Epidemiology and Health

Cohort Profile

Korea Nurses’ Health Study and the health of reproductive-aged women: a cohort profile: Chiyoung Cha, Heeja Jung, Sue Kim, Jung Eun Lee, Kwang-Pil Ko, Eunyoung Cho, Hyun-Young Park, Joong-Yeon Lim, Bo Mi Song, Sihan Song, Soojin Park, Aram Cho; Epidemiol Health. 2024;46:e2024048. Published online April 30, 2024; DOI: https://doi.org/10.4178/epih.e2024048

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Abstract Summary PDF: Abstract
The Korea Nurses’ Health Study (KNHS) is an ongoing, large-scale, prospective cohort study of women nurses, focusing on the effects of occupational, environmental, and lifestyle factors on the health of women. The first KNHS survey was performed in 2013-2014 (n=20,613). As of December 2023, 11 follow-up surveys have been conducted. Participants who were pregnant were asked to participate in the early pregnancy survey (n=2,179) and postpartum survey after giving birth (n=2,790). The main variables included socio-demographic, work-related, lifestyle, physical, mental, and women’s health factors. Blood, urine, and toenail samples were collected from a participant subgroup of the first survey (n=1,983). The subgroups of the second survey completed a food frequency questionnaire in 2019 (n=300) and 2021 (n=871). In 2020, a subgroup of the first survey answered a coronavirus disease 2019-related survey (n=975). To examine various health-related factors in young adults, new participants were added to the KNHS cohort in the 11th (n=1,000) and 12th (n=1,002) surveys. The KNHS cohort will help identify health and illness determinants in Korean women. Data can be accessed at https://coda.nih.go.kr/frt/index.do.; Summary

Korean summary
한국간호사건강연구(Korea Nurses’ Health Study, KNHS)는 2013년부터 수행되고 있는 대규모 전향적 추적관찰 코호트 연구이다. 본 연구는 질병력, 약물복용력, 임신력, 여성건강, 정신건강(우울, 스트레스, 피로 등), 생활습관(흡연, 음주, 신체활동, 수면 등), 근무특성을 조사하여 여성건강에 장기적으로 미치는 영향을 파악하고 한국 고유의 여성건강 결정요인을 도출하는 것을 목표로 한다.

Key Message
The Korea Nurses' Health Study (KNHS) is a large-scale, prospective cohort study that has been conducted since 2013. It measures various factors affecting reproductive-aged women, including disease history, medication usage, pregnancy, women's health characteristic, mental health (such as depression, stress, and fatigue), lifestyle characteristic (including smoking, drinking, and physical activity, sleep), and work-related characteristics. The study aims to understand the long-term impact on women's health and identify unique determinants of women's health specific to Korea.

Original Article

Increased risk of cancer and cancer-related mortality in middle-aged Korean women with prediabetes and diabetes: a population-based study: Thi Xuan Mai Tran, Soyeoun Kim, Huiyeon Song, Boyoung Park; Epidemiol Health. 2023;45:e2023080. Published online August 28, 2023; DOI: https://doi.org/10.4178/epih.e2023080

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated the risk of developing and dying from all types of cancer, as well as cancer-specific mortality, in women diagnosed with prediabetes and diabetes.

METHODS

We included women aged ≥40 years who underwent cancer screening from 2009 to 2014 with follow-up until 2020. Diabetes status was determined based on fasting plasma glucose levels, self-reported history of diabetes, and the use of antidiabetic medication. We quantified the risk of cancer and mortality in the prediabetes and diabetes groups, relative to the normoglycemia group, by calculating adjusted hazard ratios (aHRs).

RESULTS

The study included 8,309,393 participants with a mean age of 52.7±9.7 years. Among these participants, 522,894 cases of cancer and 193,283 deaths were detected. An increased risk of cancer was observed in both the prediabetes group (aHR, 1.03; 95% confidence interval [CI], 1.02 to 1.04) and the diabetes group (aHR, 1.13; 95% CI, 1.12 to 1.14). The highest risk was identified in those with diabetes who developed liver (aHR, 1.72; 95% CI, 1.66 to 1.79), pancreatic (aHR, 1.68; 95% CI, 1.60 to 1.76), and gallbladder cancer (aHR, 1.43; 95% CI, 1.36 to 1.51). Women with prediabetes and diabetes exhibited a 1.07-fold (95% CI, 1.05 to 1.08) and 1.38-fold (95% CI, 1.36 to 1.41) increased risk of death from cancer, respectively.

CONCLUSIONS

Both prediabetes and diabetes were associated with an elevated risk of cancer, as well as an increased risk of death from cancer, in middle-aged Korean women. However, the degree of risk varied depending on the specific site of the cancer.

