Pediatrics and Child Health

Permanent URI for this collection

http://etd.aau.edu.et/handle/123456789/66

Browse

Now showing 1 - 20 of 54

Breastfeeding Practices among Mothers of Babies Admitted to Nicu, Tah, Addis Ababa, and Factors Influencing Practices
(Addis Ababa University, 2012) Berta, Hailu; Ziegler, Ekhard
Background: Breastfeeding within the first hour of life is a potential mechanism for health promotion and is the basis for improved quality & quantity of milk production. The purpose of this study was to determine the prevalence of timely initiation of breastfeeding and to investigate predictors of early initiation of breast feeding among mothers of babies admitted to the Neonatal Intensive Care Unit (NICU), Tikur Anbessa Hospital, Addis Ababa, Ethiopia. Method: A cross-sectional study was conducted involving all mothers of babies admitted to the NICU from June through September, 2012. A total of 429 mother-infant pairs were included in this study. Information about mother and baby characteristics, pregnancy, birth, and time of breastfeeding initiation was collected in the first 72 hours after delivery, through interviews with mothers and use of hospital records.The data gathered were stored and analyzed using the SPSS 20, IBM 2011. The chi-square & Kruskal-Wallis1-way ANOVA and binary logistic regression analysis were used to examine the relationship between breastfeeding within the first hour and different variables. Results: The prevalence of timely initiation among mother-infant pairs was 13.8%; breast feeding initiation within 72 hours after delivery was 79.3%. Timely initiation of breastfeeding (initiation of breast feeding within one hour of delivery) was associated with vaginal delivery [aOR: 2.919(95%C.I: 1.185-7.189)], P = 0.02. and with term delivery [aOR: 6.26(95%C.I: 2.126-18.431)], P = 0.001. Conclusions: In order to improve the rates of breastfeeding within the first hour of life, health care professionals and policy makers must promote the factors favoring this practice such as improving rate of vaginal delivery and full term birth, through giving emphasis on early booking and regular antenatal follow ups, early detection and correction of vulnerable situations that may lead to C/S &/or preterm birth. Prenatal education and guidance regarding the advantages of breastfeeding, and promotion of this practice in vulnerable situations such as mothers with cesarean section and preterm birth is also recommended. This study can be used as basis for further and broader study.
Avoidable Factors in Perinatal Mortality Identified by Clinical Audit at Tikur Anbessa Hospital
(Addis Ababa University, 2012) Demtse, Asrat (PhD); Spector, Jonathan (Professor )
Perinatal Mortality (PNM) is high in developing countries when compared to high income countries. The major causes of PNM are infection, birth asphyxia and complications related to prematurity. The current perinatal mortality rate in Ethiopia is 37 per 1000 births. Clinical audit has emerged as a powerful methodology for determining cause of mortality and identifying potential avoidable factors that contributed to the death. Systematically analyzing deaths in this way is important in order to improve clinical management and introduce new measures to reduce PNM in the future. This study is a prospective investigation of stillbirths and early neonatal deaths that was conducted for a six month period (from June 1st to November 30th 2012) among inborns at Tikur Anbessa Hospital. The audit was conducted by a multi-disciplinary team comprised of obstetricians, midwives, pediatricians and neonatal nurses. The audit process was involved medical record review; interview of relevant health staff; and interview of families (after informed consent). The cause of death and potential avoidable factors was assessed for each case. The findings was collected and presented in a publishable-quality manuscript. Feedback was given to clinical and administrative leaders at Tikur Ambessa Hospital to inform new measures to be implemented to decrease PNM.
Prevalence of Chest X Ray Finding of Patients with Severe Pneumonia a Prospective Study
(Addis Ababa University, 2013-11) Anteneh, Yalemwork; Tefera, Muluwork (Associate Professor)
Background: Respiratory diseases are a major cause of mortality and morbidity worldwide especially in most developing countries . Amongst these respiratory diseases, pneumonia is the leading cause of death in children worldwide . In developing countries childhood pneumonias are diagnosed using clinical parameters, usually based on presence of cough and raised respiratory rate. The simple chest radiograph has been an important investigative tool in the diagnoses of respiratory infection and pneumonia. Objective: is to know the prevalence of of chest x ray finding of patients with severe pneumonia Methods: A prospective cross sectional study of 162 patients with severe pneumonia who were admitted at causality and emergency ward of paediatric and child health in TASH . All children had chest radiography on the bases of clinical decision by paediatricians. Expected Outcomes ; the prevalence of chest x ray finding of patients with severe pneumonia was( 48%) ,and the commonest site was on the right side74(78.7%) of this RUL is commonly affected and commonest type of chest x-ray finding was consolidation( 27%).chest x-ray has strong association with late presentation and underlying medical illness . Analysis: descriptive and analytic statistics as applicable. Statistically significant associations is when P-value of <0.05. Key words: pneumonia ,chest x ray, TAH-causality and emergency ward,
Factors Determining Rheumatic Fever Recurrence Among Rheumatic Heart Disease Patients Who Are Taking Monthly Benzanthine G Penicillin Prophylaxis
(Addis Ababa University, 2014) Dagmawi, Fitsum; Mekasha, Amha
