BackgroundThe incidence of premature rupture of membranes ranges from about 5% to 10% of all deliveries. A woman with premature rupture of membranes is at risk of intra-amniotic infection, postpartum infection, endometritis, and death. A neonate born from premature rupture of membranes mother is at high risk of respiratory distress syndrome, sepsis, intraventricular hemorrhage and death. Little is known regarding the risk factors in Ethiopia. Therefore, this study was conducted to identify risk factors of premature rupture of membranes among pregnant women admitted to public hospitals in Mekelle city, Tigray, Ethiopia.MethodsHospital based unmatched case control study design was implemented on 240 samples (160 controls and 80 cases) from pregnant mothers admitted to public hospitals in Mekelle city from February – April/2016. Data was collected by interviewer administered Structured questionnaire and checklist. Binary logistic regression model was used to see the association between dependent and independent variables and multivariable logistic regression was used to identify the independent predictors of premature rupture of membranes.ResultsA total of 160 controls and 80 cases were enrolled in the study. Multivariable logistic regression showed that history of abortion [AOR 3.06 (CI: 1.39, 6.71)], history of PROM [AOR 4.45 (CI: 1.87, 10.6)], history of caesarean section [AOR 3.15(CI: 1.05, 9.46)] and abnormal vaginal discharge in the index pregnancy [AOR 3.31(CI: 1.67, 6.56)] were positively associated with premature rupture of membranes.ConclusionsPast obstetric history and risks in the index pregnancy have an association with premature rupture of membranes. The finding of the study suggests early identification and treatment of genitourinary infection.

Background. Maternal tetanus is defined as tetanus acquired during pregnancy or within 6 weeks after the end of conception. As tetanus is a vaccine-preventable disease, immunization of pregnant mothers with a TT (tetanus toxoid) dose is one of the most effective ways to protect against the disease. Some studies showed that 94% of neonatal mortality reduction could be achieved through immunization of pregnant and childbearing-age mothers with at least two doses of TT vaccination. Objective. To assess the uptake of tetanus toxoid vaccine and associated factors among mothers who gave birth in the last 12 months in Errer district, Somali Regional State, Eastern Ethiopia, 2017. Methods and Materials. A community-based cross-sectional study design was implemented to study 440 mothers who gave birth in the last 12 months. Participants were selected using the strata and systematic sampling technique after conducting a preliminary survey. Data were collected through a face-to-face interviewer-administered questionnaire. The collected data was entered into EpiData version 3.02 and then exported to Statistical Package for the Social Sciences (SPSS) version 20. Bivariate and multivariate logistic regressions were carried out to see the association between variables at p<0.05 and 95% confidence interval. Finally, the information was presented by using frequencies, summary measures, and tables. Result. The overall tetanus vaccination uptake (≥TT2) doses was found to be 51.8%, 95% CI (47.7%, 56.4%). The total number of mothers who complete the five TT doses was 31 (14.8%). Urban residence [AOR=6.1, 95% CI: (2.33, 10.43)], multiparity [AOR=2.3, 95% CI: (1.7, 6.4)], and traveling less than 30 minutes from the home to a health facility [AOR=4.6, 95% CI: (1.34, 6.72)] were some the factors that were significantly associated with tetanus toxoid vaccination uptake. Conclusion and Recommendation. Although TT immunization is a scientifically proven mechanism to protect against maternal and neonatal tetanus, only half of the district mothers received ≥TT2 doses. Besides, our study revealed that the low vaccine uptake is attributed to long distance travel to reach a health facility, maternal illiteracy, and pastoralist lifestyle of mothers in the district. Thus, the regional stakeholders are required to scale up efforts on mother’s awareness creation towards the importance of the vaccine through health education and to arrange outreach TT vaccination campaigns in distant pastoralist communities within the region.

