Pediatrics and Child Health

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    A Quality Improvement Project to Improve the Knowledge of Nurses Working at Tikur Anbessa Specialized Hospital Neonatal Intensive Care Unit (NICU): A Pre - and Post - Test Studyl
    (Addis Ababa University, 2025-10-19) Firehiwot Markos; Asrat Demtse
    Background: The first 28 days of life – the neonatal period – is the most vulnerable time for a child’s survival. Globally 2.3 million children died in the first 28 days of life in 2022. Children who die within the first 28 days of birth suffer from conditions and diseases associated with lack of quality care at birth or skilled care and treatment immediately after birth and in the first days of life. The neonatal intensive care unit (NICU) is the home to a fragile patient population consisting of babies born prematurely or with congenital anomalies and newborns requiring surgical intervention. These patients need special medical attention and support. The medical staff must provide quality care and implement evidence-based nursing practices to improve outcomes for the neonatal population. Objective of the study: The aim of this study is to improve the knowledge of NICU nurses by training on common neonatal problems. Method and Materials: A Quasi Experimental Pre- and Post- Test study design was used to assess knowledge of NICU nurses in Tikur Anbessa Specialized Hospital(TASH). A structured knowledge questionnaire in the form of Multiple Choice Questions(MCQs) was administered to obtain data regarding the knowledge of NICU nurses on common neonatal problems. Statistical analysis included differences in the knowledge scores before, immediately after the training and after 1 year of the training sessions and between the three periods. Result: A total of 35 NICU nurses were trained on common newborn problems with a majority of female participants(82.9%). Seventeen(48.0%) of the nurses have Bachelor's degree in nursing and 14(40%) have Masters in Neonatal Nursing.The majority of them 14 (40.0%) had over 10 years of nursing experience. The participants' mean knowledge score during pre-test was 6.97 ±1.85 which increased to 9.23 ±1.09 immediately after the training and dropped to 6.94 ±1.51. This increase in mean scores indicates the effectiveness of the training in enhancing participants' performance in the short term. Conclusion: The training programs are effective and significantly improve knowledge of nurses on common neonatal problems. Key words: Neonatal Resuscitation, Hypothermia, Training, Pre-test, Post-test
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    Admission Hypothermia and Neonatal Mortality: A Cross Sectional Study of Prospectively Collected Data
    (Addis Ababa University, 2024-01-13) Kullehe Haddis; Asrat Demtse
    Background According to a March 2024 WHO report, 2.3 million deaths occurred in newborns less than 28 days globally in 2022. Sub-Saharan Africa had the highest neonatal mortality rate, of 27 per 1000 live births [1]. Hypothermia is known to increase the risk of both morbidity and mortality. Thus maintaining a normal body temperature is one of the very important steps for survival of the newborns. Despite the different mechanisms proposed to prevent hypothermia, it remains a global problem especially for low-income countries like Ethiopia. Objective The objective of the study was to determine the effect of admission hypothermia on neonatal mortality across 20 Ethiopian hospitals discharged from neonatal units from January 1-December 31, 2021. Methodology This study is a secondary analysis of prospectively collected data. A total of twenty hospitals participating in the Ethiopian Neonatal Network (ENN) in the Vermont Oxford Network (VON) Global Health Database were included. All newborns whose temperature was recorded in one hour of birth were included in the study. The admission hypothermia was assessed in association with gestational age, birth weight, the environmental temperature, level of neonatal intensive care unit where the neonatal care provided, season of the year the newborn was born, and whether the newborn was born in the weekdays or weekends. Associations were tested for mode of delivery, birth weight, place of delivery and whether the newborn was term or preterm in relation to mortality. Effect modification by discharge diagnosis was considered. Associations were calculated using relative risk (RR) with a 95% CI. Data analysis was done using SAS 9.4. iii Results A total of 12,363 newborns were included in the study. The overall rate of hypothermia was 51.6%. Predictors for hypothermia and mortality included being part of a multiple birth, low birth weight and lower gestational age. The season of the month, mode of delivery or hospital environmental temperature did not have any impact in predicting hypothermia or death. In unadjusted analyses, the risk of death increased more than five times [RR 5.65 (95% CI: 4.31, 7.41)] when the admission temperature was less than 33.9°C, more than four times [RR 4.25 (95% CI: 3.30, 5.49)] when the temperature was between 34 - 34.9°C. In a multivariable analysis with other confounding factors controlled, the risk of death increased by two times for body temperatures less than 36.5°C. Admission temperature was not an effect modifier in the associations between perinatal asphyxia, respiratory distress, or meconium aspiration syndrome and mortality. However, admission temperature was an effect modifier in the association between any sepsis and mortality. Conclusion Admission hypothermia is high in Ethiopia and is associated with a twofold increased risk of death. Lower gestational ages, low birth weight infants, septic patients, newborns with congenital anomaly and multiple births were associated with increased risk of death. Measures to improve admission hypothermia through the use of intensive quality improvement projects should be undertaken to improve the situation in the country.