Introduction: Rheumatic fever is a major cause of acquired heart disease in children worldwide, with the disease occurring most frequently in underdeveloped countries. ARF and its chronic sequela RHD remain significant causes of morbidity and mortality in Ethiopia. The main priority of long-term management of ARF or RHD is to ensure secondary prophylaxis is adhered to. Despite its importance, the rate and risk factors of rheumatic fever recurrence is not known in Ethiopian children with ARF/RHD. This study will identify ARF recurrence rates and the extent to which ARF is concentrated in certain populations based on age, sex, education, income, and types of valves involved. Objectives: The objective of this study was to identify risk factors for rheumatic recurrence in patients receiving monthly benzanthine G penicillin prophylaxis. Method: We conducted a retrospective review of medical records of 211 eligible patients with rheumatic heart disease at TASH, pediatric cardiac clinic from April /2014 to Aug. 2014. A descriptive and analytic statistics was used as applicable. Statistically significant associations were set at P-value of <0.05. Results: A total of 211 children’s medical records were reviewed. Rheumatic fever recurrence occurred in 22 (10.4%) of the 211 patients. Patients with recurrence of RF were less adherent to monthly BGP prophylaxis than patients without recurrence of RF the odds of nonadherent patients was 19.42 (odds ratio= 19.42, CI= (6.885, 54.766) P= 0.000). Non-adherence to BGP prophylaxis at any time during follow up was detected in 10.9% (23 of the 211) of study subjects. Rates of non-adherence were higher in the group of patients that were younger (27.3%, 9.6%, and 7.4% for children less than or equal to 5 year, 6 to 10 year, and 11 to 15 year of age, respectively) than in the group of patients who were older (p=0.046). Conclusion: We recommend implementation of a registry, and a system of active search of missing patients in every service responsible for the follow-up of RHD/RF patients. Measures to increase adherence to secondary prophylaxis need to be implemented formally, once non-adherence to secondary prophylaxis is the main cause of RF recurrence. Key words: Rheumatic fever recurrence, rheumatic heart disease.
Neonatal Intestinal Obstruction: A 3- Year Review in a Teaching Hospital Addis Ababa, Ethiopia
(Addis Ababa University, 2014) Mustefa, Mohammed; Moges, Tamirat (Assistant professor)
Background: Intestinal obstruction is the most common surgical emergency in the newborn period. It is a life threatening condition with high mortality especially in developing countries. Neonates with intestinal obstruction require specialized care and facilities for survival. Objective: We aim to study the etiology, presentation, outcome, and factors associated with mortality in the setting of Tertiary university hospital at Addis Ababa, Ethiopia. Method: Records of all cases of NIO managed at TASH, NICU during the period of January 1, 2010 to December 31, 2013 were retrospectively reviewed and all the possible factors that may result in mortality were analyzed. Results: Fifty-one neonates with intestinal obstruction were managed, representing 0.0058% of the neonatal admissions during the study period. Forty-one (80.4%) were males, 9(17.6%) were females (M: F=4.55:1), while one newborn had ambiguous genitalia. All patients presented with in the first week of life. Anorectal malformation constituted 56.9% of the causes of NIO, while intestinal atresias including duodenal, jejunal, ileal atresias accounted for 13.7% of cases. Other causes included Hirschprung’s disease, intestinal malrotation, meconium plug, congenital band, paralytic ileus, blind sigmoid colon, and spontaneous gastric perforation. There were 10 deaths, with a mortality rate of 19.6%. Perioperative sepsis was significant determinant of mortality. Conclusion: Early presentation, prevention and prompt management of sepsis is needed to decrease the high mortality seen in this study. There is a need for improved facilities including Intensive Care Units for pre- and postoperative management of neonatal intestinal obstruction. Key words: Intestinal obstruction, neonates, anorectal malformation, intestinal atresia
Assessment of Prevalence of Sexual abuse &Predisposing Condition of Child Sexual Abuse Among Children Treated in Tikur Anbesa Specialized Hospital Department of Pediatrics & Child Health.
(Addis Ababa University, 2014) Elfu, Teferi; Gedilu, Etsegent
BackgroundChild sexual abuse is becoming more common public health issue, only reported cases of theincidence are common source of information to get insight on how to understand the problem.The objective of this study was toassess the prevalence of child sexual abuse and predisposingconditions among children treated in Tikur Anbesa specialized hospital from a period of 2003E.C—2005 E.C. MethodsThe research was conducted by collecting reported child sexual abuse cases fromthe records ofpatients whopresented to all Out Patient department as a case of Child sexual abuse fromSeptember 2003 E.C—July 2005E.Ctreated in Tikur Anbesa specialized hospital. A total 300selected samples of victim children were included from the three years period then completeda semi-structured questionnaire and data were analyzed. ResultsAll children are at risk of sexual abuse irrespective of their age, sex, socioeconomic status and degree of relationship between the perpetrators and victims.The prevalence of childsexual abuse at Tikure Anbesa specialized hospital is estimated 0.56%, Majority of the victim’sfemales, their peak age is middle child hood age (6-11yr). 2/3rd of the victims live with their both parents, followed by single parent care taker and presence of family problem is prone forCSA.Nearly half of the cases were victimized attheir neighbour oodfollowed by their ownhome. Even though half of them have normal physical finding at presentation, minor lacerationand major bleedings were also common. Almost all the perpetrators are male and majority ofthe perpetrators are known by the child and most of them use force during attack. Conclusion: From the study itshows all children are at risk of sexual abuse irrespective of their age, sex,socioeconomic status and degree of relationship between the perpetrators and victims. The prevalence of child sexual abuse at Tikure Anbesa specialized hospital is estimated 0.56%,Majority of the victims females, their peak age is middle child hood age(6-11yr). 2/3 of the victims live with their both parents , followed by single parent care taker and presence of family problem is prone for CSA. Almost all the perpetrators are male & known by the child.
