Conectar
by Tadesse Tarik Tamir, Berhan Tekeba, Alebachew Ferede Zegeye, Deresse Abebe Gebrehana, Mulugeta Wassie, Gebreeyesus Abera Zeleke, Enyew Getaneh Mekonen
IntroductionSolitary childbirth—giving birth without any form of assistance—remains a serious global public health issue, especially in low-resource settings. It is associated with preventable maternal complications such as hemorrhage and sepsis, and poses significant risks to newborns, including birth asphyxia, infection, and early neonatal death. In Ethiopia, where many births occur outside health facilities, understanding the spatial and socio-demographic patterns of solitary childbirth is vital for informing targeted interventions to improve maternal and child health outcomes. This study aims to identify and map the spatial distribution of solitary childbirth across Ethiopia and to analyze its determinants using data from the 2019 national Interim Demographic and Health Survey.
MethodWe analyzed data from the 2019 Interim Ethiopian Demographic and Health Survey to determine the spatial distribution and factors of solitary birth in Ethiopia. A total weighted sample of 3,884 women was included in the analysis. Spatial analysis was used to determine the regional distribution of solitary birth, and multilevel logistic regression was employed to identify its determinants. ArcGIS 10.8 was used for spatial analysis, and Stata 17 was used for multilevel analysis. The fixed effect was analyzed by determining the adjusted odds ratio with a 95% confidence interval.
ResultThe prevalence of solitary childbirths in Ethiopia was 12.73%, with a 95% confidence interval spanning from 11.71% to 13.81%. The western and southern parts of Oromia, all of Benishangul-Gumuz, most parts of the SNNPR, and the west of Amhara regions were hotspot areas for solitary birth. Having no formal education, not attending ANC visits, and residing in pastoral regions were significantly associated with higher odds of solitary birth in Ethiopia.
CocnlusionA notable proportion of women are experiencing childbirth alone, which highlights a significant aspect of maternal health in the country, reflecting both the challenges and improvements in childbirth practices. The distribution of solitary births exhibited spatial clustering with its hotspot areas located in western and southern parts of Oromia, all of Benishangul-Gumuz, most parts of the SNNPR, and west of Amhara regions. Lack of education, not having an ANC visit, and being a resident of pastoral regions were significant determinants of solitary birth. The implementation of maternal and child health strategies in Ethiopia could benefit from considering the hotspot areas and determinants of solitary birth.
by Tamrat Endebu Gebre, Girma Taye, Wakgari Deressa
Loss to follow-up (LTFU) remains a major challenge in HIV care, particularly in resource-limited settings. While several studies have identified its predictors, many have neglected the competing risks of transfer out and death, as well as the dynamic influence of these predictors over time. A retrospective cohort study was conducted among adult HIV patients who initiated antiretroviral therapy (ART) between 2019 and 2024. LTFU was a primary outcome, whereas transfer out and death were competing risks. A Fine‒Gray subdistribution hazard ratio (SHR) regression analysis identified LTFU predictors within a competing risk framework. An extended SHR model with a time‒covariate interaction term was used to examine the predictors’ time‒varying effects on LTFU risk. Data analysis was performed via STATA 17 and Python 3.9. In a cohort of 4,135 HIV patients (8,521.54 person-years of follow-up), the overall incidence of LTFU was 13.10 per 100 person-years (95% CI: 12.35–13.89), with cumulative risks of 15%, 25%, and 35% at 1, 3, and 5 years post-ART, respectively. The predictors of LTFU included younger age (15–24 years: aSHR = 1.51), male sex (aSHR = 1.24), incomplete address details (aSHR = 1.72), noninitiation/noncompletion of TPT (aSHR = 2.16), poor adherence (aSHR = 2.54), and undernutrition (aSHR = 2.03). While younger age (e.g., 15–24 years) was associated with an increased risk of LTFU at baseline (baseline aSHR = 1.36, p = 0.014), this association diminished over time (interaction aSHR = 0.54, p = 0.001). Undernutrition consistently predicted LTFU (baseline aSHR = 1.64, pby Claudia Di Dio, Antonella Porrazzo, Alex De Gregorio, Patrizia Morciano, Maria Antonella Tabocchini, Giovanni Cenci, Francesca Cipressa, Giuseppe Esposito
Although the biological effects of low doses/dose rates of ionising radiation have been extensively studied both in vitro and in vivo, there are still knowledge gaps to be filled. For example, the mechanisms underlying the phenomena of radioadaptive responses and hypersensitivity to low doses of radiation are still not fully understood. This study aims to investigate the phenomenon of radioadaptive response in Drosophila melanogaster larval neuroblasts, focusing on the influence of different gamma priming doses and priming dose rates. We examined the modulation of cytogenetic damage, specifically the frequency of chromosome breaks, induced by a challenging dose of 10 Gy following different priming doses (0–2.7 Gy) delivered at dose rates ranging from 1.4 to 17 mGy/h. Our findings reveal the presence of a distinct window in which radioadaptive responses occurs, notably above a certain threshold dose when delivered at a rate of 1.4 mGy/h. Consistently with our previous results, we confirmed that the maximal protection was observed at a priming dose of 0.4 Gy delivered at 2.5 mGy/h. Additionally, we studied the occurrence of chromosome breaks after irradiating larval neuroblasts at doses ranging from 0.7 to 10 Gy. Notably, in this case we observed a low-dose hyper-radiosensitivity phenomenon up to 2.7 Gy, followed by increased resistance above 2.7 Gy. Our results provide insight into the complex cellular responses to low-dose/dose rate radiation and have implications in various fields, including radiation protection, diagnostics, theragnostics and biodosimetry.
FreshRSS