Summary

Korean summary
40세 이상의 중년 여성에서 당뇨 또는 당뇨 전 단계는 암 발생 위험과 암으로 인한 사망위험을 증가시킴. 암 종별로는 위암, 대장암, 직장암, 간암, 담낭암, 췌장암, 유방암, 자궁경부암, 자궁암, 신장암, 방광암의 발생 위험이 증가한 반면, 갑상선암의 발생 위험은 감소하였음. 거의 대부분의 암종에서 당뇨는 암으로 인한 사망위험을 증가시킴

Key Message
Both prediabetes and diabetes were independently associated with an overall increased risk of cancer, with a stronger association with malignancies in the liver and pancreas in women. Additionally, both prediabetes and diabetes status are associated with an elevated risk of death from cancer. These findings support the need for prevention and management to reduce cancer-related burden and premature deaths due to cancer, not only in individuals with diabetes but also in those with prediabetes.

Citations

Citations to this article as recorded by

Prediabetes persistence or remission and subsequent risk of gallbladder cancer: A nationwide cohort study
Joo-Hyun Park, Jung Yong Hong, Kyungdo Han, Young Suk Park, Joon Oh Park, Ho Yeong Lim, Jay J. Shen
European Journal of Cancer.2024; 213: 114312. CrossRef

Brief Communication

Effect of premature rupture of membranes on preterm labor: a case-control study in Cilegon, Indonesia: Ita Marlita Sari, Asri C. Adisasmita, Sabarinah Prasetyo, Dwirani Amelia, Ratih Purnamasari; Epidemiol Health. 2020;42:e2020025. Published online April 10, 2020; DOI: https://doi.org/10.4178/epih.e2020025

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Abstract PDF

Abstract

OBJECTIVES
The global prevalence of preterm labor is approximately 11.1% of live births. However, preterm labor contributes to 75-80% of neonatal morbidity and mortality. The morbidity experienced by preterm infants may continue to influence their subsequent development, imposing physical, psychological, and economic burdens. Premature rupture of membranes (PROM) is a causal factor that may affect preterm birth. Previous studies have shown an association between PROM and preterm labor, but this association should be investigated in more diverse populations. Therefore, this study was conducted in Cilegon, Indonesia to determine the magnitude of the risk of preterm labor associated with PROM at Cilegon Hospital from July 2014 to December 2015.

METHODS

This case-control study used data from patients’ medical records. The cases were all mothers who delivered at less than 37 weeks of gestation, while the control population comprised all mothers who delivered at greater or equal to 37 weeks. The data were analyzed using logistic regression.

RESULTS

The bivariate analysis yielded an odds ratio (OR) of 2.97 (95% confidence interval [CI], 1.92 to 4.59) before controlling for covariates. The model derived through multiple regression analysis after controlling for education, history of preterm labor, and anemia resulted in an OR of 2.58 (95% CI, 1.68 to 3.98).

CONCLUSIONS

Mothers who experience PROM during pregnancy were at a 2.58 times higher risk of preterm labor after controlling for education, history of preterm labor, and anemia.

Summary

Citations

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Putri Maharani Tristanita Marsubrin, Naufal Arkan Abiyyu Ibrahim, Mohammad Adya Firmansha Dilmy, Yulia Ariani, Budi Wiweko, Rima Irwinda, Achmad Kemal Harzif, Badriul Hegar, Ray Wagiu Basrowi
Journal of Perinatal Medicine.2024; 52(3): 270. CrossRef
Experience in the use of immunochromatographic test of insulin-like growth factor binding protein-1 in the diagnosis of premature rupture of fetal membranes
S.V. Barinov, T.V. Kadtsyna, Yu.I. Tirskaya, O.V. Lazareva, Yu.I. Chulovskii, I.N. Zyryanova, O.Yu. Zhivotchenko, M.B. Kazakova, A.D. Orlitskaya
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BMC Pregnancy and Childbirth.2023;[Epub] CrossRef
High Apoptotic Index in Amniotic Membrane of Pregnant Women is A Risk Factor for Preterm Labor
Anak Agung Gede Putra Wiradnyana, Anak Agung Ngurah Jaya Kusuma, Anak Agung Ngurah Anantasika, I Made Darmayasa, Ryan Saktika Mulyana, Gde Bagus Rizky Kornia
European Journal of Medical and Health Sciences.2023; 5(3): 79. CrossRef
A Prospective Cohort Study of Etiology and Neonatal Outcome of Preterm Labor in a Tertiary-care Hospital Attached to a Medical College
NS Sreedevi, Srijana Mathai, Rachel Mathew, Suja M Mani
Journal of South Asian Federation of Obstetrics and Gynaecology.2022; 14(3): 253. CrossRef
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Adam Mabrouk, Amina Abubakar, Ezra Kipngetich Too, Esther Chongwo, Ifedayo M. Adetifa
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Cohort Profile

