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Strengthening Health Education Professionals Workforce In Zambia Symposium 加强赞比亚卫生教育专业人员队伍研讨会
Pub Date : 2023-07-27 DOI: 10.55320/mjz...254
Mjz Special Issue Shepiz
MJZ Special Issue - SHEPIZ
MJZ特刊- SHEPIZ
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引用次数: 0
Postpartum Typhoid Intestinal Perforation 产后伤寒肠穿孔
Pub Date : 2022-11-21 DOI: 10.55320/mjz.49.2.1135
A. O. Lawal, J. Dare, Hafsoh Olabinjo, A. Adenuga, Balogun Olayinka, Ishaq Aremu
Background: Typhoid fever remains a highly contagious and multi-systemic infection caused by salmonellae typhi, and like other gastro-enteric infection, it poses a higher risk of morbidity and mortality during pregnancy as a result of the physiological changes associated with pregnancy as well as concerns of antibiotic safety in pregnancy. The occurrence of typhoid perforation in pregnancy may be easily confused for other causes of acute abdomen in pregnancy. We report the presentation, management and outcome of a 25 year old postpartum woman who presented with typhoid intestinal perforation in a resource limited environment. She had an emergency exploratory laparotomy and was managed post operatively in the ICU but clinically deteriorated and subsequently died on the third post-operative day secondary to multiple organ failure from severe sepsis. Typhoid perforation in pregnancy is a rare presentation, a high index of suspicion, and early intervention, would reduce the incidence of morbidity and mortality associated with this disease condition.
背景:伤寒仍然是一种由伤寒沙门氏菌引起的高度传染性多系统感染,与其他胃肠道感染一样,由于与妊娠相关的生理变化以及对妊娠期抗生素安全性的担忧,它在妊娠期间具有更高的发病率和死亡率风险。妊娠期伤寒穿孔的发生很容易与其他原因引起的妊娠急腹症混淆。我们报告的介绍,管理和结果的25岁产后妇女谁提出伤寒肠穿孔在资源有限的环境。患者接受了紧急剖腹探查术,术后在ICU接受治疗,但临床情况恶化,并于术后第三天死于严重败血症引起的多器官衰竭。妊娠期伤寒穿孔是一种罕见的表现,怀疑指数高,早期干预,将降低与此病相关的发病率和死亡率。
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引用次数: 0
Clinical Audit of Stillbirths at a Faith-Based Secondary Health Centre in Ibadan, Nigeria: A Six-Year Review 尼日利亚伊巴丹一家以信仰为基础的二级保健中心死产临床审计:六年回顾
Pub Date : 2022-11-21 DOI: 10.55320/mjz.49.2.1067
O. Ogunbode, Mobolaji Philip Oyeyiola, A. Arowojolu
Objective: The determine the prevalence of stillbirth and identify associated factors among pregnant women. Method: This was a retrospective audit of two hundred and twenty-five stillbirth deliveries at Our lady of Apostle, Catholic Hospital, Oluyoro, Oke-Offa, Ibadan, Nigeria, between January 1, 2013, and December 31, 2018. Data was extracted from hospital records for socio-demographic characteristics, obstetric factors, complications, and outcomes of pregnancy. Data analysis was done using SPSS version 20 and the level of statistical significance was set at p < 0.05. Results: The stillbirth rate was 27.75 per 1000 births. More than half (129; 57.4%) were macerated. The ratio of stillbirth rate among the booked and unbooked parturients was 1:21. The common causes of stillbirths were hypertensive disorders in pregnancy (24.9%) and anaemia in pregnancy (20.4%) while the least were congenital anomalies (1.0%) and gestational diabetes mellitus (1.0%). Conclusion: This study confirmed that most of the stillbirths were due to unsupervised or poorly supervised pregnancies. There is need to ensure quality antenatal care services for the early detection and management of risk factors in order to reduce the burden of stillbirths.