Parental Knowledge and Participation in the Management of Children with Chronic Rheumatic Heart Disease
(Addis Ababa University, 2014) Gezahegn, Wendmagegn; Tefera, Endale(PhD)
Background:-RHD is the most common cause of acquired heart disease in developing countries with prevalence being highest in sub-Saharan countries. It follows throat infection by Group A β hemolytic streptococcal infection. The high prevalence in these countries, including Ethiopia, could be attributed to the low socioeconomic status, overcrowding, poor health seeking attitude during early illness. And even after first diagnosis of Rheumatic fever/RHD there is a tendency to have a poor adherence to monthly bezantine penicillin which increases the risk of rheumatic recurrence and the severity of carditis. Objective:-to assess the understanding and participation of parents/guardians about the nature and prognosis of their children’s cardiac illness and to assess the degree of their involvement in the management of their children. Methodology and material:-A quantitative, descriptive cross sectional study was done to assess knowledge of parents/guardian about the nature and prognosis of their children’s cardiac illness and the extent of their participation in the management process. The study was conducted at the pediatric cardiac clinic of the Addis Ababa University hospital (Tikur Anbessa hospital). A structured, standardized and pretested questionnaire, which contains 35 questions, was used to assess 206 parents during the period from September 2013 to February 2014. Results: -All parents answered the interview questions. The mean age of the attendants was 38 years with M: F ratio being 2.3:1.Half (51%) of the parents had educational level of elementary school and above. From the parents interviewed 91 % reported the child has heart disease and 18 % knew about the etiology, two parents (0.9%) knew about the chronicity of the disease and fourteen (6.8%) parents knew about the possibility of recurrence of the disease. When we look at the habit of reporting the problems faced during follow-up 21% reported their problems and 68% of the parents who reported found a solution. In this study attendant’s educational level was significantly associated with parental knowledge about the disease and participation in the management of their child. Conclusion: - While most parents know that their child has heart disease, parental knowledge of etiology, chronicity, possibility of recurrence and ultimate therapy was limited. So, intensified education and awareness programs are needed in order to prevent potential major morbidity and mortality for pediatric patients with Rheumatic heart disease.
Assement of the Magnitude , Cause and Outcomes of Acute Upper Air Way Obestruction in Tikure Anbessa Specialized Hospital of Pediaatrics and Child Health Department at Pediatric Emergency Unit
(Addis Ababa University, 2014-06) Metaferia, Gtachew; Tefera, Muluwork (Assistant Professor)
Background: Acute upper airway obstruction is a common cause of respiratory emergencies among children. However, the magnitude, the causes, and the outcomes of acute upper airway obstruction in Ethiopia are not studied and documented. Objective: To determine the magnitude, the causes, and the outcomes of Acute Upper Airway Obstruction among pediatric patients who visited the pediatric emergency department of Tikur Anbessa Specialized Hospital. Methodology: Retrospective record review based on the institutional record of children who had Acute upper airway obstruction and visited the pediatric emergency unit over a one year period was conducted in Tikur Anbessa Specialized Hospital between July 2012 to June 2013 relevant data were collected from institutional records of all children visited the pediatric emergency unit due to Acute upper air way obstruction. Major causes of Acute upper air way obstruction were identified and its outcomes were determined. SPSS version-16 was used to verify the association between selected socio demographic characteristics and clinical conditions with the outcome of Acute upper air way obstruction. Result:. During the study period 2,327 children have visited the pediatrics emergency OPD due to different problems. Among which 161 (6.9%) children were presented with acute upper airway obstruction. Croup was found to be the most common cause of Acute upper airway obstruction(75.8%)followed by foreign body aspiration(9.9%). Majority of the patients (68.9%) were treated at the emergency OPD and sent home with improvement after they were kept for few hours for observation. The study also revealed that 7(4.%)Patients were died of Acute upper airway obstruction. Statistically significant association was not observed between socio demographic characteristics, clinical conditions and the outcome of upper air way obstruction. Conclusion and Recommendation On average, at least three children with Acute upper airway obstruction visited the emergency OPD per week during the study period. The causes of acute upper airway obstruction were varied although infectious diseases (croup, bacterial tracheitis, retropharyngeal abscess, and peritonsillar abscess) were responsible for the majority of the cases (82.6%). Seven patients died of upper airway obstruction during the study period. Therefore, improving the Acute upper air way obstruction diagnosis and management capacity of health workers and the clinical set up of the pediatric emergency unit is crucial to provide an immediate and aggressive response.
