Background: Gestational diabetes mellitus (GDM) is a major public health problem and threat to maternal and child health in Africa. No prior review has been conducted in Africa using the updated GDM diagnostic criteria. Therefore, this review aimed to estimate the pooled prevalence and determinants of GDM in Africa by using current international diagnostic criteria. Methods: A systematic review and meta-analysis was conducted by comprehensive search of the published studies in Africa. Electronic databases (PubMed, Scopus, Cochrane Library, EMBASE, Google Scholar, CINAHL, Web of Science, Science direct and African Journals Online) were searched using relevant search terms. Data were extracted on an excel sheet and Stata/ SE 14.0 software was used to perform the meta-analysis. Heterogeneity of included studies were assessed using I 2 and Q test statistics. I 2 > 50% and Q test with its respective p-value < 0.05 were suggestive for the presence of a significant heterogeneity. Publication bias was assessed using the Egger's regression test and funnel plot. Subgroup and sensitivity analyses were done. A random effects model was used to estimate the pooled prevalence of GDM and odds ratio (OR) with 95% confidence interval (CI). Result: A total of 23 studies were included in the final analysis. The pooled prevalence of GDM in Africa was 13.61% (95% CI: 10.99, 16.23; I 2 = 96.1%), and 14.28% (95% CI, 11.39, 17.16; I 2 = 96.4%) in the sub-Saharan African region. The prevalence was highest in Central Africa 20.4% (95% CI, 1.55, 38.54), and lowest in Northern Africa 7.57% (95% CI, 5.89, 9.25) sub-regions. Overweight and obesity, macrosomia, family history of diabetes, history of stillbirth, history of abortion, chronic hypertension and history of previous GDM had positively associated with GDM. Conclusions: The prevalence of GDM is high in Africa. Being overweighed and/or obese, ever had macrocosmic baby, family history of diabetes, history of stillbirth, history of abortion or miscarriage, chronic hypertension and history of previous GDM were factors associated with GDM. Preventing overweighed and obese, giving due attention to women having high-risk cases for GDM in pregnancy are strongly recommended to mitigate the burden. Systematic review registration: PROSPERO (2018:CRD42018116843).

Background Globally, Gestational Diabetes Mellitus (GDM) is rising, but it is a neglected health threat to mothers and their children in low resource countries. Although, GDM is known in Ethiopia, information regarding it remains scarce by recent diagnostic criteria. Therefore, this study aimed to determine the prevalence of GDM and associated factors among women attending antenatal care at Gondar town public health facilities, Northwest Ethiopia. Methods A cross-sectional study was conducted among 1027 pregnant women selected by the systematic random sampling technique. The universal one-step screening and diagnostic strategy was done using a two-hour 75 g oral glucose tolerance test. GDM was diagnosed using updated diagnostic criteria (2017 American Diabetes Association (ADA) or 2013 World Health Organization (WHO) or modified International Association of the Diabetes and Pregnancy Study Groups diagnostic criteria (IADPSG)). Binary logistic regression model was used to identify factors associated with GDM. Results Of the total 1027 pregnant women, 12.8% (95% CI: 10.8–14.8) were diagnosed with GDM. Overweight and/or obesity (MUAC ≥28 cm) (AOR = 2.25, 95% CI: 1.18–4.26), previous history of GDM (AOR = 5.82, 95% CI: 2.57–13.18), family history of diabetes (AOR = 4.03, 95% CI: 1.57–10.35), low physical activity (AOR = 3.36, 95% CI: 1.60–7.04), inadequate dietary diversity (AOR = 1.9, 95% CI: 1.02–3.53), and antenatal depression (AOR = 4.12, 95% CI: 1.85–9.20) were significantly associated with GDM. Conclusions The prevalence of GDM among women attending antenatal care at Gondar town public health facilities was high. Previous history of GDM, antenatal depression, family history of diabetes, low physical activity, overweight and/or obesity and inadequate dietary diversity were significantly associated with GDM. Routine screening of pregnant women and healthy lifestyle are strongly recommended.