目的:了解孕妇死产的发生率及相关因素。方法:回顾性审计2013年1月1日至2018年12月31日期间,尼日利亚伊巴丹奥克奥法奥卢约罗天主教医院圣母使徒医院225例死胎分娩。从医院记录中提取有关社会人口统计学特征、产科因素、并发症和妊娠结局的数据。采用SPSS version 20进行数据分析,p < 0.05为统计学显著性水平。结果:死胎率为27.75 / 1000。超过一半(129;57.4%)浸泡。预约产妇死产率与未预约产妇死产率之比为1:21。导致死产的常见原因是妊娠期高血压疾病(24.9%)和妊娠期贫血(20.4%),其次是先天性异常(1.0%)和妊娠期糖尿病(1.0%)。结论:本研究证实,大多数死产是由于无监督或监督不良妊娠。有必要确保高质量的产前保健服务,以便及早发现和管理风险因素,以减少死产的负担。
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引用次数: 0
Kristen Rat Sarcoma Viral Oncogene Mutations in Colorectal Carcinomas at the University Teaching Hospital in Lusaka, Zambia 赞比亚卢萨卡大学教学医院结肠直肠癌中的Kristen大鼠肉瘤病毒癌基因突变
Pub Date : 2022-11-21 DOI: 10.55320/mjz.49.2.1113
E. Shilika, Stepfanie N Siyumbwa, Maurice Mwale, P. Julius
Background: The second leading cause of cancer-related deaths worldwide is colorectal cancer. With an incidence rate of 4.8 per 100,000, this is Zambia’s sixth most prevalent cancer;   Methods: This laboratory-based, cross-sectional study examined the frequency of Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation and its association with prognostic factors in colorectal carcinoma cases from the University Teaching Hospital-Adult Hospital (UTHs), Lusaka, Zambia;   Results: Thirty (30) formalin-fixed paraffin-embedded (FFPE) samples collected between June 2017 and June 2018 were sent to the Lancet laboratories and analyzed for KRAS mutations (codons 12 and 13). One FFPE block did not meet the inclusion criteria and was excluded. The demographic and clinicopathological data were analyzed using STATA 12. Males outnumber females by 20 to nine. The average age of the patient was 45 ± 16 years. The rectum was the location of 44.8% of the tumors, with the majority being conventional adenocarcinoma (CAC) (65.6 %). All cases (100%) had advanced-stage (stages 3 and 4) disease; however, only 27.6% of patient tumors exhibited lymphovascular invasion. KRAS mutation was detected in 11 (37.9%) cases and mainly in left-sided tumors (62.5%). KRAS mutations were only detected in CAC and serrated adenocarcinoma subtypes. No significant associations were observed between the KRAS mutation status and tumor or patient’s clinical and sociodemographic factors;   Conclusion: We advocate for incorporating KRAS mutation testing into the standard of care for treating colorectal cancer.
背景:全球癌症相关死亡的第二大原因是结直肠癌。每10万人中有4.8人罹患此病,是赞比亚第六大常见癌症;方法:本研究以实验室为基础,横断面研究了来自赞比亚卢萨卡大学教学医院成人医院(UTHs)的结直肠癌病例中Kirsten大鼠肉瘤病毒癌基因同源物(KRAS)突变的频率及其与预后因素的关系;结果:2017年6月至2018年6月采集的30份福尔马林固定石蜡包埋(FFPE)样本被送往《柳叶刀》实验室,分析KRAS突变(密码子12和13)。1个FFPE块不符合纳入标准,被排除。使用STATA 12分析人口学和临床病理资料。男性的数量是女性的20比9。患者平均年龄45±16岁。直肠为44.8%的肿瘤部位,以常规腺癌(CAC)居多(65.6%)。所有病例(100%)均为晚期(3期和4期)疾病;然而,仅有27.6%的患者肿瘤表现为淋巴血管浸润。KRAS突变11例(37.9%),主要发生在左侧肿瘤(62.5%)。KRAS突变仅在CAC和锯齿状腺癌亚型中检测到。未观察到KRAS突变状态与肿瘤或患者临床和社会人口学因素之间的显著关联;结论:我们提倡将KRAS突变检测纳入治疗结直肠癌的护理标准。
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引用次数: 0
The Maternal factors and short term outcomes associated with episiotomy during vaginal delivery at Women and Newborn Hospital , Lusaka, Zambia 赞比亚卢萨卡妇女和新生儿医院阴道分娩时外阴切开术相关的产妇因素和短期结果
Pub Date : 2022-11-21 DOI: 10.55320/mjz.49.2.978
Rowshan Jahan Urmee, B. Vwalika
