Browsing by Author "Arega Gashaw"

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    Barriers and Self-Reported Practices towards the use of Continuous Positive Airway Pressure (CPAP) Machine in Newborns among Pediatrics’ Residents in Tertiary Hospital, Addis Ababa, Ethiopia: A Cross Sectional Study
    (Addis Abeba University, 2021-12) Arega Gashaw; Demtse Asrat
    Introduction: - Child survival should remain at the heart of global health and development goals. The leading causes for neonatal death in Ethiopia are prematurity, asphyxia, and neonatal sepsis. Premature newborns with RDS can be managed effectively with breathing support, such as mechanical ventilation or continuous positive airway pressure (CPAP), as well as surfactant replacement therapy. CPAP is strongly recommended by the World Health Organization (WHO) for the treatment of preterm newborns with RDS. Objective: The objective of this study is to assess barriers and self-reported practices towards the use of Continuous Positive Airway Pressure (CPAP) machine in newborns among Pediatrics Resident’s at Tikur Anbessa Specialized Hospital Methods: Cross sectional study was conducted from July 1 – September 30, 2021 G.C to assess barrier’s and self-reported practices towards the use of Continuous Positive Airway Pressure (CPAP) in newborns among Pediatrics Resident’s at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. Self-administered questionnaire used to collect data among Pediatrics residents of TASH. Data was analyzed using descriptive statistics by SPSS version 25. Result: Of the total 112 participants 57.1% (64/112) have any form of formal teaching, learning or training session on CPAP in their Newborn care practice. 80.4 % of Participants used improvised water bottle system. The most common reported barriers to the usage of CPAP at NICU are availability of CPAP machine, availability of oxygen, availability of nasal prong and shortage of staff. There was significant difference in the practice of CPAP safety check lists between residents with different year of residency. Recommendation: - The current findings suggest that there is significant room for improving CPAP usage in NICU by optimizing teaching and training session on CPAP, by enhancing and increasing the knowledge and practice of health care workers, tackling perceived barrier’s that hamper the practice of using CPAP, preparing manuals that can be a guide for fostering CPAP usage and creating a smooth working environment for experience sharing among health workers practicing in NICU
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    Clinico Pathological Patterns and Treatment Outcomes of Pediatric Germ Cell Tumors Treated at Tikur Anbessa Hospital: A 10-Year Single Tertiary Hospital Experience
    (Addis Ababa University, 2024-04) Gebrehiwot Mihret; Arega Gashaw
    Background:Pediatric Germ Cell Tumors (GCTs) are rare heterogeneous neoplasms with a peak incidence in children younger than 4 years old and during adolescence. The clinical presentation and treatmentoutcomes of GCTs are not well-studied in developing countries. The main aim of this study wasto assess the clinic-pathological patterns and treatment outcomes of Pediatric Germ Cell Tumor(GCT) patients treated at Tikur Anbessa Specialized Hospital. Methods: A retrospective, cross-sectional study was conducted at Tikur Anbessa SpecializedHospital on Pediatric Germ Cell tumor patients treated from January 1, 2014, to December 31,2023. The collected data were analyzed using a statistical package for social sciences (SPSS)version 25. The Kaplan–Meier Survival estimate was used to assess the Overall Survival (OS) and Event-Free Survival (EFS). Results: A total of ninety-one patients were included in the study. The median age at diagnosis was 4 years with a female-to-male ratio of 2.3:1. Most patients were under five years of age;constituting 61.6% (n=56). The duration of the illness from the onset of symptoms to the oncologic treatment center ranged from 2 days to 12 months with a mean duration of four months.Sacrococcygeal swelling was the commonest presenting symptom accounting for 38.2% (n=34)followed by abdominal mass (36%). Most of the patients had extracranial GCTs constituting93.4% (n=85). Mature teratoma was the most common histology of GCTs constituting 52.6% followed by dysgerminomas (17.1%, n=13). About 42% of patients received a combination of chemotherapy and local control measures either surgery or radiotherapy. The Kaplan-Meier survival estimates showed the first and five-year OS was 95.7% and 85%, respectively. The first and five-year EFS was 95% and 84 % respectively. Conclusion:Our study showed the mean duration of the illness from the onset of symptoms to the oncologic treatment center was 4 months. Mature teratoma was the commonest histology. The 1-year and 5-year OS probabilities were better than other studies in similar settings
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    Time to Diagnosis and Factors Associated with Delayed Diagnosis in Children with Solid Cancer at a Tertiary Referral Hospital in Ethiopia: A Prospective Study
    (Addis Ababa University, 2024-09) Arega Gashaw; Mohamedsaid Abdulkadir; Korones David
    Background: Only one-third of children with cancer can survive in developing countries inAfrica. Timely diagnosis, early treatment initiation, and access to cancer treatment are integralcomponents of pediatric oncology to improve the outcomes of children with cancer. Objectives: The primary aim of this study was to assess the time to diagnosis (TD), and patterns of delay among newly diagnosed pediatric solid cancer patients and to investigate associated factors affecting time to diagnosis and treatment in a tertiary referral hospital in Ethiopia Materials and Methods:This prospective study was conducted in the Pediatric Hematology and Oncology (PHO) unit,Department of Pediatrics and Child Health, Tikur Anbessa Specialized Hospital, Addis AbabaUniversity from May 2023 to May 2024. All newly diagnosed solid cancers under the age of 15were included in the study. The pretreatment diagnostic time intervals were classified into Time to Presentation (TP), Time to Referral (TR), Time to Registration (Tr), Time to Definitive Diagnosis (TDD), and Time to Diagnosis (TD) from the onset of symptoms and signs to theconfirmed diagnosis at the oncology treatment center. The parental delay, referral delay,physician delay, health care system delay, treatment delay, and total delay, and the factorsassociated were also investigated. Results: A total of 250 children with solid cancers (excluding hematolymphoid cancers) were prospectively studied with a male-to-female ratio of 1.3:1, and 49.2% of children were between1-5 years old. Central nervous tumors, renal tumors, retinoblastoma, and soft tissue sarcomawere the most common solid cancers accounting for 24%, 17.2%, 16.8%, and 15.2% respectively.The median times for TP, TR, Tr, TDD, and TD were 30, 30, 2, 5, and 99 days respectively. Themedian physician, healthcare system, treatment, and total time delay were 40, 5, 46, and 112days respectively. The shortest total delay was seen in patients with germ cell tumors,neuroblastoma, and Wilms tumor, and the longest total delay was in patients with retinoblastoma,and endocrine tumors. About 63.6% of children with cancer had a referral delay to the oncologycenter of more than two weeks, and the factors associated were misdiagnosis of cancer andpatient management for non-oncologic diseases. The longer time of diagnosis (TD) wascorrelated with parental education status (p=0.007), types of solid cancers (p=0.005), and sites ofthe tumor (p=0.003). Conclusions: Educating the caregivers, training about the symptoms and signs of childhood cancer presentations to the primary care physicians, and designing policies and strategies for early diagnosis, referral and treatment of childhood cancer are crucial for better outcomes.