Family Planning Uptake and Associated Factors Among Women of Reproductive Age (15-49 Years) in Rubavu District, Rwanda

Despite global progress, 164 million women worldwide still want to limit childbearing but lack access to contraception. In Sub-Saharan Africa, 21 million women experience pregnancies annually, with half being unintended. While Rwanda has achieved a 58% family planning prevalence rate nationally, regional disparities persist. This study examined family planning uptake and associated factors among women aged 15-49 years in Rubavu District, Rwanda, to inform health policies and reduce access barriers. This cross-sectional study surveyed 382 women of reproductive age attending postnatal care services at selected health centers. Data was collected using a validated questionnaire and analysed with SPSS version 25.0, with statistical significance set at p<0.05. Among participants, 85% were currently using family planning methods. Key factors associated with increased uptake included secondary or higher education (COR=2.59), having 1-2 children versus 4-5 children (COR=2.66), husband approval (COR=3.27), and shorter travel times to health centers (COR=4.42). Multivariate analysis confirmed that women in Ubudehe category 2 (AOR=3.97), those with husband approval (AOR=2.68), previous family planning users (AOR=8.37), and women living within one hour of health centers (AOR=4.88) had significantly higher odds of family planning use. Effective interventions should focus on expanding women's education, engaging male partners in family planning decisions, and improving geographic access to health centers. Addressing these factors could substantially increase family planning uptake and improve reproductive health outcomes in Rubavu District. Keywords: Family Planning, Uptake, Associated Factors, Among Women, Reproductive Age (15-49 Years), Rubavu District, Rwand

A comparison between dissection techniques for the assessment of parity in Anopheles arabiensis and determination of sac stage in mosquitoes alive or dead on collection

BACKGROUND: The determination of parous rates in mosquitoes, despite numerous shortcomings, remains a tool to evaluate the effectiveness of control programs and to determine vectorial capacity in malaria vectors. Two dissection techniques are used for this. For one, the tracheoles of dried ovaries are examined with a compound microscope and in the other the follicular stalk of ovaries is examined, wet, with a stereomicroscope. The second method also enables the sac stage of parous insects (which provides information on the duration of the oviposition cycle) and the mated status of insects to be determined. Despite widespread use the two techniques have not previously been compared. METHODS: We compared the two dissection techniques using Anopheles arabiensis, collected with a tent-trap in Eritrea. The paired ovaries were removed in water and one was examined by each method. From a separate set of dissections from Tanzania, we also determined if the sac stages of Anopheles gambiae s.l. (83% of 183 identified by PCR being Anopheles arabiensis the remainder being A. gambiae) that were alive on collection were different to those that died on collection and what the implications for vectorial capacity estimation might be. RESULTS: Seven per cent of the dry ovaries could not be classified due to granulation (yolk) in the ovariole that obscured the tracheoles. The sensitivity of the dry dissection was 88.51% (CI [79.88-94.35%]) and the specificity was 93.55% (CI [87.68-97.17%]) among the 211 ovaries that could be classified by the dry technique and compared to the ovaries dissected wet. 1,823 live and 1,416 dead from Furvela tent-traps, CDC light-trap and window-trap collections were dissected 'wet' from Tanzania. In these collections parous insects were more likely to die compared to nulliparous ones. The proportion of parous mosquitoes with 'a' sacs (indicative of recent oviposition) was significantly greater in insects that were dead (0.36) on collection in the morning compared to those that were alive (0.12) (Chi square 138.93, p < 0.001). There was a preponderance of newly emerged virgin insects in the outdoor collection (Chi sq = 8.84, p = 0.003). CONCLUSIONS: In anophelines the examination of mosquito ovaries using transmitted light in a 'wet' dissection is a more useful and informative technique than examination of dry ovaries. In order to correctly estimate the duration of the oviposition cycle mosquitoes should be dissected as soon as possible after collection. Younger insects were more likely to attempt to feed outdoors rather than indoors.publishersversionpublishe

‘We like it wet’: a comparison between dissection techniques for the assessment of parity in Anopheles arabiensis and determination of sac stage in mosquitoes alive or dead on collection