Managment Outcome of Severe Acute Malnutrition from 6 Months to 5 Years of Age Children Admitted to Yekatit 12 Hospital
(Addis Ababa University, 2014-08) Ahmed, Muluken; Shimelis, Damte(PhD)
Background: severe acute malnutrition is major health problem in sub Sahara Africa. WHO prepared a guideline to manage SAM and Ethiopia also prepared its own guideline by adapting WHO guideline to decrease mortality below five percent even in children with HIV/AIDS. Despite applying same guideline there were different case fatality rate reports. Studying adverse outcome of SAM and associations that may lead to improve the outcome is important. Objective: the main objective of this study was assess the outcome of children admitted with SAM to yekatit 12 hospital Method: retrospective descriptive study was conducted in children between 6 months and 5 years of age with severe acute malnutrition admitted to Yekatit 12 hospital from a period of September 2012- September2013. Data was collected from the patients’ chart by using structured questionnaire. Data processing and analysis: compiled and analysed using software Statistical package for social science (SPSS 20). The charts of 193 was retrieved and analysed. Both bivariate and multivariable analysis was performed to determine the outcome of the management of SAM. A p-value of less than 0.05 was taken as statistically significant. Result: The average age of the study participants was 19.6 months, the majority being in the age group between 6months and 2 years of age. Male children accounted for 52.3 % of the study participants. The treatment outcome revealed that 75% of the patients improved while 12.4% died and the remaining 12.4% defaulted. Conclusion: This study shows a high mortality rate of severe acute malnutrition despite treatment with the standard guideline. This findings show that the treatment s goal, which is to keep the mortality below 5 % is far from achievable. The finding of high death rate suggests an urgent need to revisit our practice in the management of severe acute malnutrition and warrants more prospective studies.
Prevalence of Asymptomatic Microscopic Hematuria in 7-12 Years School Age Children of Medhanealem Primary School in Addis Ababa
(2014-10) Yeshidinber, Abate; Shimelis, Damte(PhD)
Background Hematuria is one of the most important signs of renal or bladder disease in children and it can represent a process that is simple and benign or complex and life threatening. Asymptomatic microscopic hematuria is common in unselected populations of children, with a prevalence that ranges from 0.4% to 4.1% depending on the criteria used to define hematuria. Urine analysis, a simple and inexpensive test, is the cornerstone in the evaluation of the kidney function. Proteinuria or hematuria may be the only early signs of renal disease including membranous nephropathy, membranoproliferative glomerulonephritis, post infectious glomerulonephritis, IgA nephropathy and others. The basic dipstick method is the most rapid screening procedure that could be helpful in the early detection of renal or urinary tract diseases among apparently healthy or asymptomatic subjects in the hope of preventing and retarding progression to chronic renal failure. Many countries have used this screening program to prevent and follow children with asymptomatic children. However the prevalence of asymptomatic hematuria is unknown in Ethiopia and there is no recommendation on routine screening urinalysis in Ethiopian school children. Objective To determine the prevalence of asymptomatic hematuria in school age children in Addis Ababa Methods A cross sectional survey using urinalysis was done over a period of 8 weeks in 382 apparently healthy school age children (7-12 years) at MAPS in Addis Ababa. The children who tested positive in the first screening were re-tested after 2 weeks. Results In the first screening 32 children (8.4 %) tested positive for hematuria. Of these children, 16 (4.2 %) cases tested positive in a second screening. The prevalence was both age and sex dependent. Co-existing proteinuria and leucocytes were common findings (19.6 % and 8.4 % respectively) where as pyuria, glycosuria and nitrite were seen in < 1% of children. Glomerulonephritis was the most commonly detected disorder (43.75%). 75 students (19.6%) were positive for protein,7 students(1.8%) were positive for both blood and protein, 1 student(0.3%) was positive for glucose,1 student (0.3%) was positive for nitrite ,32 students (8.4%) were positive for leukocyte- esterase. 8 8 Subsequently, 10 children from the secondary screening group were lost to follow up and only 6 students were referred to TAH pediatric renal clinic. Conclusions This study helped to assess the prevalence of urinary abnormalities in school-aged children for the first time in Ethiopia. Urine abnormalities are common finding among apparently healthy school aged children with hematuria and proteinuria being the most prevailing abnormalities. Our study demonstrated that hematuria is higher in Ethiopian children than other African children and worldwide. Coexisting urinary abnormalities especially Leukocyturia and proteinuria (most are trace) are common while nitrituria and glucosuria are uncommon.