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    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
    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.
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    Assessment Knowledge, Attitude and Practice of Nurses towards Neonatal Pain Management and Determinant Factors at Public Hospitals in Addis Ababa, Ethiopia, 2021.
    (Addis Abeba University, 2021-08) Marelign Solomon; Moges Tamirat
    Background: Pain is a significant global problem in the field of health.Recent advances inneurobiology, clinical medicine and neonatal research have established that the fetus andnewborn may experience acute, established, and chronic pain and that controlling pain has short-and long-term benefits for all newborns (1)(2). Despite the growing knowledge about pain assessment and intervention, the neonatal pain remains unrecognized and undertreated (3).Appropriate management of neonatal painprevents unnecessary hospital stay and suffering themfrom pain. In clinical settings, nurses play a vital role in pain assessment and management and must be knowledgeable regarding how to best access and manage the pain. Objective: The aim of the study was to assess the neonatal ICU nurses’ knowledge andpracticeand factors associated regarding neonatal pain management at public hospital of AddisAbaba,Ethiopia, 2020. Method: -Institutional based cross-sectional study design will be used to collect data fromfourselected public hospitals in Addis Ababa, from 21July-22August 2021. Simple random samplingwill be used to recruit study participants using structured, self-administered questionnaire. Data will be cleaned and entered using SPSS version 26.0 software and data will analysis. Result:Majority (98(87.5.0%)) and (87(77.7%)) of the nurse had good overall knowledge andattitude. However, one third (42(37.5%) of the respondents have good practice. Conclusion:Most nurses had poor practice in managing neonatal pain but majority of nurses had adequate knowledge concerning neonatal painmanagement. There was gap between their knowledge and practice.
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    Assessment of Behavioral Abnormalities among Children with Congenital Heart Disease Aged 4-14 Years Attending Follow-up at Pediatric Cardiac Clinic in Tikur Anbessa Specialized Hospital and Cardiac Center Between October 2023-March 2024, Addis Ababa, Ethiopia
    (Addis Ababa University, 2024) Yak Acheng; Ahmed Hayat
    Background:Congenital heart disease (CHD)is a gross structural abnormality of the heart or intrathoracic great vessels that is actually or potentially of functional significance.Congenital heart disease is one of the most frequently diagnosed congenital disorders affecting approximately 0.8% of live births worldwide.(Liu et al., 2019)Children with CHD are experiencing challenges throughout their development. They can be affected by several circumstances that may contribute to serious behavioral problems, which interfere with their normal development, socialization, or future life(Dahlawi et al., 2020). Objectives:The purpose of this study is to assess behavioral abnormalities among children with congenital heart disease aged 4-14 years on follow up at the Pediatric cardiac Clinic inTikur Anbessa Specialized Hospital, Addis Ababa, from October 2023 to March 2024. Methods:A hospital based cross sectional study design was conducted among children withcongenital heart disease aged 4-14 years attending cardiac clinic at TASH and theirprimary caretakers. A total of 231 selected patient were studied, pre- test questionnaire was used to assess socio-demographic characteristics, and Strengths and Difficulties Questionnaire (SDQ), was used to assess the behavioral problems, data were collected through ODK and analyzed using SPSS version 27 software package. Mean, median,mode and standard deviation were used to describe Continuous data; and frequencyand percentage were used to describe categorical data. To identify factors associatedwith behavioral abnormalities Bivariable and Multivariable binary logistic regression analyses were done. Statistical significance was considered at level of significance of5% (p-value 0.05). Adjusted odds ratio (AOR) with 95% confidence interval (CI) wasused to present the estimates of the strength of the association. Result: the over all prevalence of behavioral abnormalities was 61% with a 95% CL.The prevalence of emotional symptoms was 17.7%, conduct problems 9.5%,hyperactivity 2.6% and peer problems was 38.5%. first birth order (AOR = 1.4, 95%CL, (1.15,8.72) , family size (1-4) ( AOR = 10.8 , 95% CL , ( 4.94 , 23.68) , cyanotic CHD( AOR = 1.8 , 95% CL , ( 1.37, 2.88), present of pulmonary hypertension (AOR = 1.5 ,95% CL, ( 1.17 , 2.81) and if the child has a history of hospitalization or history of heart failure(AOR = 8.4 ,95% CL , (3.82 , 18.74) were more likely to have any form of behavioral disorder than their counterparts. Conclusion: the magnitude of behavioral abnormalities among children with congenital heart disease is significant. children with cyanotic CHD, present of pulmonary hypertension and previous history of hospitalization or history of heart failure are more likely to suffer from a behavioral and mental abnormality. we recommend children with congenital heart disease especially cyanotic CHD should be provided with better counseling services.