Cohort profile: the Kisalaya cohort of mother-infant dyads in rural south India (2008-2012): Smitha Chandrashekarappa, Krupa Modi, Karl Krupp, Kavitha Ravi, Anisa Khan, Vijaya Srinivas, Poornima Jaykrishna, Anjali Arun, Murali Krishna, Purnima Madhivanan; Epidemiol Health. 2020;42:e2020010. Published online March 11, 2020; DOI: https://doi.org/10.4178/epih.e2020010

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Abstract PDF

Abstract

The Kisalaya cohort was established in 2008, providing integrated antenatal care (ANC) and human immunodeficiency virus (HIV) testing in order to reduce adverse birth outcomes and pediatric HIV infections. The program used a mobile clinic model to deliver health education, ANC, and HIV/sexually transmitted infection testing and management to pregnant women in rural communities in southern India. This cohort includes pregnant women residing in 144 villages of the Mysuru taluk (a rural region) who received ANC through the mobile clinic and delivered their infants between 2008 and 2011. Of the 1,940 women registered for ANC at primary healthcare centers during this time period, 1,675 (75.6%) were enrolled in the Kisalaya cohort. Once women enrolled in the Kisalaya cohort gave birth, the cohort expanded to include the mother-infant dyads with a retention rate of 100% at follow-up visits at 15 days and at 6 months post-delivery. The baseline data collected during the Kisalaya study included both questionnaire-based data and laboratory-based investigations. Presently, a study entitled “Early life influences on adolescent mental health: a life course study of the Kisalaya birth cohort in south India” is in the process of data collection (2019-2020).

Summary

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Vulnerability to Sexually Transmitted Infections (STI) / Human Immunodeficiency Virus (HIV) among adolescent girls and young women in India: A rapid review
Sohini Paul, Anupam Sharma, Radhika Dayal, Mahika Mehta, Sudeshna Maitra, Kuhika Seth, Monal Nagrath, Sowmya Ramesh, Niranjan Saggurti, Ajoke Basirat Akinola
PLOS ONE.2024; 19(2): e0298038. CrossRef

Original Articles

Effects of living in the same region as one’s workplace on the total fertility rate of working women in Korea: Yeon-Yong Kim, Hee-Jin Kang, Seongjun Ha, Jong Heon Park; Epidemiol Health. 2019;41:e2019043. Published online October 9, 2019; DOI: https://doi.org/10.4178/epih.e2019043

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Abstract Summary PDF

Abstract

OBJECTIVES
The lowest-low fertility status of Korea has continued for the past 17 years despite governmental efforts to encourage childbirth. As the number of working women has increased, their residence patterns have changed; however, the impact of this factor has yet to be explored. Therefore, this study was conducted to investigate the effects of residence patterns relative to the workplace on the total fertility rate of working women.

METHODS

Information on eligibility and healthcare utilization was obtained from the National Health Information Database between 2011 and 2015. The study participants were working women aged 15-49 years. We classified their residence relative to their workplace into 3 patterns: same municipality, same province, and different province. The total fertility rate was calculated and logistic regression was performed of childbirth according to residence pattern, adjusting for age, insurance contribution quartile, size of the workplace, year of birth, and province of residence.

RESULTS

The total fertility rates of working women from 2011 to 2015 were 1.091, 1.139, 1.048, 1.073, and 1.103, respectively. The total fertility rate by residence pattern was highest in women residing in the same municipality as their workplace. After adjustment, the odds of childbirth in women from the same municipality and the same province were 21.6% and 16.0% higher than those of women residing in a different province, respectively.

CONCLUSIONS

The total fertility rate was higher among women living near their workplace. Therefore, effective policy measures should be taken to promote the proximity of working women’s workplace and residence.

Summary

Korean summary
이 연구를 통하여 직장과 동일한 시군구에 거주하는 직장 여성의 출산율이 타 시군구 및 타 시도에 거주하는 경우보다 더 높게 나타나는 것을 확인하였다. 기존 인구사회학적 특성 위주의 출산 관련 연구에 비해 이 연구에서는 직장과 거주지의 차이의 영향을 확인하였다는 데 의의가 있다. 저출산 대책에 대한 다양한 정책적 접근이 요구되는 시점에 직장 여성의 출산율을 높이기 위하여 거주지 대책 등이 종합적으로 고려될 수 있음을 시사한다.

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Distribution and social determinants of overweight and obesity: a cross-sectional study of non-pregnant adult women from the Malawi Demographic and Health Survey (2015-2016): Leonard Mndala, Abhay Kudale; Epidemiol Health. 2019;41:e2019039. Published online September 27, 2019; DOI: https://doi.org/10.4178/epih.e2019039

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Abstract PDF

Abstract

OBJECTIVES
Hitherto regarded as a public health issue of well-heeled nations, overweight and obesity have emerged as a problem of concern in developing nations. Although social and demographic factors are equally important as proximal lifestyle factors affecting health, their role is neither well researched nor well understood. We conducted a novel study to determine the distribution, prevalence, and social and demographic determinants of overweight/obesity in Malawi.