Background: An episiotomy is a surgically planned incision on the posterior vaginal wall   and perineum performed during the second stage of labour to facilitate the delivery of the neonate. The practice has been used for many decades in the belief that it offers benefit to   the mother and the neonate. With the objective of protecting the pelvic floor and preventing fetal trauma, during the birth, its routine use was widely accepted in the past, principally in woman in her first delivery. However, it is not free from complications which include iatrogenic injury to the anal canal, perineal pain and excess bleeding. This study was therefore conducted to explore the short term maternal outcomes and factors associated with episiotomy.   Methodology: An unmatched case control study was conducted in postnatal wards of Women and New-born hospital in Lusaka, Zambia between November 2019 and April 2020 with convenient sample for the cases and systematic sample for the controls. A semi-structured interviewer administered questionnaire was used and 102 participants (cases) who had episiotomy performed were recruited while 204(controls) were without episiotomies.   Results: A total of 306 (102 are cases and 204 are control) were included. Age was found to be a good predictor of episiotomy in that those younger than 18 years were more than seven times likely to have an episiotomy (AOR=7.65; 95%CI 1.36-18.21; p=0.035). It was also found out that primi gravidas were five times likely to have an episiotomy performed compared to parous women (OR=4.96; 95%CI 2.58-9.52; p<0.001). Out of those delivered by a midwife, 73(28.3%) participants had an episiotomy performed compared to 29(60.4%) delivered by a medical officer. Multivariate regression it was shown that being delivered by a midwife was protective against an episiotomy (OR=0.260; 95%CI 0.14-0.49; p=0.001). Out of the 102 participants who had an episiotomy, only two had third degree tear extension. It was also noted that 99 out of 102 (97%) participants who had an episiotomy experienced post-delivery perineal pain compared to 94 out of 204(46%) of those who had no episiotomies. In univariate analysis, it was found that post-delivery perineal pain was associated with episiotomy (p<0.001). It was further found that those who had an episiotomy performed were about 4 times likely to experience perineal pain post- delivery (OR=3.8; 95%CI 1.2-12.3). The mean blood loss among those who has had no episiotomy was 230mls compared to 270mls among those who had an episiotomy. However, post-delivery blood loss was found to be a poor predictor of an episiotomy (OR=0.998; 95%CI 0.991-1.006; p=0.670).   Conclusion: Maternal factors associated with episiotomy included age, parity, method of induction, and the personnel conducting the delivery Short term maternal outcomes of episiotomy were perineal tear extension, excess blood loss and post-delivery perineal pain. It was found that 8.5% of women had undergone an episio
背景:会阴切开术是在分娩第二阶段在阴道后壁和会阴处进行的手术计划切口,以促进新生儿的分娩。这种做法已经使用了几十年,人们相信它对母亲和新生儿都有好处。为了保护骨盆底和防止胎儿外伤,在分娩过程中,它的常规使用在过去被广泛接受,主要是在首次分娩的妇女中。然而,它并非没有并发症,包括医源性肛管损伤,会阴疼痛和出血过多。因此,本研究旨在探讨外阴切开术的短期产妇预后和相关因素。方法:于2019年11月至2020年4月在赞比亚卢萨卡妇女和新生儿医院的产后病房进行了一项无与伦比的病例对照研究,病例样本为方便样本,对照组为系统样本。采用半结构化访谈问卷,招募了102例接受外阴切开术的参与者(病例)和204例未接受外阴切开术的参与者(对照组)。结果:共纳入306例,其中病例102例,对照组204例。年龄被发现是会阴切开术的一个很好的预测因素,年龄小于18岁的患者接受会阴切开术的可能性超过7倍(AOR=7.65;95%可信区间1.36 - -18.21;p = 0.035)。研究还发现,初产妇女接受外阴切开术的可能性是已产妇女的5倍(OR=4.96;95%可信区间2.58 - -9.52;p < 0.001)。在助产士接生的产妇中,有73人(28.3%)接受了会阴切开术,而由医务人员接生的产妇中有29人(60.4%)接受了会阴切开术。多因素回归显示,由助产士接生对会阴切开术有保护作用(OR=0.260;95%可信区间0.14 - -0.49;p = 0.001)。在102名接受外阴切开术的参与者中,只有2人有三度撕裂延伸。还值得注意的是,102名接受外阴切开术的参与者中有99名(97%)经历了分娩后会阴疼痛,而204名未接受外阴切开术的参与者中有94名(46%)经历了分娩后会阴疼痛。单因素分析发现,分娩后会阴疼痛与会阴切开术相关(p<0.001)。进一步发现,那些做过会阴切开术的人分娩后会阴部疼痛的可能性约为4倍(OR=3.8;95%可信区间1.2 - -12.3)。未做过外阴切开术的患者的平均失血量为230毫升,而做过外阴切开术的患者的平均失血量为270毫升。然而,产后失血被发现是会阴切开术的不良预测因子(OR=0.998;95%可信区间0.991 - -1.006;p = 0.670)。结论:与会阴切开术相关的产妇因素包括年龄、胎次、引产方式、分娩人员等。会阴切开术短期结局为会阴撕裂扩大、失血过多、分娩后会阴疼痛。研究发现,8.5%的女性接受过外阴切开术。进行分娩的卫生专业人员应接受外阴切开术指征的教育,外阴切开术中患者的选择,并接受外阴切开术修复手术技能的培训,以减少手术相关的发病率。