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    Assessment of Clinical Presentations, and outcome of Patients Admitted to Pediatrics Intensive Care Unit, Saint Paul’s Hospital Millennium Medical College: A Two-Year Retrospective Cross-Sectional Study
    (Addis Ababa University, 2025-04-13) Gemechu Edae; Tigist Bacha
    Introduction: A pediatric intensive care unit is a separate physical facility or unit specifically designated for the treatment of pediatric patients, because of shock, trauma, or other life threatening conditions, require intensified, comprehensive observation and care. Knowledge of the characteristics and outcomes of critically ill children admitted to PICU in low income countries may help with the identification of priorities and the resources required for improvement of the care of critically ill patients. Objective: - To assess the clinical presentations, and outcome of children admitted to the pediatric intensive care unit of Saint Paul’s Millennium Medical College. Methods: - Data were collected through chart abstraction of pediatric patients who were admitted to the PICU during the period from January 2017 to December 2018. Data were analyzed using Statistical Package for Social Sciences version 20.0 for windows. Data were summarized by using frequency tables, figures and odds ratio with its 95% confidence interval was determined when it is appropriate. A retrospective cross-sectional study design was used. Results: From 400 admitted patients, 260 patients were analyzed. Average age at admission was 48.13 ± 53.65 months, with M: F ratio of 1.4:1. Overall (from infectious and non-infectious) the most commonly affected systems were central nervous system (79/260 pts, 33.2%) and respiratory system (55/260 pts. 23.1%). The mean duration of stay was 7.26 ±6.87, the median being 6.0 days. Binary logistic regression shows, need for mechanical ventilation (p = 0.04), and post cardiopulmonary resuscitation admission (p=0.001) were independent predictors of mortality. The major causes of death being septic shock in a total of 24 (43.6%), followed by respiratory failure in 14 (25.5%) secondary to severe chest infection, GBS and various central causes. Cardiogenic shock accounted for 7 (12.7%). The overall mortality rate was (21.1%). Conclusion: The mortality rate of our PICU was 21.1 %, with the most common cause of admission, and death being infectious causes mostly affecting CNS and respiratory, and septic shock respectively. The mean duration of stay of 7.26 ±6.87 days. The statistically significant predictor of mortality in this study was need for mechanical ventilation and post cardiopulmonary resuscitation admission. Key Words: SPHMMC, Pattern, Intensive care unit, outcome
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    Assessment of Health –Related Quality of Life of Children with Chronic Kidney Disease on Follow up at Pediatric Renal Clinic Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-11) Chekol Getasew; Abebe Bezaye; Pais Priy
    Background :Children with chronic kidney disease face lifelong increases in morbidity, mortality, and decreased quality of life. As most of other chronic illnesses, CKD has hard impact on ill children's and care givers life style, peer relationship, pain interference and social functioning moreover CKD has impact on intellectual functions and behavioral characteristics including anxiety and depression. Objective- To assess health related quality of life of children with CKD as well as their caregivers‟ perception on their Childs performance and to determine the factors that adversely affect it. Methods and material: A cross-sectional analytical study conducted using a pre coded, pretested structured questionnaire including PedsQoLTM 4.0 scale score generic core and family impact module. Data obtained for demographic and clinical parameters of children and for each domain of generic core and family impact module and data was analyzed using IBM SPSS® version 26. Results- 105 children with CKD aged 2-18 years, 61(58.1%) males and 44(41.9%) females were included in this study. Among the child self reported domains of generic core scale, child‟s „school performance‟ was most affected with mean of 74.91 (SD±22.29) followed with child „physical performance‟ 77.6±26.41. In the family impact module domains with mean also, the most affected being „school performance‟ with 75 (SD±19.89) followed with „physical functioning‟ with 78.13 (SD±24.96). Recommendation: „School performance‟ and „physical functioning‟ were the most affected domains in child generic scale and family impact modules. Optimal care requires attention not only to medical management, but also to an assessment of health related Quality of Life factors, that may help promote pediatric CKD patient‟s health like Implementation of a standardized tool and Multidisciplinary approach in addressing HRQoL in all CKD patients on follow up.