Background: Gestational diabetes mellitus is a leading medical condition woman encounter during pregnancy with serious short-and long-term consequences for maternal morbidity. However, limited evidence was available on potential impacts of gestational diabetes mellitus using updated international diagnostic criteria on adverse maternal outcomes. Therefore, this study aimed to assess the effects of gestational diabetes mellitus on the risk of adverse maternal outcomes in Northwest Ethiopia. Methods: A prospective cohort study was conducted among pregnant women followed from pregnancy to delivery. Gestational diabetes mellitus status was determined by using a two-hour 75 g oral glucose tolerance test and based on updated international diagnostic criteria. Multivariable log-binomial model was used to examine the effects of gestational diabetes mellitus on the risk of adverse maternal outcomes. Results: A total of 694 women completed the follow-up and included in the analysis. Women with gestational diabetes mellitus had a higher risk of composite adverse maternal outcome (ARR=1.58, 95% CI: 1.22, 2.04), caesarean delivery (ARR=1.67; 95%: 1.15, 2.44), pregnancy induced hypertension (ARR= 3.32; 95%: 1.55, 7.11), premature rupture of membranes (ARR= 1.83; 95%: 1.02, 3.27), antepartum hemorrhage (ARR= 2.10; 95%: 1.11, 3.98) and postpartum hemorrhage (ARR= 4.85; 95%:2.28, 10.30) compared to women without gestational diabetes mellitus. Conclusions: Gestational diabetes mellitus increased the risk of adverse maternal outcomes. This implies that maternal care and intervention strategies relating to women with gestational diabetes mellitus should be strengthened.

Despite the overall national success in reducing infant mortality rate in Ethiopia, infant mortality rate is still high in northwest Amhara region. This study is conducted in one of the high mortality areas with the aim of identifying risk factors that are associated with infant mortality in Northwest Amhara Region, Ethiopia. A prospective open cohort study involving 1752 infants (1472.4518 person years of follow-up) was undertaken from November 2009 to August 2011. Kaplan-Meier Survival analysis was used to estimate infant mortality rate. Risk factors associated with infant mortality were assessed using multivariate Poisson regression. The overall infant mortality rate was 88 per 1000 person-years (95% CI: 74.3, 104.9). After controlling other important predictors in multivariate Poisson regression, infants not exclusively breastfed [IRR = 7.86, 95% CI: (5.11, 12.10), )], breast milk initiated after 24 hours of birth [IRR = 4.84,95% CI: (2.94,7.99)], mothers not washing hands with soap after visiting toilet and before feeding child [IRR = 4.61, 95% CI: (2.24, 9.48)], being rural residents [IRR = 2.33, 95% CI: (1.12, 4.88)], infants born within 24 months for the previous birth [IRR = 2.79, 95%CI: (1.88, 4.15)], have increased the risk of infant mortality. In conclusion, exclusive breast feeding is the strongest predictor of infant survival in this predominantly rural setting where hygienic standards are poor. Supporting mothers to exclusively breast feeding which is cost effective, safe and feasible strategy, can help reduce infant mortality in the study setting.

Background: Alcohol consumption during pregnancy represents a significant public health concern. It has several adverse health effects for both the mother and the developing fetus. This study aimed to estimate the pooled prevalence and the effect size of associated factors of alcohol consumption during pregnancy in Sub-Saharan Africa countries.