METHODS

A population-based, quantitative cross-sectional study using data from the Malawi Demographic and Health Survey (2015-2016) was conducted among non-pregnant women aged 18-49 years. A total of 6,443 women were included in the analysis. Overweight/obesity, defined as a body mass index (BMI) ≥25.0 kg/m2 , was the main outcome variable. The analysis was done in SPSS version 20.0; after calculating descriptive statistics, bivariate and multivariate logistic regression was conducted to evaluate associations and determine odds.

RESULTS

In total, 16.8% and 6.3% of women were overweight and obese, respectively (p<0.001). Overweight and obesity were more prevalent in urban than in rural areas. The BMI distribution among women varied across different background characteristics. Women from the Ngoni ethnicity were more likely to be overweight/obese than others (adjusted odds ratio [aOR], 1.54; 95% confidence interval [CI], 1.14 to 2.08). Socioeconomic status (SES) and the age of the respondent were highly significant determinants that were strongly associated with being overweight/obese. The richest women were 3 times more likely to be overweight/obese than the poorest (aOR, 3.30; 95% CI, 2.46 to 4.43).

CONCLUSIONS

Overweight and obesity were highly prevalent and significantly associated with increasing SES, age, and being from the Ngoni ethnicity. Holistic interventions should also focus on improving social determinants in order to entirely curb the epidemic.

Summary

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Mahashweta Chakrabarty, Subhojit Let, Jay Saha
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Adedire Timilehin Adenuga, Iliya Karniliyus Salu, Usman Mohammed Bello, Abuchi Okaro
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Socioeconomic inequalities in obesity among Korean women aged 19-79 years: the 2016 Korean Study of Women’s Health-Related Issues: Eunji Choi, Ha Na Cho, Da Hea Seo, Boyoung Park, Sohee Park, Juhee Cho, Sue Kim, Yeong-Ran Park, Kui Son Choi, Yumie Rhee; Epidemiol Health. 2019;41:e2019005. Published online February 13, 2019; DOI: https://doi.org/10.4178/epih.e2019005

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Abstract Summary PDF

Abstract

OBJECTIVES
While the prevalence of obesity in Asian women has remained stagnant, studies of socioeconomic inequalities in obesity among Asian women are scarce. This study aimed to examine the recent prevalence of obesity in Korean women aged between 19 years and 79 years and to analyze socioeconomic inequalities in obesity.

METHODS

Data were derived from the 2016 Korean Study of Women’s Health-Related Issues. The chi-square test and logistic regression analysis were used to analyze the associations between socioeconomic factors and obesity using Asian standard body mass index (BMI) categories: low (<18.5 kg/m2 ), normal (18.5-22.9 kg/m2 ), overweight (23.0-24.9 kg/m2 ), and obese (≥25.0 kg/ m2 ). As inequality-specific indicators, the slope index of inequality (SII) and relative index of inequality (RII) were calculated, with adjustment for age and self-reported health status.

RESULTS

Korean women were classified into the following BMI categories: underweight (5.3%), normal weight (59.1%), overweight (21.2%), and obese (14.4%). The SII and RII revealed substantial inequalities in obesity in favor of more urbanized women (SII, 4.5; RII, 1.4) and against of women who were highly educated (SII, -16.7; RII, 0.3). Subgroup analysis revealed inequalities in obesity according to household income among younger women and according to urbanization among women aged 65-79 years.

CONCLUSIONS

Clear educational inequalities in obesity existed in Korean women. Reverse inequalities in urbanization were also apparent in older women. Developing strategies to address the multiple observed inequalities in obesity among Korean women may prove essential for effectively reducing the burden of this disease.

Summary

Korean summary
한국 성인 여성의 과체중 및 비만유병률은 서구여성에 비해 낮으며 2005년 이후 큰 변화 없이 약40%대로 일정하게 유지되어왔으나, 사회경제적불평등에 대한 연구는 체계적으로 이루어지지 않음. 경사불평등(Slope index of inequality)과 상대불평등(Relative index of inequality) 지표를 사용하여 비만유병률에서 발견되는 사회경제적불평등을 조사한 결과, 교육수준별 불평등이 유의하게 나타남. 19-44세의 젊은 여성층에서는 소득수준이 낮은 집단에, 65-79세의 노년기 여성층에서는 도시화된 지역에 사는 집단에 비만유병률이 치중되어있음.

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Domestic elder abuse and associated factors in elderly women in Tehran, Iran: Negar Piri, Parisa Taheri Tanjani, Soheila Khodkarim, Koorosh Etemad; Epidemiol Health. 2018;40:e2018055. Published online November 10, 2018; DOI: https://doi.org/10.4178/epih.e2018055

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Abstract PDF

Abstract

OBJECTIVES
Elderly people are often abused in many ways, with serious and lasting consequences. Elder abuse remains one of the most hidden forms of family conflict, and its frequency is anticipated to be rising in many countries that are rapidly experiencing population aging. The purpose of this study was to investigate the status of domestic elder abuse in elderly women in Tehran, Iran and to identify associated factors.