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    Assessment of Knowledge on Cardiopulmonary Resuscitation among Pediatric Nurses in Tikur Anbessa Specialized Hospital
    (Addis Ababa University, 2024-02-25) Abdirahman Bahja; Tefera Muluwork
    Background: -. The nurses, who are the first witnesses to the cardiac arrest patients, must implement cardiopulmonary resuscitation (CPR) to them at once, and the immediate implementation of CPR by the first witness is very important in ix enhancing the survival rate by raising the circulation recovery rate. Out of the factors that influence the nurse in providing CPR, knowledge and self-efficacy are factors that need to be noticed. Knowledge of CPR related to the standard of care and the effectiveness of CPR performance. Objective: - assess knowledge of cardiopulmonary resuscitation among pediatric nurses in Tikur Anbessa Specialized Hospital Methods: - all nurses working in pediatric department were included in the study. From these 20 were not included in the study due to annual, maternity leave and refusal. The total numbers of participants were 94 making the response rate of 81%. Data was collected by total enumerating (censes) method and the collected data entered in epi data version 4.2 and analyzed by SPSS version 25. After cleaning the data were analyzed by SPSS and the result were explained through graphs, tables and charts. To determine the associated variable 95% CI used and those having a p-value <0.05stated as statistically significant. Result : - the knowledge levels shows that only 38 (45.5%) of those who scored good levels of knowledge and skill levels were calculated and shows that only 31 (33%) of those who scored on skill items good levels of skill. Year of the study participants and level of education were a statistically significant for level of knowledge on BLS using chi square test at p-value <0.05
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    Assessment of Knowledge on Cardiopulmonary Resuscitation among Pediatric Nurses in Tikur Anbessa Specialized Hospital
    (Addis Ababa University, 2024-02) Mohamed Bahja ; Tefera Muluwork
    Background: -. The nurses, who are the first witnesses to the cardiac arrest patients, must implement cardiopulmonary resuscitation (CPR) to them at once,and the immediate implementation of CPR by the first witness is very important inenhancing the survival rate by raising the circulation recovery rate. Out of thefactors that influence the nurse in providing CPR, knowledge and self-efficacy arefactors that need to be noticed. Knowledge of CPR related to the standard of care and the effectiveness of CPR performance. Objective: - assess knowledge of cardiopulmonary resuscitation among pediatric nurses in Tikur Anbessa Specialized Hospital. Methods: - all nurses working in pediatric department were included in the study.From these 20 were not included in the study due to annual, maternity leave and refusal. The total numbers of participants were 94 making the response rate of81%. Data was collected by total enumerating (censes) method and the collecteddata entered in epi data version 4.2 and analyzed by SPSS version 25. Aftercleaning the data were analyzed by SPSS and the result were explained throughgraphs, tables and charts. To determine the associated variable 95% CI used andthose having a p-value <0.05 stated as statistically significant. Result : - the knowledge levels shows that only 38 (45.5%) of those who scoredgood levels of knowledge and skill levels were calculated and shows that only 31(33%) of those who scored on skill items good levels of skill. Year of the studyparticipants and level of education were a statistically significant for level of aknowledge on BLS using chi square test at p-value <0.05 and Year of the serviceof the study participants, sex and level of education were a statistically significant for level of skill on BLS using chi square test at p-value <0.05.