Background The determination of parous rates in mosquitoes, despite numerous shortcomings, remains a tool to evaluate the effectiveness of control programs and to determine vectorial capacity in malaria vectors. Two dissection techniques are used for this. For one, the tracheoles of dried ovaries are examined with a compound microscope and in the other the follicular stalk of ovaries is examined, wet, with a stereomicroscope. The second method also enables the sac stage of parous insects (which provides information on the duration of the oviposition cycle) and the mated status of insects to be determined. Despite widespread use the two techniques have not previously been compared. Methods We compared the two dissection techniques using Anopheles arabiensis, collected with a tent-trap in Eritrea. The paired ovaries were removed in water and one was examined by each method. From a separate set of dissections from Tanzania, we also determined if the sac stages of Anopheles gambiae s.l. (83% of 183 identified by PCR being Anopheles arabiensis the remainder being A. gambiae) that were alive on collection were different to those that died on collection and what the implications for vectorial capacity estimation might be. Results Seven per cent of the dry ovaries could not be classified due to granulation (yolk) in the ovariole that obscured the tracheoles. The sensitivity of the dry dissection was 88.51% (CI [79.88–94.35%]) and the specificity was 93.55% (CI [87.68–97.17%]) among the 211 ovaries that could be classified by the dry technique and compared to the ovaries dissected wet. 1,823 live and 1,416 dead from Furvela tent-traps, CDC light-trap and window-trap collections were dissected ‘wet’ from Tanzania. In these collections parous insects were more likely to die compared to nulliparous ones. The proportion of parous mosquitoes with ‘a’ sacs (indicative of recent oviposition) was significantly greater in insects that were dead (0.36) on collection in the morning compared to those that were alive (0.12) (Chi square 138.93, p < 0.001). There was a preponderance of newly emerged virgin insects in the outdoor collection (Chi sq = 8.84, p = 0.003). Conclusions In anophelines the examination of mosquito ovaries using transmitted light in a ‘wet’ dissection is a more useful and informative technique than examination of dry ovaries. In order to correctly estimate the duration of the oviposition cycle mosquitoes should be dissected as soon as possible after collection. Younger insects were more likely to attempt to feed outdoors rather than indoors

Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and meta-analysis

Background: Early childhood caries (ECC) is a type of dental caries in the teeth of infants and children that is represented as one of the most prevalent dental problems in this period. Various studies have reported different types of prevalence of dental caries in primary and permanent teeth in children worldwide. However, there has been no comprehensive study to summarize the results of these studies in general, so this study aimed to determine the prevalence of dental caries in primary and permanent teeth in children in different continents of the world during a systematic review and meta-analysis. Methods: In this review study, articles were extracted by searching in the national and international databases of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) between 1995 and December 2019. Random effects model was used for analysis and heterogeneity of studies was evaluated by using the I2 index. Data were analyzed by using the Comprehensive Meta-Analysis (Version 2) software. Findings: In this study, a total of 164 articles (81 articles on the prevalence of dental caries in primary teeth and 83 articles on the prevalence of dental caries in permanent teeth) were entered the meta-analysis. The prevalence of dental caries in primary teeth in children in the world with a sample size of 80,405 was 46.2% (95% CI: 41.6–50.8%), and the prevalence of dental caries in permanent teeth in children in the world with a sample size of 1,454,871 was 53.8% (95% CI: 50–57.5%). Regarding the heterogeneity on the basis of meta-regression analysis, there was a significant difference in the prevalence of dental caries in primary and permanent teeth in children in different continents of the world. With increasing the sample size and the year of study, dental caries in primary teeth increased and in permanent teeth decreased. Conclusion: The results of this study showed that the prevalence of primary and permanent dental caries in children in the world was found to be high. Therefore, appropriate strategies should be implemented to improve the aforementioned situation and to troubleshoot and monitor at all levels by providing feedback to hospitals

Menstrual hygiene management practices and associated factors among primary school girls in Gakenke district, Rwanda

Abstract Background Menstruating girls encounter persistent social, cultural, and religious restrictions, alongside inadequate facilities at home and school, hindering effective menstrual hygiene management (MHM). In rural Rwanda, limited awareness and preparedness worsen these challenges. This study investigates MHM practices and associated factors among primary schoolgirls in the Gakenke District to inform targeted interventions. Materials and methods An institution-based cross-sectional study of 384 primary school girls was conducted. A systematic sampling technique was used for recruiting participants. The data were collected using a structured questionnaire and were entered in Excel, which was subsequently sent to SPSS V. 25 for analysis. Bivariate and multivariate logistic regression analyses were used to test associations. Two-tailed P-value < 0.05 was considered statistically significant. Results The mean age of the study participants was 14 years (1.3 years). About one in ten (9.11%) school-aged girls in Gakenke District, Rwanda, had poor knowledge of MHM, 11.2% had negative attitudes toward MHM, and 14.3% had poor practices. The odds of good MHM practices were significantly greater among school girls who knew that their menstrual blood came from the uterus (AOR: 4.57; 95% CI: 1.62 to 12.89), who knew that menstruation is a monthly cycle (AOR: 2.86; 95% CI: 2.08 to 15.75), who received formal puberty or menstrual education (AOR: 2.18; 95% CI: 1.19 to 9.13), who knew that disposable and reusable pads are available on the market (AOR: 7.06; 95% CI: 5.37 to 18.58), who had good knowledge of MHM (AOR: 3.32; 95% CI: 1.87 to 21.05) and who had a positive attitude toward MHH (AOR: 11.44; 95% CI: 9.60 to 16.02). Conclusion Addressing poor MHM among young adolescents requires collaborative interventions, including stakeholder-led sensitization for formal puberty education, improved access to disposable and reusable pads, and initiatives that boost knowledge and foster positive attitudes toward menstruation