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引用次数: 0
Characteristics and Surgical Repair Outcomes of Obstetric Fistula Patients Managed at a Teaching Hospital in Zambia: A Retrospective Cross Sectional Study 赞比亚一家教学医院产科瘘患者的特点和手术修复效果:回顾性横断面研究
Pub Date : 2022-11-21 DOI: 10.55320/mjz.49.2.1132
M. Imakando, C. Michelo, Tapiwa Mkandawire, L. Kasonka
Background The obstetric fistula is a chronic maternal morbidity of global public health concern. The condition is preventable and in most cases treatable. Surgical repair is the mainstay of treatment with varying degrees of success. The aim of this study was to determine the characteristics, surgical outcomes and factors influencing surgical outcomes of women presenting with obstetric fistulas at a Teaching Hospital in Lusaka, Zambia. Methods A retrospective review of medical records for all women who underwent obstetric fistula repair surgery at Women and Newborn Hospital from 2017 to 2019.  Descriptive analysis was done. Fischer’s exact test was used to measure association between surgical outcomes and variables in the model. Results In total, 18 out of 29 records of patients who underwent fistula repair were retrieved and analyzed. Ages ranged from 15 to 47 years, mean age 29years. Over two thirds (72.23%) were multiparous, and over 3/4ths (77.8%) underwent caesarean section in the antecedent pregnancy. Success rate for fistula repair was 83% at 2 weeks post-operative. Study findings were inadequate to show a significant association between successful repair and factors in the model. Conclusion Majority of women presenting with obstetric fistula were multiparous with a history of prolonged labour, delivery by cesarean section and poor birth outcomes. The success rate for obstetric fistula repair at Women and Newborn Hospital was 83% at 2weeks postoperative. Further studies are needed to assess long-term outcomes and factors influencing surgical outcomes.
背景产科瘘管病是全球公共卫生关注的一种慢性产妇疾病。这种情况是可以预防的,在大多数情况下是可以治疗的。手术修复是治疗的主要方法,成功率各不相同。本研究的目的是确定在赞比亚卢萨卡的一家教学医院患有产科瘘的妇女的特点、手术结果和影响手术结果的因素。方法回顾性分析2017年至2019年在妇女新生儿医院接受产科瘘修复手术的所有妇女的医疗记录。进行描述性分析。Fischer精确检验用于测量手术结果与模型中变量之间的关联。结果29例行瘘管修补术的患者中有18例被检索和分析。年龄15 ~ 47岁,平均29岁。超过三分之二(72.23%)的女性曾多次分娩,超过四分之三(77.8%)的女性曾剖腹产。术后2周瘘管修复成功率为83%。研究结果不足以显示成功修复与模型中因素之间的显著关联。结论产科瘘患者多为多胎患者,既往有长时间分娩、剖宫产史和不良分娩结局。妇女和新生儿医院产科瘘修复术后2周的成功率为83%。需要进一步的研究来评估长期结果和影响手术结果的因素。
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引用次数: 0
Oral Health of Vegetarians is a Neglected Aspect of Stomatological Research: A Reflection based on PubMed Evidence 素食者的口腔健康是口腔研究中一个被忽视的方面:基于PubMed证据的反思
Pub Date : 2022-11-21 DOI: 10.55320/mjz.49.2.1119
K. Kanmodi, L. Nnyanzi, O. Sulaiman, C. Adetunji
The vegetarians form one-fifth of the global population. The vegetarians are a peculiar group of people; existing body of scientific evidence shows that they are a highly vulnerable group of people when it comes to oral diseases. The oral health of vegetarians is a critical aspect of dentistry; however, current evidence—based on PubMed database search—shows a dearth of literature on this thematic area. This research area has been neglected in the field of stomatological research.