Background Perinatal mortality remains a problem in Ethiopia. Findings of primary studies varied on level of perinatal mortality and its predictors including inter-pregnancy interval. The aim of this review was to estimate the pooled perinatal mortality rate, its trend overtime and verify the association with inter-pregnancy interval in Ethiopian context. Methods Studies were accessed through the electronic web-based search strategies from PubMed, ScienceDirect, Hinari for health via Research4Life, Google and Advanced Google search, and retrieving via relevant references using a combination of medical subject headings (MeSH terms) and key words related with inter-pregnancy interval. R version 3.4.3 software was used for the meta-analysis. A forest plot and I 2 test were done to assess heterogeneity. Sensitivity analysis and subgroup analysis were done to deal with heterogeneity. A weighted inverse variance random-effects model was applied to estimate pooled effect sizes. A funnel plot and Egger’s regression test were done to check publication bias. Results A total of 34 studies used to answer review questions (30 for perinatal mortality rate and its trend estimation from 1997 to 2019 and 8 for its relationship with inter-pregnancy interval). The pooled perinatal mortality rate was 51.3 per 1000 total births (95% CI: 40.8–62.8). The pooled stillbirth rate was 36.9 per 1000 births (95% CI: 27.3–47.8) and early neonatal mortality rate was 29.5 per 1000 live births (95% CI: 23.9–35.6). Increasing trend was seen in stillbirth rate (23.7 to 36.9 per 1000 births) while decreasing trend in early neonatal mortality rate (51 to 29.5 per 1000 live births). Slight reduction trend was observed in overall perinatal mortality rate (66 to 51.3 per 1000 births). An inter-pregnancy interval less than 15 months was found to be statistically significantly associated with perinatal mortality; pooled OR = 2.76 (95% CI: 2.1–3.62). Spacing pregnancy for at least 15 months was related with reducing perinatal mortality by 64% (95% CI: 52.38, 72.38%). Conclusions In Ethiopia, perinatal mortality rate remains high. Insignificant reduction trend was observed in overall perinatal mortality rate. Counseling couples about the importance of spacing pregnancy and intensifying long-acting contraceptive use will help in reducing perinatal mortality related to poor pregnancy spacing.

BackgroundMental health problems among trafficked persons could be the result of concomitantly interwoven effects of various factors. Analyzing the networked relationships concurrently could be a more substantive approach to better understand the role of risk factors in this population. This study aimed to assess the magnitude of mental health symptoms as well as the association among socio-demographic, trafficking related exposure variables, and mental health problems of Ethiopian returnees from trafficking.MethodsA sample of 1387 returnees who were trafficked via three major human trafficking corridors of Ethiopia were selected consecutively. Data related to socio-economic, trafficking exposure variables, and symptoms of mental illness were collected in personal interviews. Anxiety was measured with a brief measure for generalized anxiety disorder (GAD-7), depression with a patient health questionnaire (PHQ-9), and PTSD with post-traumatic checklist (PCL-C). Generalized structural equation modeling was employed to estimate the relationships among exogenous, mediating, and endogenous variables simultaneously.ResultsThe prevalence of symptoms of anxiety was estimated at 51.9% (95% CI 49.3–54.6%); PTSD was estimated at 34.5% (95% CI 32.1–37.1%) and depression at 58.3% (95% CI 55.6–60.9%). Restricted freedom of movement had a direct positive effect on anxiety (β = 1.24, 95% CI 0.97–1.51), depression (β = 0.94, 95% CI 0.71–1.17) and PTSD (13.00, 95% CI 11.23–14.77). Violence experienced during the trafficking period was a mediator variable and significantly associated with anxiety (β = 0.46; 95% CI 0.26–0.66) and PTSD (β = 4.00; 95% CI 2.06–5.94). History of detention had a positive total effect on GAD (total β = 1.380, 95% CI 1.074–1.687) and PTSD (total β = 15.63, 95% CI 13.708–17.545), and direct positive effect on depression (β = 0.89, 95% CI 0.65–1.13).ConclusionEthiopian trafficked persons were highly likely to return with increased levels of mental health symptoms, namely anxiety, depression, and PTSD. Socio-economic and trafficking related exposures mediated by violence were factors affecting mental health symptoms. Thus, in addition to economic re-integrations of victims, strategies should be designed and implemented to address the prevalent mental health problems.Electronic supplementary materialThe online version of this article (10.1186/s13033-018-0241-z) contains supplementary material, which is available to authorized users.

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