Prevalence of Behavioral Problems among Epileptic Children on Follow up at Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2014-10) Admassu, Mahlet; Gedlu, Etsegenet(PhD)
Background: Children with epilepsy are documented to have increased incidence of behavioral and psychiatric disorders. The reported prevalence range from 30%to 66% according to studies from developed and developing country’s respectively. The magnitude of this co morbidity is not known in Ethiopia. Objective: To assess the prevalence of behavioral abnormalities among children on follow up at Tikur anbessa specialized hospital pediatric seizure follow up clinic using SDQ-p form. Method: a facility based cross sectional study was carried out in Addis Ababa from February 1-June 30,2014G.C.the source population was epileptic children who visited TASH pediatrics seizure follow up clinic, accordingly 384 children were included in the study. Results: in this study 36.2% of the CWE have high or abnormal total difficulty score. In bivariate logistic regression model older children aged 11-14 were more likely to have abnormal result (p value<0.05). On the subscales of the SDQ conduct problem and peer relationship problem were more likely in the age group 11-14 (OR=2.3, 95% CI: 1.4, 3.82) and (OR=1.97, 95%CI 1.12, 3.47) respectively. Abnormal emotional and prosocial problem scores were more likely in the age group 5- 7(OR=2.35, 95%CI, 1.12-4.93) and (OR=3.59, 95%CI, 2.12-6.06) respectively.
Quality of Pediatric Prescription Writing at the Department of Pediatrics and Child Health Outpatient and Emergency Unit, Tikur Anbessa Specialized Hospital
(Addis Ababa University, 2014-10) W/Gebriel, Fitsum; Shimelis, Damte(PhD)
Introduction: Drugs are important components of health care and play crucial role in saving life. Drug prescription is the product of most medical consultations. Despite the importance of good quality prescriptions erroneous prescribing habits are not uncommon worldwide. Illegible or incorrect prescription can result in loss of the patient, physician and pharmacist time and may cause therapeutic error or drug toxicity. Hence the objective of this study was to assess the nature of prescription deficiencies (omission and error) in production of prescription with regard to Patient identification, drug information, prescriber’s identification. Methods: This was a prospective, cross- sectional hospital based study. All prescriptions issued to non admitted patients below 14 yrs of age visiting pediatric regular OPD, emergency and follow up clinics were collected from pediatric emergency and special clinic every day and assessed for their quality based on the nationally adopted format approved by Food Medicine and Healthcare Administration and Control Authority . Data was collected from May 1 to 31/2014 until the desired sample size is reached. Data was analyzed by SPSS for windows version 20. Results: Total number of prescription studied was 246. With regard to patient identification, 78% of prescriptions were lack patient age, 80.5% sex and 86.2% patient weight. 50.8% of the prescriptions were without drug formulation and 19.9% drug generic name. 30% of the prescriptions were issued with erroneous dose. Prescribers name was not documented in 45.5% of the prescriptions and date of prescriptions issued was not written in 65% of the prescriptions. Based on the predefined …. Conclusion and recommendation: From this study production of prescription quality is unsatisfactory as most of the prescriptions lack the essential elements. Patients are not well identified drug information is incomplete and prescribes identification is lacking in most of the prescriptions studied. And most of the prescriptions with poor quality are from clinics attended by senior residents. As a specialized teaching hospital the department should device corrective measure to enhance prescription quality, the hospital has to have prescription error reporting system and this calls for medication error study to evaluate the impact of prescription quality in the patient care. Key words: Prescription, Quality; Handwriting, physicians
Clinical profile and outcome of repaired cases of Coarctation of Aorta at TASH paediatric cardiology unit Ethiopia from Jan 2009 to Feb 2017G.C
(2017-10) Gebremeskel, Kalkidan; Moges, Tamirat(Dr.)
Introduction Coarctation of aorta (COA) is one of the acyanotic congenital heart disease where the portion of aorta gets narrowed often involving the descending aorta distal to the aortic isthmus. It requires treatment with definitive surgery or balloon dilation and if not treated associated with many complication. But even after the advert of multiple surgical approach it is associated with post- operative complication at times may also need lifelong post op follow up. Little experience is available in Ethiopia regarding post coarctation of aorta repair. Objectives To determine clinical profile and post-repair outcome of children with COA who underwent repair for COA. Methodology: The study was conducted from March 2017 to Sept 30 of 2017 with a retrospective chart review of 39 patients with repair for native COA from Jan 2003 to Feb 2017 both at local and outside of the country. In this study clinical profile, immediate complication and outcome were assessed. Result : A total of 39 patient with repair of COA of which 27(67.3%) were male and 12(30.8%) female. The age at time of intervention ranges from 3months to 25 years, with mean age of 6.9 ±5.7 yrs. 82.1% of the patients were hypertensive before intervention. 15(38.5%) had complex COA,13(33.3%) discrete COA,7(17.9) simple COA,4(10.3%) with interrupted aorta. Type of intervention was balloon angioplasty with or without stent in 20(51.3%), end to end resection and anastomosis 14(35.9%) and patch arthroplasty in 5(12.8%). Immediate complication seen were rebound hypertension 18(46.15%), post coarctectomy syndrome 3(7.69%). Other complication include Intracranial hemorrage, spinal cord injury ,pneumomedastinium ,chylothorax, Infective endocarditis, pericardial effusion, hemodynamic collapse 2ry to bleeding , lung atelectasis complicate 1(2.56%) each. There was no death following surgery. At 6 month 35 patient were evaluated at follow up clinic and only 40% of patients where hypertensive and echocardiography shows residual COA in 7(20%) and aneurism in 1(2.85%) patient. Conclusion: the most practiced method of the repair in the study was balloon angioplasty. Rebound hypertension was the most common immediate complication encountered. Mortality rate is very low comparing it from other setting. Surgical repair has significant association with rebound hypertension. Six month follow up echocardiography showed significant number of re-coarctation