素食者占全球人口的五分之一。素食者是一群特殊的人;现有的科学证据表明,当涉及到口腔疾病时,他们是一个非常脆弱的群体。素食者的口腔健康是牙科的一个重要方面;然而,目前基于PubMed数据库搜索的证据显示,这一主题领域的文献缺乏。这一研究领域在口腔医学研究中一直被忽视。
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引用次数: 0
Perceptions and Willingness to Undertake Transvaginal Sonography by Women at the Sally Mugabe Central Hospital, Zimbabwe 津巴布韦萨利·穆加贝中心医院妇女接受阴道超声检查的认知和意愿
Pub Date : 2022-11-21 DOI: 10.55320/mjz.49.2.1093
B. Chinene, L. Mutandiro, L. Mudadi, Paridzai Nyawani
Introduction: Patient’s opinions are an important facet of guideline development. There is little that is known about Zimbabwean women perceptions and willingness to undergo Transvaginal Sonography (TVS) and there are no specific guidelines to guide its use. Aim: To evaluate the perception and willingness to undergo TVS among women attending Obstetrics and Gynaecology clinic at Sally Mugabe Central Hospital in Harare, Zimbabwe. Methods: A cross-sectional survey using a structured questionnaire was conducted between 1 and 30 June 2022. A total of 170 women attending the obstetrics and gynaecology clinic at Sally Mugabe Central Hospital were randomly selected to participate in the study. Results: Majority of women (81.76%) had no previous TVS experience, with an equally large proportion (60.84%) not having seen a TVS probe before. Most of the women would prefer female sonographers (85.37%) to conduct the examination. In addition, about 58% of the participants concurred that a chaperone should be present. Less than half of the females (47.93%) were eager to have a TVS done on them. Equally, just 45% of the females said they would encourage others to have a TVS scan. The difference in willingness to undergo a TVS study stratified by employment status was statistically significant (chi square 7.26, p = 0.03).   Conclusion: Our study findings revealed that a large proportion of females had no previous TVS experience, with an equally large proportion not having seen a TVS probe before. Only a sizeable proportion of women were willing to accept TVS provided it is conducted by female sonographers and or in the presence of a chaperone. The findings underscore the importance of education and awareness of the benefits of TVS in terms of diagnosis on maternal health outcomes, to the Zimbabwean population.