METHODS

This cross-sectional study was conducted in 2017 among 260 women aged 60 and over, selected through multistage random sampling. Information on abuse and its risk factors was collected through interviews with the elderly in their homes. In order to measure domestic elder abuse, the validated Domestic Elderly Abuse Questionnaire was used. The ordinal logistic test was used in Stata version 12 to identify factors related to elder abuse.

RESULTS

Overall, 90.4% of the subjects had experienced at least 1 type of abuse, among which authority deprivation (68.5%) was the most common and rejection (11.2%) the least common. The ordinal logistic analysis showed that the likelihood of experiencing more severe severe abuse was significantly higher in elderly people over 72 than in those aged 60-62 years (odds ratio, 2.07; 95% confidence interval, 1.03 to 4.17).

CONCLUSIONS

Domestic elder abuse was found to be common in older women. Old age was an important risk factor for domestic elder abuse in elderly women in Tehran. Managing and preventing elder abuse is an important issue that needs to be addressed.

Summary

Citations

Citations to this article as recorded by

Prevalence of Elder Abuse and Its Related Factors in Isfahan, Iran
Sima Siadat, Narges Motamedi
Iranian Journal of Psychiatry and Behavioral Sciences.2024;[Epub] CrossRef
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Roger Flores Ceccon, Carlos Alberto Severo Garcia-Jr
Interface - Comunicação, Saúde, Educação.2024;[Epub] CrossRef
Using the ecological approach to explain risk factors of elder abuse in Iran (A qualitative study)
Maryam Rahmati Andani, Fereshteh Zamani, Majid Rahimi, Marjan Mansourian, Firoozeh Mostafavi
Journal of Education and Health Promotion.2024;[Epub] CrossRef
Prevalence of elder abuse and its related factors in Iran: A community-based study
Saeideh Motahedi, Mahboobeh Khajeh, Ahmad Khosravi, Seyedmohammad Mirhosseini, Hossein Ebrahimi
Current Psychology.2023; 42(21): 17960. CrossRef
Alcohol Use Disorder and Associated Factors Among Elderly in Ethiopia
Asrat Wolde
Substance Abuse: Research and Treatment.2023;[Epub] CrossRef
Assessment of life satisfaction and risk of violence in elderly / Avaliação da satisfação com a vida e o risco para violência em idosos
Gleicy Karine Nascimento de Araújo Monteiro, Renata Clemente dos Santos, Rafaella Queiroga Souto, Cláudia Quézia Amado Monteiro Leal, Bárbara Maria Lopes da Silva Brandão, Waglânia Mendonça Faustino e Freitas
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The prevalence of elder abuse and risk factors: a cross-sectional study of community older adults
Reza Nemati-Vakilabad, Zahra Khalili, Leila Ghanbari-Afra, Alireza Mirzaei
BMC Geriatrics.2023;[Epub] CrossRef
Development and validation of the short form domestic elder abuse assessment questionnaire (SF-DEAQ)
Amirreza Zobdeh, Razieh Bandari, Majideh Heravi-Karimooi, Maryam Mashayekh, Maryam Hazrati, Ali Montazeri
BMC Geriatrics.2023;[Epub] CrossRef
ABUSE AGAINST THE ELDERLY PERSON: ANALYSIS OF THE INTERNAL CONSISTENCY OF INSTRUMENTS*
Renata Clemente dos Santos Rodrigues, Gleicy Karine Nascimento de Araújo-Monteiro, Emanuella de Castro Marcolino, Bárbara Maria Lopes da Silva Brandão, Lindemberg Arruda Barbosa, Ronei Marcos de Moraes, Rafaella Queiroga Souto
Cogitare Enfermagem.2023;[Epub] CrossRef
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Renata Clemente dos Santos Rodrigues, Gleicy Karine Nascimento de Araújo-Monteiro, Emanuella de Castro Marcolino, Bárbara Maria Lopes da Silva Brandão, Lindemberg Arruda Barbosa, Ronei Marcos de Moraes, Rafaella Queiroga Souto
Cogitare Enfermagem.2023;[Epub] CrossRef
VIOLÊNCIA CONTRA PESSOA IDOSA: ANÁLISE DA CONSISTÊNCIA INTERNA DE INSTRUMENTOS*
Renata Clemente dos Santos Rodrigues, Gleicy Karine Nascimento de Araújo-Monteiro, Emanuella de Castro Marcolino, Bárbara Maria Lopes da Silva Brandão, Lindemberg Arruda Barbosa, Ronei Marcos de Moraes, Rafaella Queiroga Souto
Cogitare Enfermagem.2023;[Epub] CrossRef
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Pradnya Chandanshive, Sonu H. Subba, Swayam Pragyan Parida, Shree Mishra
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A Community-Based Exploratory Cross-Sectional Study of Elder Abuse Perpetration or Victimization Among Elders in Ethiopia, 2022
Asrat Wolde, Wadu Wolancho, Yeshitila Belay, Asamirew Alemu, Ashenaf Asefa, Tsehaye Gebremedhin
Clinical Interventions in Aging.2022; Volume 17: 957. CrossRef
Elder Abuse in Rural Belagavi
Nishtha Malhotra, M. S. Shivaswamy
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Shiva Raj Acharya, B. K. Suman, Sandip Pahari, Yong Chul Shin, Deog Hwan Moon
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Reyhaneh Aminalroaya, Mahtab Alizadeh-Khoei, Sakar Hormozi, Farshad Sharifi, Fahimeh Taati
Journal of Elder Abuse & Neglect.2020; 32(1): 84. CrossRef
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Karolina Filipska, Monika Biercewicz, Adam Wiśniewski, Kornelia Kędziora-Kornatowska, Robert Ślusarz
Archives of Gerontology and Geriatrics.2020; 90: 104152. CrossRef
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Maryam Hazrati, Maryam Mashayekh, Nasrin Sharifi, Seyedeh Ameneh Motalebi
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Prevalence of disrespect and abuse of women during child birth and associated factors in Bahir Dar town, Ethiopia: Biresaw Wassihun, Leul Deribe, Nadia Worede, Teklemariam Gultie; Epidemiol Health. 2018;40:e2018029. Published online July 1, 2018; DOI: https://doi.org/10.4178/epih.e2018029

