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Abstract BACKGROUND: The Apgar score is a method to quickly summarize the health of newborn children. It establishes a simple and clear classification of newborns, which could be used to predict survival and to compare methods of resuscitation and perinatal experience across hospitals and obstetric practices. Low Apgar score is associated with various immediate and long-term adverse health outcomes of newborns. Hence; in order to decrease the risk/complications, identifying the determinant factors of low Apgar is crucial to act on the modifiable risk factors. This study is aimed to investigate the determinant factors of a low Apgar score in newborn children.METHOD: The study was conducted in Lemelem Karl general hospital; northern Ethiopia. An institutional-based unmatched, case-control study was implemented. Data were retrieved from medical charts of 662 newborns’ mothers who gave birth in the hospital from Sep 2014 to Sep 2017. Among these, 221 of them were cases (charts of mothers whose newborns’ fifth minute Apgar score was <7) and 441 of them were controls (charts of mothers whose newborns’ Apgar score was 7 and above). Data was collected using a pretested and structured checklist using systematic sampling and data was entered & analyzed using SPSS version 20. Binary and multivariable logistic regression was done to determine the association and statistical significance was declared at P-value of ≤0.05. RESULTS: This study revealed that low Apgar score was significantly associated with antepartum hemorrhage [Adjusted odss ratio (AOR) 3.509; 95% confidence interval (CI) 1.526-8.067), P= 0.003], pregnancy-induced hypertensive disorders [AOR 2.69; 95% CI (1.351-5.357), P= 0.005], prolonged second stage of labor [AOR 2.63; 95% CI (1.399-4.944), P= 0.003], Cesarean delivery [AOR 2.005; 95%CI (1.223-3.287), P= 0.006],meconium-stained liquor [AOR 6.955; 95% CI (3.721-13.001), P<0.001], and low birth weight [AOR 4.38; 95% CI (2.216-8.657), P<0.001].CONCLUSION: Result from this study showed a remarkable linkage of low Apgar score with antepartum hemorrhage, pregnancy-induced hypertensive disorders, meconium-stained liquor, and low birth weight. Therefore, meticulous antenatal care and labour management service are recommended to prevent low Apgar score and the concomitant neonatal death.

BACKGROUND: The Apgar score is a method to quickly summarize the health of newborn children. It establishes a simple and clear classification of newborns, which could be used to predict survival and to compare methods of resuscitation and perinatal experience across hospitals and obstetric practices. Low Apgar score is associated with various immediate and long-term adverse health outcomes of newborns. Hence; in order to decrease the risk/complications, identifying the determinant factors of low Apgar is crucial to act on the modifiable risk factors. This study is aimed to investigate the determinant factors of a low Apgar score in newborn children.METHOD: The study was conducted in Lemelem Karl general hospital; northern Ethiopia. An institutional-based unmatched, case-control study was implemented. Data were retrieved from medical charts of 662 newborns’ mothers who gave birth in the hospital from Sep 2014 to Sep 2017. Among these, 221 of them were cases (charts of mothers whose newborns’ fifth minute Apgar score was <7) and 441 of them were controls (charts of mothers whose newborns’ Apgar score was 7 and above). Data was collected using a pretested and structured checklist using systematic sampling and data was entered & analyzed using SPSS version 20. Binary and multivariable logistic regression was done to determine the association and statistical significance was declared at P-value of ≤0.05. RESULTS: This study revealed that low Apgar score was significantly associated with antepartum hemorrhage [Adjusted odds ratio (AOR) 3.509; 95% confidence interval (CI) 1.526-8.067), P= 0.003], pregnancy-induced hypertensive disorders [AOR 2.69; 95% CI (1.351-5.357), P= 0.005], prolonged second stage of labor [AOR 2.63; 95% CI (1.399-4.944), P= 0.003], Cesarean delivery [AOR 2.005; 95%CI (1.223-3.287), P= 0.006],meconium-stained liquor [AOR 6.955; 95% CI (3.721-13.001), P<0.001], and low birth weight [AOR 4.38; 95% CI (2.216-8.657), P<0.001].CONCLUSION: Result from this study showed a remarkable linkage of low Apgar score with antepartum hemorrhage, pregnancy-induced hypertensive disorders, meconium-stained liquor, and low birth weight. Therefore, meticulous antenatal care and labour management service are recommended to prevent low Apgar score and the concomitant neonatal death.

BackgroundCervical cancer screening and prevention programs have been given considerable attention in high-income countries, while only receiving minimal effort in many African countries. This meta-analytic review aimed to estimate the pooled uptake of cervical cancer screening uptake and identify its predictors in Sub-Saharan Africa.MethodsPubMed, EMBASE, CINAHL, African Journals Online, Web of Science and SCOPUS electronic databases were searched. All observational studies conducted in Sub-Saharan Africa and published in English language from January 2000 to 2019 were included. The Newcastle-Ottawa Scale was applied to examine methodological quality of the studies. Inverse variance-weighted random-effects model meta-analysis was done to estimate the pooled uptake and odds ratio of predictors with 95% confidence interval. I2 test statistic was used to check between-study heterogeneity, and funnel plot and Egger’s regression statistical test were used to check publication bias. To examine the source of heterogeneity, subgroup analysis based on sample size, publication year and geographic distribution of the studies was carried out.ResultsOf 3,537 studies identified, 29 studies were included with 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2= 98.5%). Meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly 5-folds (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors include educational status, age, HIV status, contraceptive use, perceived susceptibility, and awareness about screening locations.ConclusionCervical screening uptake is low in Sub-Saharan Africa and influenced by several factors. Health outreach and promotion targeting identified predictors are needed to increase uptake of screening service in the region.sProtocol registrationCRD42017079375