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    Assessment of Knowledge, Attitude and Practice of Pediatric Residents towards Child Abuse in Three selected Hospitals, in Addis Abba, Ethiopia, 2021.
    (Addis Abeba University, 2021-11) Gelesu Kidist; Moges Ayalew; Tefera Muluwork
    Background: - Child abuse is not only physical abuse, but it can be in the form of emotional abuse involving humiliating a child, coercive, constant belittling, shaming, frequent yelling, threatening, or bullying of the child, making negative comparisons to others, rejecting and ignoring the child as punishment, having limited physical contact with the child (no signs ofaffection), or any other demeaning acts. Obtaining a detailed history and judging parent child interaction are important tools of identification. Lack of clinicians’ knowledge or clinical experience more often results in misdiagnosis and under reporting of the cases of abuse. This study is being carried out to determine the knowledge, attitude and practice of child abuse and itsmanagement among pediatric residents. Objective: -Assessment of knowledge, attitude and practice of pediatric residents towards child abuse in three selected hospitals of Addis Ababa, Ethiopia, 2021. Method: - Institutional based Cross-sectional study design was employed with facility based self-administer question among pediatrics residents with sample size of 135.Data were checked,cleaned and entered in to SPSS version 25.0 software for analysis. The magnitude and the association between the different independent variables in relation to dependent was measured and 95% confidence interval (CI) and P values below 0.05 were considered statistically significant. Result: -The knowledge attitude and practice of pediatric and child health resident on child abuse were significantly low (50%, 56% and 43%) respectively. The determinant of knowledge was participant having formal teaching, learning or training session on child abuse attitude regarding to the topic and the determinant of attitude were married status and knowledge and the determinants of participants practice were years resident and experienced on child abuse treatment/ management. Recommendation: -the recommendation goes to : for the study participant, better to see concentrated about child abuse issues to solve and alleviate the problem as you are a ground back bone. For the institution/ department: - better to put standard protocol of knowledge measurement of pediatric resident regarding to child abuse, due to the fact of the issue community problem. For research: - better to assess by mixed study as a national level.
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    Assessment of Knowledge, Attitude and Practice of Pediatrics Residents on Autism Spectrum Disorders in Three Selected Teaching Hospitals, in Addis Ababa, Ethiopia, 2021.
    (Addis Abeba University, 2021-10) Hizkiel Selamawit; Muhe Lulu ; Tsige Selamenesh
    Background:- Autism spectrum disorders (ASD) is a spectrum of neurodevelopmental disorders occurring early in childhood that is characterized by persistent deficits in social communication and interaction and restricted, repetitive patterns of behavior, interests, or activities. However,limited knowledge among health care providers, poor community awareness, and a dearth of specialist care services are some of the issues confronting autism. Objective: - To assess knowledge, attitude and practice of pediatrics residents on autism spectrum disorder in three selected teaching hospitals in Addis Ababa, Ethiopia Method: - Institutional based Cross-sectional study was done with facility based self-administered question among pediatrics resident with sample size of 141.The data were entered and analyzed by using SPSS version 25. Data cleaning and screening were conducted exclusively by the principal investigator. Descriptive statistics was employed to summarize the data and data were presented using Tables, Figures and texts.Binary logistic regression model was used and p- value<0.05 was considered as statistically significant. Result: - In this study 138 participants contributed to a response rate of 97.9%. The overallknowledge, attitude and practice of pediatric and child heath resident on autism spectrum disorderwere 70%, 59% and 51% respectively. Participants having experience in autism management had2.6 folds increase in the knowledge than non-experienced participant. Participants having favorable attitude are 6.8 times knowledgeable than participant with unfavorable attitude. Thedeterminant of attitude and practice were participants having formal teaching, learning or trainingsession before on ASD, year of residency, having experience and good knowledge on childhood autism. Recommendations: - 1. For the residents: - It is important for residents to improve the KAP regarding to ASDas they are future cornerstone for the management of these cases: 2. For the department: this research may be used as a clue and better to develop protocolof standard autism assessment to increase the level of KAP on medical studies on ASD, 3. For the researcher: - suggest to study in all health professionals those involved in ASDmanagement
