BackgroundAdolescence is the period between 10 and 19 years with peculiar physical, social, psychological and reproductive health characteristics. Rates of adolescent pregnancy are increasing in developing countries, with higher occurrences of adverse maternal and perinatal outcomes. The few studies conducted on adolescent pregnancy in Africa present inconsistent and inconclusive findings on the distribution of the problems. Also, there was no meta-analysis study conducted in this area in Africa. Therefore, this systematic review and meta-analysis were conducted to estimate the prevalence and sociodemographic determinant factors of adolescent pregnancy using the available published and unpublished studies carried out in African countries. Also, subgroup analysis was conducted by different demographic, geopolitical and administrative regions.MethodsThis study used a systematic review and meta-analysis of published and unpublished studies in Africa. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was strictly followed. All studies in MEDLINE, PubMed, Cochrane Library, EMBASE, Google Scholar, CINAHL, and African Journals Online databases were searched using relevant search terms. Data were extracted using the Joanna Briggs Institute tool for prevalence studies. STATA 14 software was used to perform the meta-analysis. The heterogeneity and publication bias was assessed using the I2 statistics and Egger’s test, respectively. Forest plots were used to present the pooled prevalence and odds ratio (OR) with 95% confidence interval (CI) of meta-analysis using the random effect model.ResultThis review included 52 studies, 254,350 study participants. A total of 24 countries from East, West, Central, North and Southern African sub-regions were included. The overall pooled prevalence of adolescent pregnancy in Africa was 18.8% (95%CI: 16.7, 20.9) and 19.3% (95%CI, 16.9, 21.6) in the Sub-Saharan African region. The prevalence was highest in East Africa (21.5%) and lowest in Northern Africa (9.2%). Factors associated with adolescent pregnancy include rural residence (OR: 2.04), ever married (OR: 20.67), not attending school (OR: 2.49), no maternal education (OR: 1.88), no father’s education (OR: 1.65), and lack of parent to adolescent communication on sexual and reproductive health (SRH) issues (OR: 2.88).ConclusionsOverall, nearly one-fifth of adolescents become pregnant in Africa. Several sociodemographic factors like residence, marital status, educational status of adolescents, their mother’s and father’s, and parent to adolescent SRH communication were associated with adolescent pregnancy. Interventions that target these factors are important in reducing adolescent pregnancy.

This update yielded six new trials but no change in conclusions. The six COCs evaluated in placebo-controlled trials are effective in reducing inflammatory and non-inflammatory facial acne lesions. Few important and consistent differences were found between COC types in their effectiveness for treating acne. How COCs compare to alternative acne treatments is unknown since only one trial addressed this issue. The use of standardized methods for assessing acne severity would help in synthesizing results across trials as well as aid in interpretation.

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Background Adolescents have physical, social and psychological characteristics that are different from adults. Adolescent pregnancy results in pregnancy and childbirth complications- an area neglected in developing countries like Ethiopia. This study, therefore, was conducted to assess the adverse neonatal outcomes of adolescent pregnancy in Northwest Ethiopia. Methods Institutional-based study was conducted in East Gojjam zone, Northwest Ethiopia. A total of 374 adolescent (15–19 years) and 760 adult (20–34 years) women were included in this study. Data were collected among women who came to randomly selected health facilities in East Gojjam zone. Data were collected by trained research assistants using a structured data collection questionnaire. Descriptive statistics, chi-square test, and Student's t-tests were utilized. Bivariate and multivariable logistic regression analysis were employed to adjust for confounding factors of adverse neonatal outcomes. Statistical significance was declared when the p-value was less than 0.05. Results Higher proportion of adolescent than adult women were from rural area (57.2% vs 44.7%), were not married (5.1% vs 1.7%), were pregnant for the first time (91.7% vs 34.1%), didn’t attend antenatal care (ANC) follow-up (12% vs 4.5%), and had late initiation of ANC follow-up. After adjusting for known confounding factors, the odds of low birth weight (LBW) was higher among adolescents than adult women (AOR 2.14; 95% CI, 1.36, 3.36, p-value = 0 . 001 ). Similarly, the odds of preterm birth was higher among adolescents than adult women (AOR 1.65; 95% CI, 1.09, 2.49, p-value = 0 . 017 ). There was no statistically significant difference in the rate of low Apgar score at first and five minutes after birth and neonatal Intensive Care Unit (ICU) admission between babies born from adolescent and adult women. Conclusions Adolescent women were less likely to receive ANC service. Babies born from adolescent women are at higher odds of adverse neonatal outcomes like LBW and preterm birth than babies born from adult women. Use of community- and health facility-based intervention programs that can prevent adolescent pregnancy and reduce adverse neonatal outcomes among adolescent girls is recommended.