17,677 View
423 Download
42 Web of Science
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Abstract PDF

Abstract

OBJECTIVES
Disrespect and abuse are an often-unacknowledged cause of maternal mortality and morbidity globally. The objective of this study was to assess the prevalence and associated factors of disrespect and abuse of women during childbirth at a health facility in the town of Bahir Dar, Ethiopia.

METHODS

In this community-based cross-sectional study, 422 mothers were interviewed from March 1 to 30, 2017 using a systematic random sampling technique with the kth value of 23 calculated based on the number of households in each sub-city and the expected sample size from sub-cities. Data were collected using a structured face-to-face interview questionnaire. EpiData version 3.1 was used to code and enter data, which were analyzed using SPSS version 22. Descriptive statistics were calculated for each variable, and binary logistic regression analysis with 95% confidence intervals (CIs) was carried out to determine the associations between predictor variables and outcome variables.

RESULTS

A total of 410 women participated in the study, with a response rate of 97.2%. The overall prevalence of disrespect and abuse was 67.1% (95% CI, 63.0 to 72.0). Disrespect and abuse were more prevalent in women with a monthly income less than 2,000 Ethiopian birr (adjusted odds ratio [aOR], 1.74; 95% CI, 1.08 to 2.80), mothers who stayed in a health facility after delivery (aOR, 5.14; 95% CI, 2.23 to 11.82), those who received care at a governmental hospital (aOR, 2.49; 95% CI, 1.15 to 5.40), and those who attended fewer than 4 antenatal care visits (aOR, 1.97; 95% CI, 1.15 to 3.40).

CONCLUSIONS

The prevalence of disrespect and abuse was high in this study setting. To decrease the prevalence of this phenomenon, appropriate interventions should be designed, focusing on increasing the number of antenatal care visits, increasing the incomes of mothers, and improving the relationship between health workers and mothers during mothers’ stay at health facilities.

Summary

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Effect of antiretroviral therapy on changes in the fertility intentions of human immunodeficiency virus-positive women in Addis Ababa, Ethiopia: a prospective follow-up study: Hussen Mekonnen, Fikre Enquselassie; Epidemiol Health. 2017;39:e2017028. Published online July 16, 2017; DOI: https://doi.org/10.4178/epih.e2017028

14,102 View
186 Download
9 Web of Science
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Abstract PDF

Abstract

OBJECTIVES
With access to antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV) are able to consider childbearing to a greater extent than previously. In many cases, ART has transformed their intentions to have children. The present study aimed to assess changes in fertility intentions 12 months after ART initiation among HIV-positive women in Addis Ababa, Ethiopia.

METHODS

An institution-based follow-up study was conducted among 360 HIV-positive women in Addis Ababa. A logistic regression model was used to assess the influence of socio-demographic, reproductive health, and clinical characteristics on changes in the fertility intentions of women.

RESULTS

Overall, 40.8% (147 of 360) of the women reported that they desired to have a child in the future at the baseline visit, while 48.3% (174 of 360) did so at the 12-month follow-up. The proportion of women who reported that they desired to have a child 12 months after ART initiation was higher among ART-initiated women (55.8%, 106 of 190) than ART-naïve women (40.0%, 68 of 170). The adjusted analysis indicated that a change in fertility intentions between baseline and the follow-up visit was significantly associated with ART use (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.20 to 5.20) and marital status, with single (aOR, 5.33; 95% CI, 1.10 to 25.92) and married (aOR, 6.35; 95% CI, 1.44 to 27.99) women being more likely to report fertility intentions than divorced/widowed women.