Pediatrics Index of Mortality 2 Scoring (PIM2) In Patients Admitted at Pediatric Intensive Care Unit of Tikur Anbesa Specialized Hospital
(Addis Ababa Universty, 2017-12) Mekuanint, Ayal; Bacha, Tigist (MD,MPH,Associate professor)
Introduction Mortality risk scoring systems have been widely used in modern intensive care unit. It is considered as important measures for quality assessments, controlling for severity of illness in clinical studies and studies of resource utilization and management. Objective The aim of this study was to determine pediatrics index of mortality 2 (pim2) scoring for Pediatric intensive care unit (PICU) admitted to Tikur Anbesa specialized hospital (TASH) patients, and to evaluate its service with the standards. Methodology Descriptive cross sectional study with prospective data collection. All patients admitted to PICU from April, 1-September, 20-2017 were included. Pretested questioner which includes demographics, diagnoses at admission, and duration of intensive care unit stay, PIM2 score and outcome was used. The data was entered and analyzed using SPSS version 20. The ratio of observed to predicted mortality using Standardized mortality ratio (SMR) was calculated for the group of patients by using chi square. Results The study included 82 patients. The main causes of admission surgical (34.1%), neurology (17.1%) and cardiac diseases (13.1%) Patients stay in PICU ranged from (1 – 120) days with a median 4(interquartile range (IQ): 1-120) days. Fourthy four (53.66%) needed mechanical ventilator within 1 hour of admission from this 23(52.3%) of them died which contributed 69.7%of the total death. The mean predicted mortality by pim2 was 13.1[95%CI: 15.26-26.86] and the observed mortality was 40.2% making a SMR 3.1. Conclusion and recommendation In our study PIM2 scoring didn’t discriminate between died and improved in PICU case mix patients at TASH so it is better to do another scoring system with its validation study.
Practices, perspectives and barriers of HIV disclosure to children and adolescents by Health care workers; in Addis Ababa health facilities, Ethiopia
(Addis Ababa Universty, 2017-12) Fentie, Shitahun(MD); Gedlu, Etsegenet (MD, Associate Professor of Pediatrics and child health, Consultant Pediatric Cardiologist)
Introduction According to 2016 global HIV statistics, in 2016, globally there are an estimated 36.7 million people living with HIV of which 25. 5 million are in sub‐Saharan Africa and 1.8 million are children .In Ethiopia, by 2017, there are estimated 722,248 people living with the virus of which 57,132 are children up to the age of 14 years according to the Ethiopian public health institute. Survival of perinatally infected children into adolescence and beyond made disclosure a major challenge for caregivers and healthcare professionals providing service to HIV‐infected children. Although disclosure is associated with improved adherence to HAART and attendance to follow up clinics, there are significant numbers of children and adolescents who are receiving treatment without being fully informed about their HIV status because many health care workers fear that disclosure may create distress for the child. Objectives The objective of this research was to assess the practices, perspectives and barriers of pediatric HIV disclosure among health care workers in Addis Ababa health facilities, Ethiopia Methodology A quantitative cross sectional study design was conducted at health facilities taking care of pediatric HIV patients (both adult and pediatric ART clinics) in Addis Ababa, Ethiopia from June 1, 2017 to July 30, 2017. A structured, standardized and pretested questionnaire was used to asses 138 HCWs during the study period. Data was collected by trained nurses through self‐administration. Collected data was edited, coded, entered and analyzed using Statistical package for social science (SPSS) version 20. The results were presented with percentages, frequency tables and figures. Bivariate analysis was done to test the association between pediatric HIV status disclosure by HCPs and different factors of the health care workers. To identify the independent predictors of disclosure to children by HCPs, we did multivariable logistic regression. Results A total of 138 HCPs included in the study the majority 96(69.6%) were females and nurses account more than half of the participants 75 (54.3%).More than half of the health care workers 76 (55.1%) had work experience of 5 to 10 years. Though most of HCPs 134(97.1%) believed children will benefit if they are disclosed, more than one third (36.2%) of them have not ever disclosed a child. Training on pediatric HIV disclosure [AOR=6.264; 95%CI: 1.978‐19.841, p value =0.001] and availability of guidelines for 3 disclosure [AOR =8.350; 95%CI: 1.737‐40.126, p value =0.001] independently increased the odds of HIV positive status disclosure to children by HCPs. Conclusion and Recommendations Unavailability of guidelines at the health facilities and lack of training on pediatric HIV disclosure for HCPs have been found healthcare providers constraints in the process of disclosure. Improved training and availability of guidelines on pediatric HIV disclosure would alleviate the discrepancies that exist among healthcare providers on this issue.