Sublingual misoprostol was as effective as i.v. oxytocin infusion in reducing blood loss at cesarean section. It offers several advantages over oxytocin, including long shelf life, stability at room temperature, and oral administration, which make it a suitable uterotonic agent in low-resource areas.

BackgroundTeenage childbearing among adolescents aged 15 to 19 is a common sexual and reproductive health (SRH) issue among young people, particularly in developing countries. It is associated with higher maternal and neonatal complications. Almost half (47%) of the population in Ethiopia are young people under 15 years old. Therefore, a clear understanding of the trend and determinants of teenage childbearing is essential to design proper intervention programs.MethodsSecondary analysis of the 2000 to 2016 Ethiopia Demographic and Health Survey (DHS) data were conducted. A total of 3710 (DHS 2000), 3266 (DHS 2005), 4009 (DHS 2011) and 3381 (DHS 2016) adolescents (aged 15 to 19 years old) were included from the four surveys. The main outcome variable of this study was teenage childbearing, and independent variables were categorized into individual- and community-level factors. The 2016 DHS was used to identify the factors associated with teenage childbearing. Multi-level logistic regression analysis technique was used to identify the factors associated with teenage childbearing. The analysis was adjusted for different individual- and community- level factors affecting teenage childbearing. Data analysis was conducted using STATA software.ResultsThe prevalence of adolescents who started childbearing reduced from 16.3% in 2000 DHS to 12.5% in 2016 DHS, p-value = < 0.0001. From the 2016 DHS, the percentage of adolescents who have had a live birth was 10.1%, and the percentage of adolescents who were currently pregnant was 2.4%. The highest percentage of teenage childbearing was in Affar region (23.4%), and the lowest was in Addis Ababa city (3%). The odds of teenage childbearing was higher among adolescents in the age range of 18–19 years old (AOR = 2.26; 95% CI: 1.29, 3.94, p-value < 0.01), those who started sexual intercourse before their eighteenth birthday (AOR = 12.74; 95% CI: 4.83, 33.62, p-value < 0.001), who were married or living together (AOR = 8.98; 95% CI: 2.49, 32.41, p-value < 0.01), and among those who were widowed, divorced or separated (AOR = 4.89; 95% CI: 1.36, 17.61, p-value < 0.05).ConclusionsOne in ten teenage girls have already started childbearing in Ethiopia. Variations were observed in the percentage of teenage childbearing across different sociodemographic- and economic variables. Factors like age, early sexual initiation before 18 years of age, ever married, and geographical region were significant factors associated with teenage childbearing. School- and community- based intervention programs aimed at prevention of early marriage and early sexual intercourse is essential to reduce teenage childbearing and its complications.

Selenium concentration in the sera and seminal plasma of 60 infertile males (40 oligospermia and 20 azoospermia) and 40 males with proven evidence of fertility (normospermia; control group) were estimated using atomic absorption spectrophotometry. Results were correlated with spermatogram and hormonal levels in order to determine their relationship and significance in male infertility. The mean serum concentrations of selenium was found to be significantly increased in oligospermic compared to azoospermic subjects and controls (p < 0.01), whereas the seminal plasma level was significantly higher in azoospermic compared to oligospermic subjects and controls (p < 0.001). Thus, the ratio of serum selenium to seminal plasma selenium was 1: 1 in controls, 4: 1 in oligospermia, and 1: 2 in azoospermic subject.A significant inverse correlation was observed between serum selenium level and sperm count (p < 0.01). Similarly, seminal plasma selenium correlated with spermatozoa motility, viability, and morphology. Serum selenium level shows positive correlation with the serum testosterone level (p < 0.01). In conclusion, there appears to be a physiological balance in the distribution of selenium in serum and seminal plasma compartment of control males. A disturbance in this balance has a significant influence on spermatogenesis. Selenium appears to have a positive influence on Leydig cells, thus influencing the secretion of testosterone.

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