CONCLUSIONS

ART use was a significant predictor of change in fertility intentions between the baseline and follow-up visit, which suggests that additional efforts are necessary to integrate family planning and HIV services to address the safe fertility goals of women in the study area.

Summary

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Zubairu Iliyasu, Hadiza S Galadanci, Ahmad A Zubairu, Taiwo G Amole, Nadia A Sam-Agudu, Muktar H Aliyu
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Postpartum modern contraceptive use in northern Ethiopia: prevalence and associated factors: Teklehaymanot Huluf Abraha, Alemayehu Shimeka Teferra, Abebaw Addis Gelagay; Epidemiol Health. 2017;39:e2017012. Published online March 20, 2017; DOI: https://doi.org/10.4178/epih.e2017012

25,660 View
677 Download
47 Web of Science
45 Crossref

Abstract PDF

Abstract

OBJECTIVES
The postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies. However, contraception during the extended postpartum period has been underemphasized in Ethiopia. Therefore, this study aimed to assess postpartum modern contraceptive use among women in northern Ethiopia and to identify factors associated with modern contraceptive use in the postpartum period.

METHODS

A community based cross-sectional study was conducted from March to April, 2015. Data were entered using Epi Info version 7 and then exported into Stata version 12 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of postpartum modern contraceptive use. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, and p-values <0.05 were considered to indicate statistical significance.

RESULTS

Nearly half (48.0%) of women used modern contraceptives during the extended postpartum period. Postpartum modern contraceptive use was significantly associated with secondary and tertiary education levels (aOR, 4.25; 95% CI, 1.29 to 14.00; aOR, 5.36 ; 95% CI, 1.14 to 25.45, respectively), family planning counseling during prenatal and postnatal care (aOR, 5.72 ; 95% CI, 2.67, 12.28), having postnatal care (aOR, 2.36; 95% CI, 1.15 to 4.87), resuming sexual activity (aOR, 9.53; 95% CI, 3.74 to 24.27), and menses returning after birth (aOR, 6.35; 95% CI, 3.14 to 13.39). In addition, experiencing problems with previous contraceptive use was negatively associated with modern contraceptive use (aOR, 0.34; 95% CI, 0.16 to 0.72).

CONCLUSIONS

Low rate of postpartum modern contraceptive use were found in the study area. Therefore, strengthening family planning counseling during antenatal and postnatal care visits, improving utilization of postnatal care services and improving women’s educational status are crucial steps for to enhance modern contraceptive use among postpartum women.

Summary

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Levels of adherence and factors associated with adherence to option B+ prevention of mother-to-child transmission among pregnant and lactating mothers in selected government health facilities of South Wollo Zone, Amhara Region, northeast Ethiopia, 2016: Delelegn Tsegaye, Leul Deribe, Shambel Wodajo; Epidemiol Health. 2016;38:e2016043. Published online October 13, 2016; DOI: https://doi.org/10.4178/epih.e2016043

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Abstract PDF

Abstract

OBJECTIVES
The aim of this study was to measure the levels of adherence and to identify factors associated with adherence to option B+ prevention of mother-to-child transmission (PMTCT) among pregnant and lactating mothers in selected government health facilities of South Wollo Zone, Amhara Region, northeast Ethiopia.

METHODS

An institution-based cross-sectional quantitative study design was employed from March 1, 2016 to April 14, 2016, using a standard structured data collection instrument. A sample of 191 human immunodeficiency virus (HIV)-positive pregnant and lactating mothers who were receiving PMTCT follow-up in the selected health facilities participated in the study. The data were entered using EpiData 3.1 and analyzed using SPSS version 21. Bivariate and multivariate logistic regression analyses were employed to identify factors associated with adherence. The p-values <0.05 and 95% confidence intervals (CIs) were used to identify associations between independent predictors and the outcome variable.

RESULTS

The level of adherence to option B+ PMTCT drugs was 87.9%. Women who received in-hospital treatment, who lived in rural areas, and faced challenges in initiating lifelong option B+ treatment on the same-day that they were diagnosed with HIV were less likely to adhere to the treatment (adjusted odds ratios [95% CI] of 0.3 [0.11 to 0.82], 0.26 [0.1 to 0.73], and 0.08 [0.02 to 0.37], respectively).

CONCLUSIONS

Collaborative efforts of zonal health departments with health facility administrators and counselors are recommended for effective and efficient interventions focusing on hospitals, rural areas, and patients who face challenges on the day of their diagnosis.