Treatment outcome of severe acute malnutrition and associated factors among under five children admitted at hospitals in Arsi zone Oromia regional state, southeast Ethiopia,2018
(Addis Ababa University, 2018-03) Abera, Misrak; Mengistu, Zuriyash (MSc, PhD fellow)
Background: Malnutrition is a major public health problem throughout the developing world and a significant factor, approximately one third of, nearly 8 million deaths in children who are under the age of five years worldwide. Despite numerous advances made in improving child health and the clinical management protocols for treating severe acute malnutrition at treatment centers, evidences concerning the treatment outcomes are scarce. Objective: To assess treatment outcomes of severe acute malnutrition and associated factors among children age less than five years in Arsi zone, Ethiopia, 2018. Method: Institution based cross-sectional study design was conducted to collect information from 410 records of severely malnourished children who were admitted from January 2016 to January 2018. Data was entered to EpiData version 3.1 and then exported to SPSS version 20 for analysis. Bivariable and multivariable logistic regression model were fitted to identify factors associated with treatment outcomes. Adjusted Odds ratio with its 95% CI is reported and P-value less than 0.05 were considered to declare presence of significant association. Result: A total of 410 records of children with a diagnosis of severe acute malnutrition were reviewed. Of these cases of malnutrition, 83.7% (343) had severe wasting and 16.3% (67) had edematous malnutrition. Regarding treatment outcome, 74.4% were cured while 7.1% had died. The average length of stay was 12.3 and 14 days with an average weight gain of 14.7 and 5 g/kg/d for children with severe wasting and edematous malnutrition, respectively. Taking IV antibiotics plus amoxicillin and having no anemia were factors significantly associated with recovery rate. Conclusion: The recovery rate of severely malnourished children admitted at the three hospitals was 74.4 % is almost equivalent with the standard, least 75 % cure rate. However a high proportion of patients 17.6 % were defaulted from their treatment. Absence of anemia and treatment with IV antibiotic plus amoxicillin were the factors significantly associated with recovery rate. In order to address the high defaulter rate, the health Facilities should design a strategy like home based care through the outpatient therapeutic care should be strengthened.
Knowledge, attitude, practice and factors associated with pain management for hospitalized children among nurses working in public referral hospitals of Amhara region, Ethiopia, 2018
(Addis Ababa University, 2018-06) Mihretu, Esmelealem; Wondwossen, Kalkidan (Sr. ,MSc)
Background: Hospitalized children experience moderate to severe acute or chronic pain which minimizes their comfort and has become a major health problem in developed and developing countries. Unrelieved childhood pain causes unnecessary suffering and result in short- and longterm physical and emotional impacts in children and their families’ lives. Managing pain properly can prevent children from unnecessary stay in hospitals and suffer from pain. Objectives: The aim of this study was to explore the knowledge, attitude, practice and factors associated with pain management for hospitalized children among nurses working in Amhara public referral hospitals, Ethiopia Methods: A quantitative cross-sectional design was conducted from February 27 to March 27, 2018 in selected public referral hospitals of Amhara regional state. A total of 289 nurses with a response rate (97.6%) participated in the study. Study participants were recruited by simple random sampling and semi structured self administered questionnaire was used to collect data. The collected data was coded and entered in to Epi data 4.2.0 and transferred to SPSS version 21 for further analysis. Logistic regression model was used for association between independent versus out-come variables and considering the AOR, 95% CI and p < 0.05 cutoff point as significant for all the independent variables. Result: The knowledge scores of participants had a mean value of 5.57 (52.2%) out of 10. The mean score of attitude was 46.66 (46.7%) out of 57 and the mean score for the nurses’ level of practices was found to be 5.42 (45.7%) out of 10. There was a significant relationship between nurses’ knowledge scores and the level of education, attitude, and level of practice. Nursing work load, negative attitude, and lack training were factors for pain management practices. Finally, score of nurses’ attitude was significantly associated with qualification, knowledge, practice and presence of assessment tool. Conclusion and Recommendation: Results showed that nurses had poor performance and unfavorable attitude towards pain management. However, majority of Nurses were knowledgeable on some area of pharmacological and non-pharmacological pain managements for children. The hospital’s administrative bodies should provide convenient training program regarding pain and its management to staff nurses.
Pattern of Disease, Outcome & Associated Factors Among Neonates Admitted to Neonatal Intensive Care Unit at Jimma University Medical Center, Jimma, Southwest Ethiopia, 2018.
(2018-06) Bayana, Ebissa; Gela, Debela (MSc)
Background:Neonatal period is a susceptible time in which the newborn has to adapt to a totally new environment and is vulnerable to many problems, which may even be life threatening. Neonataldisease pattern changes from time to time and place to place. Analyzing the neonatal admission pattern helps health care givers and policy makers to design better strategies. Objective: This study aimed to assess the pattern of diseases, outcome and associated factors among neonates admitted to neonatal intensive care unit at Jimma university medical center, Jimma, Southwest Ethiopia, 2018. Methods:Retrospective cross-sectional study design was conducted from March 15 to 30, 2018 among neonates admitted over a period of two years (January 1, 2016 to December 31, 2017) on 341 samples. Systematic random sampling technique was employed to get required samples from database. Data was collected using structured questionnaire by 4 trained diploma nurses. Data was entered to Epi-data 3.1 and exported to SPSS Version 23 for analysis.Bivariate and multivariate logistic regression was used to analyze the association between dependent and independent variables and P-value <0.05 at 95% CI was declared statistically significant association. Finally statement, tables, charts and graphs were used for data presentation. Results:Of the total, 61.9 % were male, majority (66.9%) of them lives outside of Jimma town and 60.1% of them were inborn. The main disease patterns identified were neonatal sepsis (19.9%), prematurity (14.0%) and hyaline membrane disease (11.9%). More than half (55.56%) ofneonates were admitted in the first 24 hours. Regarding their outcome, 81.52% of admittedneonates were improved and 18.48% were died. Prematurity andperinatal asphyxia were factors associated with increased risk of death [P<0.001, AOR= 0.26, 95%CI: (0.14, 0.46)] and[P<0.05, AOR=0.44, 95% CI: (0.21, 0.91)] consecutively. Conclusion:Neonatal sepsis, prematurity, and hyaline membrane disease were the most frequently occurring diseases. Preterm, Primipara and out born were predictors of pattern of diseases whereas prematurity and perinatal asphyxia were predictors of death. The death rate was high which accounted 18.42 % which showed need of quality of care improvement. Therefore adequate resource should be put in place to improve neonatal outcomes.