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    Assessment of Nutritional Status and Associated Factors of Children with Chronic Kidney Disease in Tikur Anbessa Specialized Hospital Pediatric Renal Clinic 2024/25 Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-02-15) Adino Melkamu; Damte
    Back ground: Poor growth in children with CKD, which is a marker of disease severity, is associated with significant morbidity and mortality. We studied nutritional status and associated factors in our children with CKD. The study aims were to evaluate the nutritional status and associated factors among children with CKD at the Pediatric Renal Clinic at Tikur Anbessa Specialized Hospital 2024/25. Methods: This study was conducted at Tikur Anbessa Specialized Hospital/TASH/. An institution based cross-sectional study employed among 86 children with CKD. Data was collected from medical records and by taking history and physical examination of CKD children receiving follow up care in the pediatric renal clinic using a pre-tested structured checklist. Statistical software Epi Info (7.2.5.0) was used for data entering and (SPSS 26 version) was employed for data analysis clearance. For variables that were statistically significant, descriptive statistics, ordinal logistic regression statistical analysis was used. Data was presented with frequency, percentage, and tables. Result: Out of the 88 children with chronic kidney disease who were chosen for the study; the questionnaire was completed for 86 children, yielding a response rate of 97.7%. About 36.2% of patients were in the active age group of >10 years, and 37.2% of children were in the 5–10-year age range. Males outnumbered females, with a male-to-female ratio of 1.61:1. Among a total 86 children with CKD, 44.2% had stunting, and about 45.3% had wasting. Monthly income of the family, duration CKD from diagnosis, address (residence where the child live) and presence of comorbidity were strongly associated with malnutrition. The longer the duration illness the higher the risk of development of malnutrition with respective -14.5(95% CI: -16.564, -12.468, p-value= 0.000). Conclusion: Malnutrition was seen in a considerable portion of our children with CKD, Malnutrition status was strongly associated with their age, gender, place of residency(address), caregivers’ income, duration of illness and presence of associated comorbidity. Standard guideline needs to be prepared to diagnose and manage malnourished children with CKD. Keywords: malnutrition, CKD, children, stunting
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    Assessment of Pediatric Residents’ Knowledge, Attitude and Practice Regarding Oxygen Therapy and its Complications at, TASH and SPMMC, Addis Ababa
    (Addis Abeba University, 2021-11) Beza Kalkidan; Gebre Hanna
    Background: Oxygen therapy is a medical treatment used for tissue hypoxia. It has the potential to improve medical outcomes and save lives when used appropriately and to cause harm if used inappropriately. Objective: To assess knowledge, attitude and practice of residents and about oxygen therapy and its complications in pediatrics department of TASH and SPMMC. Methodology: A cross-sectional descriptive design was employed. All Pediatrics residents working in will be used as a source population. The total sample was determined by using single population formula by considering the assumptions 95% confidence interval with margin of error 5% the calculated final sample size is 141 by adding 10% non respondent. Level of knowledge was grouped by Bloom‘s original cut off points into good (80-100%), moderate (60-79%) and poor (< 60%). Result and discussion: Out of the 141 pediatric residents who responded, 13.5 % had a level of knowledge classifiable as poor, 68.8% moderate and 17.7% good. There is significant relation between the experience as a GP and whether there is previous training on oxygen therapy during administration of oxygen (p value= 0.026 and 0.041). Conclusion: The majority of participants had moderate to poor level of knowledge of oxygen administration and positive attitude. However their practice was generally poor. Their knowledge could be boosted with regular education and training on oxygen administration.