Background Globally, neonatal and child mortality remains still high. Under-five mortality accounts for four-fifth of child and young adolescent deaths. In Ethiopia, though there has been a remarkable progress over the past years, under-five mortality is still high. Evidence from population-based longitudinal studies on under-five mortality is limited. Thus, this study aims to investigate the magnitude, trend, and causes of under-five mortality in the Kilite-Awlaelo Health Demographic Surveillance System, Northern Ethiopia. Methods Kilite-Awlaelo health and demographic surveillance system was established in 2009 in the northern part of Ethiopia. Population-based longitudinal study design was carried out through extracting data for nine consecutive years (2009–2017). After smoothing the data revealed a visually decreasing trend. Linear, quadratic, exponential, and autoregressive time-series models were checked. Accordingly, the exponential trend model provided the best fit with the lowest standard error of estimate, lowest sum square error and highest adjusted R2 value. Cause-specific mortality was determined by cross tabulating cause of death with specific age death. Results The overall under-five mortality rate was 35.62 per 1000 livebirths. The under-five mortality rate of rural and urban residents was 37.58 and 12.99 deaths per 1000 livebirths respectively. The exponential trend model showed the under-five mortality rate was declining exponentially. Bacterial sepsis 67(20.6%), prematurity 37(11.08%), intestinal infection disease 30(8.98%), acute lower respiratory infections 26(7.78%), and birth asphyxia 24(7.19%) were the major causes of under-five mortality. Conclusion The overall under-five mortality rate for the surveillance period was comparatively lower. A statistically significant difference in under-five mortality rate was observed between urban and rural residents. A statistically significant declining trend in the under-five mortality rate was observed. Bacterial sepsis, prematurity, intestinal infection disease, acute lower respiratory infections, and birth asphyxia were the major causes of under-five mortality. We recommend the huge discrepancy in under-five mortality rate between urban and rural dwellers could be narrowed to some level by increasing healthcare access for rural residents.

Background: Neonatal tetanus remains a significant avertable cause of morbidity and mortality in neonates. Adequate vaccination strategies, including at least two doses of tetanus toxoid for reproductive age women, can decrease neonatal mortality. In Ethiopia, a few numbers of neonates were protected at birth through this proactive intervention. Therefore, this study aimed to determine factors associated with the low coverage of tetanus toxoid immunization. Objective: This study aimed to determine the status of Tetanus Toxoid immunization coverage and factors associated with it. Methods: Community-based cross-sectional study design was implemented among 515 mothers in Hawzen, Eastern zone of Tigray. The data were entered into Epi data manager version 3.5.1 and exported to Statistical Package for Social Science version 20 software for analysis. Bivariate and multivariate logistic regression was used to identify factors significantly associated with tetanus toxoid immunization coverage. Results: Two hundred and seven (40.2%) mothers were protected against tetanus at last birth. Mothers whose age was less than 20 years [AOR 0.19(0.10, 0.32), had no future plan for fertility [AOR 0.30(0.17, 0.53)], mothers attended once for antenatal care visits [AOR 0.38(0.18, 0.82)] and who got information from media [AOR 4.49(1.82, 11.07] were independent predictors of tetanus toxoid immunization status of mothers. Conclusion: More than half of the mothers were not protected against tetanus at the time of last birth. This study found the age of mothers, future fertility plans, numbers of antenatal care visits and mothers who got information from media; these were significant factors associated with the likelihood of tetanus toxoid immunization of mothers.

Introduction: Birth asphyxia is defined by the World Health Organization as not initiating and maintaining default breathing at birth. Approximately 24% of neonatal deaths occurred annually worldwide due to birth asphyxia. About 3% of the 120 million neonates born each year acquire asphyxia in third world countries. Long-term survivors may experience cerebral palsy, delay in growth, vision, hearing and intellectual deficiency, epilepsy, difficulties with communication and behavior. Thus, this study aims to determine the risk factors of birth asphyxia among neonates who were delivered at public hospitals of Tigray, Ethiopia. Materials and Methods: Hospital-based unmatched case-control study design was implemented on 390 samples from January to February 2018. Data were collected by interviews using a structured questionnaire and checklist. The collected data were coded and entered using EpiData version 3.1 statistical software and transported to statistical package for social science (SPSS) version 20 software for analysis. Cross-tabulation and odds ratio with 95% confidence interval were computed. Bivariate logistic regression and multivariable logistic regression were done. Multicollinearity was checked. Goodness of fit was checked by the Hosmer-Lemeshow test. Results: A total of 260 controls and 130 cases were enrolled in the study. Multivariable logistic regression showed that Primi-parity [AOR 5.5 (CI: 2.5,12.3)], pre-eclamcia/pregnancy-induced hypertension [AOR12.4 (CI: 4.17, 37.15)], post-term pregnancy [AOR 2.73 (CI: 1.00, 7.55)] meconium-stained liquor [AOR 29.2 (CI: 12.0, 71.1)], cord entangled [AOR 5.67 (CI: 1.66,19.3)] and non-vertex presentation [AOR 5.49 (CI: 2.20,13.7)] were found to be risk factors for perinatal birth asphyxia. Conclusion and Recommendations: Intrapartum factors and neonatal factors in the index pregnancy have an association with perinatal birth asphyxia. The research finding suggests effective antenatal care follow-up and follow-up of labor progress using partograph after labor initiation.