Determinants of inappropriate birth weight for gestational age among neonates born at Dessie Referral hospital, northeast Ethiopia, 2018
(Addis Ababa University, 2018-06) Mihret, Setegn; Wondosson, Kalkidan (BSC, MSC)
Background: Inappropriate birth weight for gestational age is neonates with birth weight below 10th and /or above 90th percentiles of reference population. Globally ten percent of newborns are large for gestational age, while 23.3 million newborns are small for gestational age in low-middle income countries. Neonates with inappropriate birth weight for gestational age are proxy of serious perinatal morbidity and mortality. Objectives: The study was aimed to assess determinants of inappropriate birth weight for gestational age among neonates born at Dessie referral hospital, Northeast Ethiopia. Methods: A retrospective facility based cross-sectional study was conducted at Dessie referral hospital among 422 systematically selected mother charts (gave birth from 2013- 2017). Epi-data version 3.1 & SPSS version 20 were used to data processing and analysis. Binary logistic regression analysis and adjusted Odds ratio with 95%CI were used to see the possible association between determinants and dependent variables. Texts, tables and graphs were employed to present the results. Result: The prevalence of inappropriate birth weight for gestational age was 34.36%. Maternal age 35 year or more (AOR = 2.079, 95%CI(1.100,3.929), inadequate prenatal care (AOR = 2.387, 95%CL(1.326,4.299), maternal anemia during pregnancy (AOR = 2.00195%CI(1.062,3.768), gestational diabetes mellitus (AOR = 3.035, 95%CI(1.413,6.519), and chat chewing during pregnancy (AOR = 2.390, 95%CI(1.319,4.329) were significantly increased IBWGA births. Conclusion and recommendation: Inappropriate birth weight for gestational age was outpaced. Advanced maternal age, inadequate prenatal care, anemia, gestational diabetes mellitus and chat chewing during pregnancy are determinants of inappropriate birth weight for gestational age births. Prevention of gestational diabetes mellitus, anemia, and giving proper prenatal care may improve maternal and neonatal outcomes.
Relationship between nutritional status and academic performance among public primary school students in Debre-tabor town, Amhara regional state, North-central ethiopia,2018.
(Addis Ababa University, 2018-06) Enyew, Tigist; Abebe, Fikertemariam (BSC, MSC)
Background: - Despite the great struggle to prevent malnutrition it is still a major global burden which mainly affects children. Under-nutrition is a fundamental factor which resulted in delayed cognitive development and under achievement of academic performance later in children’s life at school. Studies revealed that the extent of under-nutrition in Ethiopia is established well but evidences about its relationship with educational achievement of school age children are insufficient. Objective: To assess the relationship between nutritional status and academic performance among public primary school children in Debre-Tabor Town, Amhara Regional State North- Central Ethiopia, 2018. Method: - An institution based cross-sectional study was conducted. Simple and systematic random sampling techniques were used to select a total of 399 study participants at Debre- Tabor Town. The nutritional status was assessed using anthropometric measurement of WHO 2007 reference as Height for Age Z-score (HAZ), Weight for Age Z-score (WAZ) and Body Mass Index for Age Z-score (BAZ). Academic performance was assessed by calculating two semesters overall subjects average score. Descriptive statistics, Pearson’s correlation test and linear regression were used for statistical analysis. Data were analyzed using SPSS version 24 and nutritional status was analyzed using WHO AnthroPlus version 1.0.4 (5-19 years). Result:-The prevalence of stunting, wasting, underweight and overweight was 22%, 32.4%, 24.3% and 1.3% respectively. The mean academic performance for study participants was 71.65(±12.63 SD). There was statistically significant positive relationship between academic achievement and HAZ. Age of child and absenteeism were associated negatively while head of house, attending preschool and breakfast habit associated positively with educational achievement of the study participants. Conclusion:-The prevalence of under-nutrition among study participants was high. Children not having breakfast and those absent from school perform poor in academic performance. The relationship between HAZ and academic achievement was positive and statistically significant. Therefore there should be nutritional interventions during prenatal, young infant periods and at school to enhance children’s long term nutritional status and their educational achievement. Students should be encouraged to eat breakfast and attend classes regularly.

Browse

Browsing Pediatrics and Child Health by Issue Date

Results Per Page

Sort Options