements. The data were analysed using Statistical Package for Social Sciences version 21.0. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to measure the strength of the association, and a P-value < 0.05 was considered statistically significant.

Results: The overall magnitude of hypoglycemia in the neonates was 27.8% (95% CI: 23.1, 32.6). Very low birth weight (AOR= 3.32; 95% CI: 1.01, 10.83), macrosomia (AOR= 8.16; 95% CI: 2.52, 26.38), preterm birth (AOR= 2.52; 95% CI: 2.01, 8.38), birth at 32–34 weeks (AOR= 1.98; 95% CI: 1.73, 6.57), late preterm birth (AOR= 2.58; 95% CI: 1.16, 5.56), hypothermia (AOR= 2.90; 95% CI: 1.44; 5.36), perinatal asphyxia (AOR= 5.30; 95% CI: 5.23; 9.64), pregnancy-induced hypertension (AOR= 2.18; 95% CI: 1.15, 4.21), and infants of diabetic mothers (AOR= 4.30; 95% CI: 1.32, 14.03) were significant predictors of neonatal hypoglycemia.

Conclusion: One in four neonates admitted to the neonatal intensive care unit had hypoglycemia. Hence, early detection and treatment of hypothermia, perinatal asphyxia, and maternal pregnancy-induced hypertension and diabetes, as well as monitoring blood glucose in high-risk neonates, are crucial to minimizing the burden of neonatal hypoglycemia.

Toxicological Distribution of Mercury Concentrations in Abiotic and Biotic Environments: A Systematic Review and Meta-Analysis

Tolera Sina Temesgen — 2023-12-15

Background: Mercury (Hg), particularly methyl-mercury (Methyl-Hg), is a potentially dangerous heavy metal with special physicochemical features including environmentally persistent, bio-accumulative, bio-concentrated, and bio-magnification. Thus, it can potentially be a high risk to both human and environmental health. However, there are few studies quantifying mercury toxicity in all environmental components, especially in developing countries. Therefore, this systematic review and meta-analysis aimed to determine the amount of mercury present in various environmental components.

Methods: Preferred Reporting Items for Systematic Reviews (PRISMA) updated criteria were used for the flow diagram. PubMed, Medline, Web of Science, Embase, previous reviews, reports, and other methods were searched as databases. A thorough search was conducted for all studies published in 2000–2023 using keywords and MeSH terms with Boolean logic operators (AND, OR). The titles and abstracts returned by the search were screened. Data were extracted using a prescribed Microsoft Excel. The mean concentration of Hg in soil, blood, fish and dust, and plant leaf was estimated using STATA version 17. The random effect model with a 95% confidence interval was used at a p-value of less than 0.05.

Results: A total of 208 records were searched from PubMed (n = 33), Medline (n = 39), Web of Science (n = 37), Embase (n = 23), previous reviews (n = 18), reports (n = 5) and via other methods (n = 53). This review revealed that different concentrations of Mercury (Hg) are found in various components of the environment. This review found the mean mercury concentration in fish was 1.60 µg (95% CI: -0.02, 3.22 µg), soil 0.32mg/kg (95% CI: -1.25, 1.90mg/km), dust 0.47 mg/kg (95% CI: -1.10, 2.04mg/km), water bodies 0.55 µg/dm3 (95% CI: -1.04, 2.13), plant 28.96 mg/kg (95% CI: -22.57, 80.49 mg/kg), and human blood at 0.92 µg/L (95% CI: -0.72 µg/L, 2.57).

Conclusions: This systematic review and meta-analysis concluded that the methyl-mercury form is the most prevalent in both biotic and abiotic as compared to other forms of mercury. Nevertheless, limited research has been found in low- and middle-income nations, where the majority of raw mercury is produced. Moreover, the review suggested that international cooperation, national policies, and regulations on mercury management are crucial for minimizing the harmful effects of both biotic and abiotic mercury components.