Summary

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Seroprevalence and associated risk factors of hepatitis B virus among pregnant women in southern Ethiopia: a hospital-based cross-sectional study: Yeshi Metaferia, Walelign Dessie, Ibrahim Ali, Anteneh Amsalu; Epidemiol Health. 2016;38:e2016027. Published online June 19, 2016; DOI: https://doi.org/10.4178/epih.e2016027

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Abstract PDF

Abstract

OBJECTIVES
Hepatitis B virus (HBV) is a major blood-borne and sexually transmitted infectious agent that is a significant global public health issue. The aim of this study was to determine the seroprevalence and risk factors of HBV among pregnant women attending the antenatal clinic of the Hawassa University referral hospital in Ethiopia.

METHODS

A cross-sectional study was conducted from April to May, 2015. A total of 269 consecutive pregnant women attending antenatal consultations were enrolled. Sociodemographic information and data regarding possible risk factors were collected using a structured questionnaire. Hepatitis B surface antigen (HBsAg) screening was performed using an enzyme-linked immunosorbent assay, and the data were analyzed.

RESULTS

The overall seroprevalence of HBsAg among the 269 participants enrolled in the study was 7.8% (n=21). The prevalence of human immunodeficiency virus (HIV) infection was 5.2% (n=14), of whom two participants (14.2%) were also positive for HBsAg. Study participants with no formal education (odds ratio [OR], 3.68; 95% confidence interval [CI], 1.27 to 10.68; p<0.05) were more likely to be infected with HBV than those who had completed at least secondary school. Although HBsAg was detected more often in pregnant women who had multiple exposure factors (8.8%, n=13) than in pregnant women who had not experienced possible risk factors (4%, n=1), this difference was not statistically significant (OR, 2.33; 95%CI, 0.29 to 18.63).

CONCLUSIONS

A high prevalence of HBV infection was detected in the study population. Neither the type of risk factors nor exposure to multiple risk factors was significantly associated with HBV infection. Hence, screening pregnant women regardless of risk factors and improving awareness of the transmission routes of HBV within this group may reduce the risk of HBV infections.

Summary

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Risk Factors for Group B Streptococcus Colonization Among Pregnant Women in Korea: Eun Ju Kim, Kwan Young Oh, Moon Young Kim, Yong Soo Seo, Jung-Hwan Shin, Young Rae Song, Jae-Hyug Yang, Betsy Foxman, Moran Ki; Epidemiol Health. 2011;33:e2011010. Published online November 11, 2011; DOI: https://doi.org/10.4178/epih/e2011010

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Abstract

<sec><title>OBJECTIVES</title>To identify obstetric and maternal factors related to Group B Streptococcus (GBS) colonization in pregnant women in Korea.</sec><sec><title>METHODS</title>The study was conducted between the years 2006-2008 in four hospitals, Cheil and Eulji hospital in Seoul, and Motae and Eulji hospital in Daejeon. We recruited 2,644 pregnant women between 35 to 37 weeks of gestation who had visited for antenatal care. Participants completed a questionnaire, and urine, vaginal and rectal specimens were obtained and cultured using selective broth media. After delivery, medical records were reviewed.</sec><sec><title>RESULTS</title>GBS colonization was significantly associated with hospital, age group, education, frequency of pregnancy, and premature rupture of membranes (PROM, more than 18 hours). After adjustment for other variables, Cheil hospital (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.20-3.52), and the first pregnancy (OR, 2.32; 95% CI, 1.12-4.81) remained significant. History of vaginitis showed marginal significance (OR, 1.50; 95% CI, 0.98-2.29).</sec><sec><title>CONCLUSION</title>To prevent GBS infection of neonates, clinicians should be alert to the potentially higher risk of GBS colonization in pregnant women in their first pregnancy, and women with premature rupture of membranes (PROM) (18 hours+) or who have a history of vaginitis.</sec>

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Related factors on Fatigue Symptom in Married Working women.: Kyung Jae Lee, Joo Ja Kim; Korean J Epidemiol. 2008;30(1):82-88. Published online June 30, 2008; DOI: https://doi.org/10.4178/kje.2008.30.1.82

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Abstract PDF: Abstract
OBJECTIVES
To investigate the related factors on fatigue symptoms among married working women.
METHODS
Data was analyzed from a cross-sectional survey of 902 married working women. Information was obtained about fatigue symptoms, sociodemographics, health behaviors, and job-related characteristics. Multiple regression tested the related factors on fatigue symptoms in married working women.
RESULTS
Fatigue was more common in office working women than in manufacture working women. Mean fatigue symptom was significantly higher in office working than in manufacture working women(p=0.002). In a multiple regression analysis, fatigue was associated with educational level, alcohol drinking state, stress, and overtime work in a multiple regression analysis(p<0.001).
CONCLUSIONS
Our findings suggest that fatigue is affected by job-related factor like overtime work with educational level, alcohol drinking state, or stress. Further research will be needed to establish preventive strategies for controlling the negative effects of fatigue on health stats of married working women.; Summary

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