患者意见是指南制定的一个重要方面。人们对津巴布韦妇女接受阴道超声检查(TVS)的看法和意愿知之甚少,也没有具体的指导方针来指导其使用。目的:评估在津巴布韦哈拉雷萨利穆加贝中心医院产科和妇科诊所就诊的妇女接受TVS的认知和意愿。方法:在2022年6月1日至30日期间,采用结构化问卷进行横断面调查。在Sally Mugabe中心医院产科和妇科诊所就诊的170名妇女被随机选择参加这项研究。结果:大多数女性(81.76%)以前没有TVS经验,同样大比例的女性(60.84%)以前没有见过TVS探头。大多数女性(85.37%)选择女超声医师进行检查。此外,大约58%的参与者同意应该有一个陪伴者在场。不到一半的女性(47.93%)渴望在自己身上做电视。同样,只有45%的女性说她们会鼓励别人做电视扫描。按就业状况分层的接受TVS研究的意愿差异有统计学意义(卡方为7.26,p = 0.03)。结论:我们的研究结果显示,很大一部分女性以前没有电视经验,同样大比例的女性以前没有见过电视探针。只有相当大比例的妇女愿意接受电视,只要它是由女性超声医师和或在陪同人员在场的情况下进行的。调查结果强调了教育和认识到电视在诊断产妇健康结果方面对津巴布韦人民的好处的重要性。
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引用次数: 0
Oral Health Knowledge, Attitude and Practices among Adolescents in Choma District of Zambia 赞比亚乔玛地区青少年的口腔健康知识、态度和行为
Pub Date : 2022-11-21 DOI: 10.55320/mjz.49.2.898
Bright Mukanga, Kupuzo Sakala, Tato Herbert Nyirenda, V. Daka, David Mulenga
Introduction: Dental caries and periodontal diseases are the most common oral diseases globally. Early control of oral health behaviours is important because lifestyles acquired during adolescence are powerful predictors of adult health. We conducted a study to determine knowledge, attitude and practices on oral hygiene among school going adolescents in Choma District. Methodology: A cross-sectional study was conducted among school going adolescents in randomly selected schools in Choma District. A total of 335 participants were included in the study. Data were collected using a closed-end self-administered questionnaire. The sample size was distributed among the six schools in the ratio of their population. The study included anyone from grade 8-12. Data were analysed using IBM software for SPSS. We employed the Chi-Square test to investigate association between variables. A p-value less than 0.05 was considered statistically significant. Results: The study had 173 males and 162 females in the age range of 12-19 years. The majority (87.8%) had good knowledge, 69.4% had good attitude and 87.5% had good practice on oral -hygiene. Practice was influenced by sex with females having good oral hygiene as compared to their male counterparts. About 97.2% thought that dental health education is essential in schools. 34% indicated that they had visited the dentist when they experienced toothache. However, parental advice 11% (n=39) to visit the dentist regularly was low. The majority 49.9% (n=167) indicated that they had not visited the dentist due to fear of the dental equipment set up. Conclusion and recommendation: Despite the majority having good knowledge and attitude and on oral hygiene, there is need to acquaint children with milling and dental units found in most dental offices. This may instil confidence in children to seek specialist dental treatment whenever they develop any dental disease. Further, parents need to be incorporated as partners in promoting oral health hygiene among school going adolescents.    
简介:龋齿和牙周病是全球最常见的口腔疾病。早期控制口腔卫生行为很重要,因为青春期获得的生活方式是成年健康的有力预测因素。我们进行了一项研究,以确定在Choma区上学的青少年对口腔卫生的知识,态度和做法。方法:在乔玛区随机选择学校的在校青少年中进行横断面研究。共有335名参与者参与了这项研究。数据收集采用封闭式自我管理问卷。样本量在六所学校中按其人口比例进行分配。这项研究包括8-12年级的所有学生。数据分析采用IBM SPSS软件。我们采用卡方检验来调查变量之间的相关性。p值小于0.05被认为具有统计学意义。结果:研究对象为男性173人,女性162人,年龄12-19岁。大多数(87.8%)对口腔卫生有良好的认识,69.4%的人对口腔卫生有良好的态度,87.5%的人对口腔卫生有良好的习惯。实践受到性别的影响,与男性相比,女性具有良好的口腔卫生。约97.2%的受访者认为学校的牙齿健康教育很重要。34%的人表示牙痛时曾去看过牙医。然而,11% (n=39)的家长建议定期去看牙医的比例很低。49.9% (n=167)的受访者表示,由于害怕牙科设备的设置,他们没有去看过牙医。结论和建议:尽管大多数儿童对口腔卫生有良好的知识和态度,但仍有必要让儿童熟悉大多数牙科诊所的磨牙和牙科设备。这可能会给孩子们灌输信心,让他们在出现任何牙科疾病时寻求专业牙科治疗。此外,家长需要成为促进在校青少年口腔卫生的合作伙伴。
