Browsing by Author "Ernest, Alex Ibolinga"

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    Prevalence and predictors of gestational diabetes mellitus among pregnant women attending antenatal clinic in Dodoma region, Tanzania: an analytical cross-sectional study
    (BMJ Publishing Group Limited, 2021) Mdoe, Mwajuma Bakari; Kibusi, Stephen Matthew; Munyogwa, Mariam John; Ernest, Alex Ibolinga
    Gestational diabetes mellitus (GDM) is rapidly increasing worldwide. Globally, 18.4 million pregnancies are complicated by GDM. Despite its known effect, GDM screening is not part of routine antenatal services in Tanzania. There is paucity of data on the magnitude and risk factors for GDM. Therefore, this study sought to determine prevalence and predictors of GDM among pregnant women in Dodoma region, Tanzania from March to August 2018. A cross-sectional study was carried out in Dodoma region, Tanzania between April and August of 2018. A total of 582 pregnant women were recruited from four local health facilities, where purposive sampling procedure was used to select the region, districts and health facilities. Simple random sampling was used to select study participants. Screening and diagnosis of GDM were performed using the 2013 WHO criteria. Descriptive and inferential analyses were performed using SPSS V.23 to determine prevalence and independent predictors of GDM. Among 582 participants, 160 (27.5%) participants were diagnosed with GDM. GDM was more prevalent in urban areas than rural areas, among overweight participants, among participants with a history of a large for gestational age baby, among participants with a history of caesarean section, and among participants with college or university education. Multiple logistic regression analysis showed that maternal age above 35 years (adjusted OR (AOR) 3.115 (95% CI: 1.165 to 8.359)), pre-eclampsia (AOR 3.684 (95% CI: 1.202 to 5.293)), low physical activity level (AOR 4.758 (95% CI: 2.232 to 10.143)), lack of awareness of GDM (AOR 6.371 (95% CI: 1.944 to 13.919)), alcohol use (AOR 4.477 (95% CI: 1.642 to 12.202)) and family history of diabetes (AOR 2.344 (95% CI: 1.239 to 4.434)) were significantly associated with GDM. Prevalence of GDM is relatively high in Dodoma region. Most pregnant women are unaware of the condition such that it leads to a high-risk lifestyle. Besides, GDM significantly contributes to the number of high-risk pregnancies that go undetected and suboptimally managed. The antenatal care centres offer an optimum
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    Prevalence of primary Caesarean Section deliveries among primiparous and multiparous women at Iringa regional referral hospital, Tanzania
    (South Sudan Doctors Association, 2019) Mbunga, Erick Augustino; Mwampagatwa, Ipyana Hudson; Ernest, Alex Ibolinga
    Introduction: Primary Caesarean Section (CS) is an operation that is performed for the first time on a pregnant woman. Primary CS is of particular interest because it has an influence on future modes of delivery. There is also an issue about the original indication for the procedure both in a woman who has never tried her pelvis for vaginal delivery and a woman who has delivered vaginally in the past. Objectives: To determine the prevalence, indications, and outcomes of primary CS deliveries among primiparous and multiparous women, and associations with some demographic characteristics among pregnant women who deliver at Iringa Regional Referral Hospital, Tanzania. Methods: An analytical cross section hospital based study was used with a quantitative research approach. A sample size of 247 of primary CS deliveries was obtained. A structured questionnaire was used to collect the data and the Statistical Package for Service Solutions (v. 23) software programme was used for data entry and analysis. Results: The prevalence rate of primary CS delivery was 247 (21.6%) out of 1144 deliveries between January 2017 and June 2018. The highest indication for CS was foetal distress which was foetal heart rate below 120b/m and above 160 b/m 79 (32.0%) followed by prolonged labour 65 (25.1%). Maternal outcomes revealed that 65 (26.3%) women experienced significant blood loss which was above 1000mls, with blood transfusion of at least more than one unit of blood (PPH) followed by 29 (11.7%) who experienced a high body temperature above 37.5 degree of centigrade. The new born outcomes found that 128 (51.8%) were unable to breast feed and 95 (38.5%) had low Apgar scores below 7 in the 1st and 5th minute. Conclusion: There was a high prevalence of primary CS among primiparous and multiparous women which is above the recommended WHO threshold of 15%. Also, the highest indication for primary CS was foetal distress. The most common complication for the mother was significant blood loss and the commonest newborn complication was that the baby was unable to breastfeed.