Birth outcome and HIV infection among labouring women in Assosa Hospital, Southwest Ethiopia.
Abstract
Abstract Background: Perinatal mortality rate is a sensitive indicator of quality of care provided to women in pregnancy, at and after childbirth and to the newborns in the first week of life. Regular prenatal audit would help in identifying all the factors that play a role in causing prenatal deaths and thus help take appropriate interventions to reduce the avoidable once, at least. Knowledge of mothers’ HIV positive status provides an entry point for appropriate care of the mothers, HIV exposed infants and other family members including children. Objectives: To assess birth outcomes and the magnitude of HIV infection among labouring mothers in Assosa hospital. Method: An institution-based cross-sectional survey was conducted in Assosa hospital from September 2008 to August 2009. A total of 581 labouring women were interviewed using a pretested structured questionnaire. Results: Data was obtained from 581 mothers. HIV infection among labouring women was 6.5%. Mothers, who had primary education [AOR=4.76, 95%CI= 1.81-12.52], no formal education [AOR=3.05, 95%CI= 1.08-8.64], mothers with two or more pregnancies [AOR=2.64, 95%CI= 1.08-6.49], and Muslims [AOR=0.32,95%CI= 0.13-0.82] were the independent predictors of HIV infection. There were 525 live births. The prenatal deaths were 69, making an overall prenatal mortality of 119 per 1000 total births. Bivariate analysis showed that rural women, women who had no ANC visit, mothers aged 30 years and above, with no formal education, housewives, Berta women of in ethnic group and Muslim were crudely associated with higher risk of prenatal mortality. Conclusion: The study identified high level of perinatal mortality and HIV infection. This study calls for effective antenatal care, delivering service, and a coordinated referral system and community interventions including HIV counseling, testing (VCT), treatment and support. [Ethiop. J. Health Dev. 2011;25(1):10-16]References
World Health Organization 2005. Global Survey on
Maternal and Prenatal Health, Geneva; 2006.
World Health Organization Neonatal and Prenatal
Mortality Country, Regional and Global Estimates. 2006.
Bhutta S, Kerioje R, Noorani KJ, Bhutta ZA. An
audit and trends of prenatal mortality at the Jinnah
Postgraduate Medical Centre, Karachi. J pak Med Assoc 2007;57(4):168-72.
Al-Hiali SJ, Al-Mashhadani WS. Prenatal mortality
rate in Al-Ramadi Maternity and Children's Hospital,
western Iraq. Saudi Med J 2009;30(10):1296-300.
Frost 143-6.Maternal and prenatal deaths in an
Addis Ababa Hospital, 1980. Ethiop Med J 1984 Jul; 22(3):
Central Statistics Agency: Ethiopia Demographic
and Health Survey 2005. Ethiopia, Addis Ababa, Central Statistics Agency; 2006.
Yakob T. Assessment of pregnancy outcome with emphasis on prenatal and neonatal mortality in Dire Dawa town, Ethiopia. Masters Thesis, 2003.
Tilahun S, Gaym A. Past reproductive performance
and its correlation with prenatal mortality in the current gestation at teaching hospitals in Addis Ababa, Ethiopia. Ethiop Med J 2008;46(4):313-24
UNAIDS. Counseling and Voluntary HIV testing
for pregnant women in high HIV prevalence countries. Geneva: Switzerland; 2001.
Avert. Prevention of mother to child transmission of
HIV in sub-Saharan Africa countries. August 2007, accessed on 13/08/2009. Available from: URL:
WWW.avert.org/ motherchild.htm.
Federal Ministry of Health of Ethiopia and HAPCO.
AIDS in Ethiopia sixth report. Addis Ababa, Ethiopia. September 2006.
Federal Ministry of Health. Single point estimate.
Assefa T, Davey G, Dukers N and et al. Overall
HIV-1 prevalence in pregnant women over-estimates
HIV-1 in the predominantly rural population of Afar
Region. Ethiop Med J 2003;41 (Suppl 1) :43-9.
Mullu A, Kassu A and et al. Sero-prevalence of
syphilis and HIV-1 during pregnancy in teaching
hospital in northwest Ethiopia. Jpn J Infect Di. 2007;60:193-195.
FMOH and HAPCO. Guidelines for the Prevention
of Mother to Child Transmission of HIV in Ethiopia.
July 2007.
Kongnyuy Ej and et al. Acceptability of intrapartum
HIV counseling and testing in Cameroon. BMC
Pregnancy and Childbirth 2009;9:9.
Thior I, Gabaitiri L, Grimes J, Shapiro R, Lockman
S, Kim S and et al. Voluntary counseling and testing
among post-partum women in Botswana. Patient
Edu. Couns 2007;65(3):296-302.
Holmes CN, Preko PO, Bolds R, Baidoo J, Jolly PE.
Acceptance of VCT and treatment for HIV among
pregnant women in Kumsi, Ghana. Ghana Med J
March; 42(1): 8–15.
Utulu SN, Lawoyen T. Epidemiological features of
HIV infection among pregnant women in Makurdi,
Benue State, Nigeria. J Biosoc Sci 2007 May; 39(3):
-408.
Lawoyin TO, Adewole DA. Predictors of maternal
HIV infection at the primary care level in inner city
Ibadan. Int J STD AIDS 2004 Mar; 15(3): 165-8)
Mbaruku G, van Roosmalen J, Kimondo I, Bilango
F, Bergstrom S. Prenatal audit using the 3-delays
model in western Tanzania. Int J Gynaecol Obstet
;106(1):85-8.
Gaym. A. Prenatal Mortality Audit at Jimma
Hospital, South Ethiopia. Ethiopian Journal of
Health Development. 2002; 14(3); 335-343.
Habib NA, Lie RT, Oneko O, Shao J, Bergsjo P,
Daltveit AK. Socio-demographic characteristics and
prenatal mortality among singletons in North East
Tanzania a registry-based study. J Epidemiol
Community Health 2008; 62(35):960–965.
Akello B, Nabiwemba E, Zirabamuzaale C, Orach
CG. Risk factors for prenatal mortality in Arua
regional referral hospital, West Nile, Uganda. East
Afr J Public Health. 2008;5(3):180-5.
Tadesse E, Afework S, Surafiel Y, Mehari LB.
Determinants of prenatal death: a five year
retrospective survey at Tikur Anbessa Teaching
Hospital. J Obstet Gynaecol East Cent Africa
;8(1):15-7.
Mavalankar D,Trived R. Levels and risk factors for
prenatal mortality in Amhadabad, India. INDIA
WHO Bulletin OMS 1991;Vol 69.
WHO. Maternal care For The Education of Prenatal
And Neonatal Mortality: A Joint WHO /UNICEF
Statement. Geneva: WHO; 1986.