Detection of Severe Acute Respiratory Syndrome Coronavirus 2 from the Surface of Hospitals and Public Facilities during the COVID-19 Pandemic in Eastern Ethiopia: Evidence for Surface Transmission

Ayele Firayad — 2023-11-09

Background: Humans acquired Severe Acute Respiratory Syndrome Coronavirus 2 through respiratory droplets expelled by infected individuals during coughing, sneezing, and touching contaminated surfaces. However, there is no available data regarding environmental surface contamination in hospitals and public facilities in Ethiopia. Therefore, this study aimed to detect Severe Acute Respiratory Syndrome Coronavirus 2 on the surfaces of hospitals and public facilities in eastern Ethiopia during the Coronavirus-19 pandemic, from April 15 to May 15, 2021.

Methods: A cross-sectional study was undertaken, involving the collection of 384 swab samples from commonly touched surfaces in selected areas such as hospitals, automated teller machines, public transport, and game zones. The presence of viral nucleic acid was identified using a Reverse transcription-polymerase chain reaction. Subsequently, descriptive statistics were employed to summarize the findings

Results: The overall contamination of the swab environmental surfaces in hospital and community facilities with Severe Acute Respiratory Syndrome Coronavirus 2 was 12% (95% CI: 8.7, 15.2%). The virus was detected in 29.1% (32/110), of hospitals (3.6%, 1/28), automated teller machines (1.8%, 4/219), public transport, and 33.3% (9/27) of game zones. Surfaces in the surgical ward (5/6) from the hospital and gaming zone (33.3%) from the community facility were more commonly contaminated by Severe Acute Respiratory Syndrome Coronavirus 2.

Conclusions: In this study, more than one in ten of the screened environmental surfaces were contaminated with SARS-CoV-2. Surfaces in hospitals and gaming areas have significant Severe Acute Respiratory Syndrome Coronavirus 2 levels. There are strong preventive and control measures focusing on the cleaning of hand contact surfaces using appropriate chemicals to avoid viral spread across the population.

Bacteriological quality, antibiotic susceptibility pattern of isolates and associated factors among raw cow’s milk collected from cafeterias in Adama Town, Oromia Region, Ethiopia

Gudeta Nura — 2023-11-09

Background: Milk is an excellent medium for the growth of microorganisms because it is composed of water, nutrients, and an almost neutral pH, and consuming such pathogens is hazardous to human health. Based on our knowledge, there is currently no published research available regarding the bacteriological quality of raw cow's milk sourced from cafeterias in Adama Town.

Methods: A cross-sectional study was conducted in Adama Town, Oromia Region, Ethiopia, from March 23 to June 6, 2019. The study included 115 randomly selected samples of raw cow's milk obtained from cafeterias. Questionnaire was used to collect data on handling practices. The milk samples were cultured on Eosin methylene blue agar, mannitol salt agar, and Salmonella-Shigella agar to determine the total and coliform count using serial dilutions. The antibiotic susceptibility testing of the bacterial isolates was assessed using the Kirby-Bauer disk diffusion method on Muller-Hinton agar. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22. A logistic regression model was used to assess the association between predictors and milk quality and a p-value of less than 0.05 was considered statistically significant.

Results: The overall mean ± standard error of total bacterial and coliform counts of sampled milk were 6.600 ± 0.144 and 4.96 ± 0.10 log10 CFU/mL, respectively. Based on 2009 Ethiopian standards for the bacteriological quality of raw milk, 71.3% of the samples were of poor quality, and 67% of them also tested positive for total coliforms. Staphylococcus aureus (23.5%) and Escherichia coli (7.8%) strains were identified in the milk samples. All E coli isolates were found to be resistant to ampicillin, but susceptible to amoxicillin-clavulanic acid, ceftriaxone, gentamicin, cotrimoxazole, ciprofloxacin, tetracycline, chloramphenicol, cefoxitin . The majority of Staphylococcus aureus isolates showed resistance to one or more of the tested antibiotics.

Conclusions: In this study, more than seven out of ten of the milk samples had significant levels of bacterial contamination. Multidrug resistance was observed in nearly half of the total tested isolates. Adequate sanitary measures, hygienic practices, strict monitoring, and quality control measures should be in place to ensure the delivery of safe and quality milk to consumers.