Knowledge, attitude, and practice of breast Cancer among nurses in hospitals in Asmara, Eritrea

Abstract Background Breast cancer accounted for 1.03% of all deaths in 2014 in Eritrea. Yet the knowledge, attitude, and practice (KAP) of the population in general or the health personnel in the country in relation to the disease, remains unknown. Hence, this study was designed to assess the KAP regarding breast cancer among female nurses working in ten hospital wards in Asmara, Eritrea. Methods This was a cross-sectional study conducted among 414 nurses. Descriptive statistics, t-test, and ANOVA were used to evaluate the KAP of the nurses. Results Nurses’ knowledge about the possible risk factors of breast cancer was low but the nurses knew the signs and symptoms of breast cancer since each sign or symptom was mentioned by > 50% of them. The practice of breast cancer screening, however, was low (only 30 and 11.3% practiced clinical breast examination and mammography respectively). Respondents’ family history of breast cancer, having breast problems, their professional level and unit where they worked were associated with the KAP of nurses about breast cancer. Conclusion Training programs could help to increase the nurses’ knowledge about the risk factors of breast cancer and practice of breast cancer screening. This could also help to increase the knowledge of the public about breast cancer

Determinants of institutional delivery in Kenya. Evidence from population and Demographic health survey,2014

Abstract Background: Maternal mortality in Kenya remains high. Analysis of the factors associated with institutional delivery is crucial to inform reproductive health policies and programs in public health. Objective: To identify the factors associated with institutional delivery among women of reproductive age in Kenya.Methods: Data sets for this study were extracted from the 2014 Kenya Demographic health surveys (KDHS, 2014); participants were 20,661 women between the age of 15-49-year. Data sets were analyzed using Chi-square tests, univariate and multivariable binary logistic regression. Factor analysis was used to explore potential subpopulation profiles related to institutional delivery. Results: On national average 62.10% of participant women utilized institutional delivery. Although all sociodemographic variables in this analysis were associated with institutional delivery, multivariable analysis show that women from urban place were 1.37 time (95%CI:1.14-1.65) more likely to delivery in health facility compared to women from rural place. Women with higher education level tended to deliver in health facility compared with no education (Secondary and above: OR:4.03; 95%CI:2.91-5.59; primary level: OR:2.03;95%CI:1.53-2.68). Household wealth status was positively associated, richest 11.12 times (95%CI:7.18-17.22), richer 3.88 times (95% CI:2.96-5.07), middle 2.33 times (95%CI:1.87-2.90), and poorer1.82 times (95% CI:1.40-2.23) more to use institutional delivery than the poorest. The odds of having institutional delivery was 2.58 times (95%CI:2.07-3.23) and 1.44 times (95%CI:1.20-1.71) higher among the first and second to fourth birth orders than five or above respectively. Three common factors with high loading socioeconomic on (Wealth quintile, TV watching, Mother’s education, Radio listening, and Place of residence), family support on (Wanted last child, Mother’s occupation, and Husband education), and women status on (Mother age group, Birth order, and Marital status) were found significantly (p&lt;0.001) associated with institutional delivery. Women with high scores of these factors were tended to received more institutional deliveriesConclusion: Institutional delivery is low in Kenya. Maternal health programs focused on subpopulation profiles should be designed to encourage institutional delivery. Further efforts are needed to improve the accessibility and optimal up-take of institutional delivery.</jats:p

Neonatal Hypernatremic Dehydration Associated with Lactation Failure

Hypernatremic dehydration secondary to lactation failure remains a potentially life-threatening condition in countries where advanced laboratory investigations are scarce. An 11-day term baby with excessive weight loss (33.6%), reduced urine output, fever, jaundice, doughy skin, opisthotonus posturing, and tachycardia with poor perfusion was presented to our neonatal care. The baby was diagnosed with shock with hypernatremic dehydration. An initial bolus of 20 ml/kg of N/S was repeated 3 times (each over 20 minutes), i.e., a total of 204 ml was given over 1 hr, until the vital signs were normalized to PR-145, RR-45, T-37.2°C, SPO2-100%, and CRT < 3 seconds, and the baby began to void urine. Free water deficit and sodium excess was managed by gradual and slow correction over 72 hours to prevent cerebral oedema and neurologic sequelae. The baby required reconstituted solutions of 5% D/W + 1/2 N/S at a rate of 27 ml/hr for 72 hrs. Sepsis and hyperbilirubinemia were treated with antibiotics and phototherapy. Management of symptomatic hypernatremic dehydration must be considered in settings with inadequate laboratory facilities