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    Assessment of Platelet Increment and Refractoriness to Platelet Transfusion in Pediatric Cancer Patients, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia : A Prospective Cross-sectional Study
    (Addis Abeba University, 2021-11) Yilma Misrak; Shimelis Damte ; Hailu Daniel
    Background: Platelet transfusion is an essential supportive component of the treatment of oncology patients with survival benefit. Platelet transfusion refractoriness is an important challenge in pediatric cancer patients who require repeated transfusions. Objectives To assess platelet increment and refractoriness after platelet transfusion in pediatric cancer patients, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia Methods: In this study, 113 eligible patients were included and data was collected by oriented nurses and physicians using structured questionnaire. Data completeness assessment and coding was done and it was processed and analyzed by SPSS version 25 using frequency tables, Chi Square and Regression analysis tools. Result: In this study, 113 pediatric cancer patients were included. Most of the patients are in the age group of 5-10 years (46.9%) followed by under 5 years (43.4%). The majority are male sex accounting for 57.5 %. There is a significant association between platelet increment after transfusion with the type of cancer(p=0.001) and being on chemotherapy (p 0.018) on Chi square analysis. Regression analysis revealed negative correlation between age of patient and platelet increment(p=0.14). There is also significant association between splenomegaly and previous platelet transfusion with platelet increment (p=0.003 for both). The incidence of platelet transfusion refractoriness is 12.5%. Conclusion: Based on the findings of this study, increment of platelet in pediatric cancer patients in TASH is affected by age of patient, Type of cancer, Splenomegaly, Previous platelet transfusion history and Chemotherapy. Platelet transfusion refractoriness is seen in 12.5% of the patients. Recommendation We recommend a larger-scale study with better organized methodology to be conducted to draw more representative results.
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    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.
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    Assessment of Quality of Life and Associated Factors in Children and Adolescents with Diabetes Mellitus at Governmental Hospital, Addis Ababa Ethiopia, 2018.
    (Addis Ababa University, 2018-06) Girma Desalegn; Murugan Rajalakshmi
    Background: Quality of life (QoL) is a multidimensional construct incorporating an individual's subjective perception of physical function, emotional function, and social well-being. Looking for QoL after a diagnosis of diabetes used to detect problems which may be faced by children and adolescents and to manage these problems. Objective: This study aimed to assess quality of life and associated factors in children and adolescents with diabetes. Method A prospective cross sectional study was done from March 1 to April 30/2018 at Tikur Anbesa, Yekakit 12 and zewuditu hospitals. Systematic sampling method was used to select 234 study participants. The interview data collection technique was used. A 23-item multidimensional PedsQL™ 4.0 Generic Core Scales instrument was used to measure general health related quality of life (HRQoL) and a 28-item multidimensional PedsQL™ 3.0 Diabetes Module instrument was used to assess diabetes related quality of life (DRQoL) of children and adolescents. Multivariable linear regression was done and a significant association was declared at p<0.05. Result: The mean score for HRQoL of children and adolescents were 78.8±15.6 reported by children and adolescents and 61±7.9 reported by parents. The mean score for DRQoL children and adolescents were 78.3±14.6 reported by children and adolescents and was 60.5±7.9 reported by parent. About 35.5% mean score of school function and 35.8% mean score of emotional function of children and adolescents fell more than one standard deviation (>1 SD) below the mean of HRQoL of children and adolescents of self-reports. About 37.6% mean score of treatment barriers, 34.9% mean score of communication and 34.5% mean score of worry of children and adolescents fell more than one standard deviation (>1 SD) below the mean of DRQoL of children and adolescents of the self-reports. Conclusion and Recommendation: This study found that there was lower score in school and emotional function of HRQoL and lower score in treatment barriers, worry and communication sub scale score of DRQoL. Glycemic level, health education of diabetes, frequency of hospital admission was clinically significant factors of HRQoL and DRQoL are scoring. This study recommended for the sustainable health education program on diabetes for children and adolescents with diabetes.
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    Assessment Of School Performance and Associated Factors of Children with Congenital Heart Disease Attending Tikur Anbessa Specialized Hospital Pediatrics Cardiac Clinic Addis Ababa, Ethiopia 2024.