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引用次数: 0
Factors associated with failed contraception in women attending level one hospitals in Lusaka, Zambia. 在赞比亚卢萨卡一级医院就诊的妇女避孕失败的相关因素。
Pub Date : 2022-11-21 DOI: 10.55320/mjz.49.2.980
J. Sakala, L. Kasonka, M. Kasaro, C. Mabula, B. Vwalika
ABSTRACT Background: Unintended pregnancy is a major public health concern due to its impact on maternal morbidity and mortality. Contraceptive failure is one of the causes of unintended pregnancy. Data on factors associated with contraceptive method failure is scarce. This study therefore aimed to determine the proportions of contraceptive failure for various methods and factors associated with it. Methodology: Unmatched case-control study was conducted at five Level One Hospitals in Lusaka. Convenience sampling was used to enrol 108 cases for whom pregnancy occurred while on a modern contraceptive method and 108 controls who were on a modern contraceptive method and not pregnant. Binary and multiple logistic regressions were utilized for assessment of factors associated with failed contraception. Results: Among the 108 cases, 46 (42.6%), 40 (37%), 17 (15.7%) and 1 (0.9%) were on the oral contraceptive pill, injectable, implant and intrauterine device contraception methods respectively while 2 (1.9%) were on barrier and emergency contraceptive methods respectively. The odds of contraceptive failure when using the oral contraceptive pill was more than 7 times (AOR 7.790, 95% CI 1.210-50.161, p=0.031). Those who had contraception failure were more than 3 times more likely to be younger than 30 years old compared to those whose contraceptive method did not fail (AOR 3.559, 95% CI 1.100-11.521, p=0.034 and AOR 3.596, 95% CI 1.354-9.550, p=0.010 respectively for age groups 18-24 years and 24-30 years old). Other factors associated with a higher odds of contraceptive failure were duration of marriage greater than one year, with the highest odds in those married for more than 10 years (AOR 9.744, 95% CI 2.232-42.537, p=0.002), higher social support (AOR 2.402, 95% CI 1.085-5.321, p=0.031), multiparity (AOR 15.299, 95% CI 3.034-77.151, p=0.001), and duration of use of antecedent contraception method of more than 2-3 years (AOR 4.913, 95% CI 1.662-14.526, p=0.004). Conclusion: The oral contraceptive pill, younger age, marriage duration of more than one year and contraceptive use more than three years were associated with contraceptive failure. Good messaging and counseling on usage of the oral contraceptive pill is recommended.
背景:意外妊娠是一个主要的公共卫生问题,因为它影响孕产妇发病率和死亡率。避孕失败是意外怀孕的原因之一。关于避孕方法失败的相关因素的数据很少。因此,本研究旨在确定各种避孕方法失败的比例及其相关因素。方法:在卢萨卡的五家一级医院进行了不匹配的病例对照研究。采用方便抽样方法,纳入了108例使用现代避孕方法怀孕的病例和108例使用现代避孕方法但未怀孕的对照组。使用二元和多元逻辑回归来评估与避孕失败相关的因素。结果:108例患者中口服避孕药46例(42.6%)、注射避孕方法40例(37%)、植入避孕方法17例(15.7%)、宫内节育器避孕方法1例(0.9%),屏障避孕方法2例(1.9%)、紧急避孕方法2例(1.9%)。口服避孕药避孕失败的几率大于7倍(AOR 7.790, 95% CI 1.210 ~ 50.161, p=0.031)。在18-24岁和24-30岁年龄组中,避孕失败的年龄小于30岁者是避孕方法未失败者的3倍以上(AOR分别为3.559,95% CI 1.100-11.521, p=0.034; AOR为3.596,95% CI 1.354-9.550, p=0.010)。与避孕失败几率较高相关的其他因素有:婚姻持续时间大于1年,其中婚姻超过10年者的失败率最高(AOR为9.744,95% CI为2.232 ~ 42.537,p=0.002),较高的社会支持(AOR为2.402,95% CI为1.085 ~ 5.321,p=0.031),多胎(AOR为15.299,95% CI为3.034 ~ 77.151,p=0.001),以及既往避孕方法使用时间超过2 ~ 3年(AOR为4.913,95% CI为1.662 ~ 14.526,p=0.004)。结论:口服避孕药、年龄较小、结婚1年以上、使用避孕药3年以上与避孕失败有关。建议就口服避孕药的使用提供良好的信息和咨询。
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Medical journal of Zambia
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