    (Addis Ababa University, 2024-03) Tedila Asamirew; Mintesinot Helen
    Background: The condition is known as a congenital heart defect (CHD) occurs when heart or the blood arteries surrounding it don't grow normally before birth. Biological and environmental risk factors contribute to the neurodevelopmental morbidity risk in children with congenital heart disease.The risk can be higher in setting like ours where timely surgical correction palliation and Periodic developmental surveillance, screening, evaluation and interventions guidelines lacks. In our setup the magnitude of the impact that heart disease has on school performance has never been estimated Objective: To determine school performance of children with congenital heart disease who are on follow up at TASH paediatrics cardiac clinic. Method: The study was a hospital based cross-sectional study conducted between September 2023 to January 2024 .For those willing participants structuredquestionnaire was administered to collect data. There were three sections to the questionnaire. The first section included basic demographic data. Inquiries to evaluate the child's medical status were included in the second section. Seven questions made up the third section, which evaluated the child'sacademic performance. After being examined and cleaned, the data was encoded into SPSS version27.0 for analysis. Finally, the study result will be disseminated to each concerned body. Result: 140 children with CHD was participated .There were 65(46.4%)) males and 75 (63.6%) were females .the commonest non -cyanotic CHD was VSD and cyanotic lesion was TOF. Surgical correction were done for 33(23.6%). The rate drop out school withdrawal of children with congenital heart disease was 15.7 % (22 of 140) and 12.1% (17 /140) of students respectively. 48 (34.3%) of the subjects had a record of greater than 10 days of school absentee, The mean of the average score and SD of the participant in the past academic year was 74.65 ± 13.25 with 95% CI [72.34-76.96].multiple ordinal logistic analyses showed that malnutrition and low maternal educational level were negatively associated school performance while few absent days and symptomatic treatment are positively related .But type of sex, CHD ,surgical correction, socio-economic level of the family showno relation with school performance Conclusion: The rate of drop out of school among children with CHD at TASH can be higher than the healthy children. The average of score of children with CHD is above satisfactory. Higher absent days as a result heart disease related symptoms malnutrition and low maternal education negatively affect the school performance of children with CHD.
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    Assessment of Serum Iron Profiles and Associated Factors in Newly Diagnosed Female Breast Cancer Patients Attending Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2024-06) Tsegaye Melaku; Wolde Mistire; Alem Mekdes; Dendena Yonas
    Background: - Breast cancer is the leading cancer among females globally, with high morbidity and mortality rates. Iron in cells is vital for oxygen transport as part of haemoglobin, stored in ferritin, and carried by transferrin, have role in numerous biological processes, including DNA and RNA synthesis. Maintaining iron concentrations in the cells and in the body so crucial, since both iron deficiency and iron overload can impair cellular function also can raise cancer risk,including breast cancer. Objective: To assess serum iron profiles and their associated factors in newly diagnosed female breast cancer patients attending Tikur Anbessa Specialised Hospital, Addis Ababa, Ethiopia. Methods: A comparative cross-sectional study was carried out between March and November2023. In all, 74 breast cancer patients were used as cases, and 74 samples from people who were apparently healthy were used as a control group at Tikur Anbessa Specialised Hospital. After collecting socio-demographic and anthropometric data, 5 ml of blood was collected from eachparticipant. Then serum iron, ferritin, TIBC, and percent transferrin saturation levels were determined by using the COBAS 6000 machine at EPHI laboratory departments. After cleaning,checking for completeness, and entering it into MS Excel, the data was analysed using SPSS version 27.0 software. The data were analysed using descriptive statistics (mean ± SD) and assessed using Chi-square, student t-test, ANOVA, and P-value within a 95% confidence interval. Binary logistic regressions were employed to determine the association between dependent and independent variables among breast cancer patients. Finally, the findings were presented through text, tables, charts, and graphs. Results: The age of study participants ranged from 25 to 75 years, and the mean ages of breast cancer patients and the control study group were 44.66 + 11.78 and 46.0 + 12.05 years,respectively. The mean ± SD of serum ferritin levels were significantly increased (p < 0.05), and significant decreases in serum iron, TIBC, and TS% were observed in the case groups in comparison to the normal groups (p < 0.05). Factors like age, BMI, alcohol consumption, and adiet rich in meat were significantly linked with abnormal serum iron profile results. In breast cancer patients, the ferritin level was higher in postmenopausal (274.01 ± 127.72 ng/ml)compared to premenopausal (107.49 ± 83.52 ng/ml) patients and even in their healthy counterparts. Ferritin levels in advanced-stage disease exhibited a significant rise in comparison to patients at an earlier stage. Conclusion: According to the study, women with breast cancer generally have deficient iron levels, apart from increased ferritin levels. Higher ferritin levels in patients with breast cancer might serve as an additional parameter for diagnosis and staging. Iron metabolism is strongly involved in the pathogenesis of breast cancer and can serve to assess the severity of the disease.
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    Avoidable Factors in Perinatal Mortality Identified by Clinical Audit at Tikur Anbessa Hospital
    (Addis Ababa University, 2012) Demtse Asrat ; Spector Jonathan
    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.
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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