Pediatrics and Child Health

Permanent URI for this collection

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

Browse

Browsing Pediatrics and Child Health by Title

Now showing 1 - 20 of 87
  • No Thumbnail Available
    Item
    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.
  • No Thumbnail Available
    Item
    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; Dr.Moges, Tamirat(MD, Pediatrician, Pediatric Cardiologist, Associate Professor Of Pediatrics And Child Health)
    Background: Pain is a significant global problem in the field of health.Recent advances in neurobiology, clinical medicine and neonatal research have established that the fetus and newborn 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 them from 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 and practiceand factors associated regarding neonatal pain management at public hospital of Addis Ababa,Ethiopia, 2020. Method: -Institutional based cross-sectional study design will be used to collect data from fourselected 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 and attitude. 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 pain management. There was gap between their knowledge and practice.
  • No Thumbnail Available
    Item
    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(Ass.Prof.)
    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 in Tikur Anbessa Specialized Hospital, Addis Ababa, from October 2023 to March 2024. Methods:A hospital based cross sectional study design was conducted among children with congenital heart disease aged 4-14 years attending cardiac clinic at TASH and their primary 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 frequency and percentage were used to describe categorical data. To identify factors associated with behavioral abnormalities Bivariable and Multivariable binary logistic regression analyses were done. Statistical significance was considered at level of significance of 5% (p-value 0.05). Adjusted odds ratio (AOR) with 95% confidence interval (CI) was used 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.
  • No Thumbnail Available
    Item
    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; Dr.Abebe, Bezaye(MD,Assistant professor of pediatrics and child health); Dr.Pais, Priy(MD,Associate professor, Pediatric Neurologist)
    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 PedsQoL TM 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.
  • No Thumbnail Available
    Item
    Assessment of Knowledge on Cardiopulmonary Resuscitation among Pediatric Nurses in Tikur Anbessa Specialized Hospital
    (Addis Ababa University, 2024-02-25) Abdirahman Bahja; Tefera Muluwork
    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 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.
  • No Thumbnail Available
    Item
    Assessment of Knowledge on Cardiopulmonary Resuscitation Among Pediatric Nurses in Tikur Anbessa Specialized Hospital
    (Addis Ababa University, 2024-02) Mohamed,Bahja Abdirahman; Tefera,Muluwork(Ass.Prof.)
    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 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 <0.05 stated 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 and Year of the service of 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.
  • No Thumbnail Available
    Item
    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; Dr.Moges, Ayalew(Assistant Professor of Pediatrics and Child Health, Pediatric Neurologist); Dr.Tefera, Muluwork (Associate Professor of Pediatrics and Child Health, Pediatrics Emergency and Critical Care Sub - Specialist)
    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 of affection), 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 its management 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.
  • No Thumbnail Available
    Item
    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; Prof.Muhe, Lulu M.(Professor of pediatrics and child health); Dr.Tsige, Selamenesh(Consultant pediatrician and assistant professor of pediatrics and child health)
    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 overall knowledge, attitude and practice of pediatric and child heath resident on autism spectrum disorder were 70%, 59% and 51% respectively. Participants having experience in autism management had 2.6 folds increase in the knowledge than non-experienced participant. Participants having favorable attitude are 6.8 times knowledgeable than participant with unfavorable attitude. The determinant of attitude and practice were participants having formal teaching, learning or training session 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 ASD as 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 protocol of 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 ASD management
  • No Thumbnail Available
    Item
    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 (MD; assistant professor of pediatrics and child health)
    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 cutoff 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.
  • No Thumbnail Available
    Item
    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 (Professor of Pediatrics, Consultant Pediatric Nephrologist); Hailu, Daniel (Assistant professor of Pediatrics, Consultant Pediatric HematoOncoligist)
    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.
  • No Thumbnail Available
    Item
    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.
  • No Thumbnail Available
    Item
    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 (Asst. professor, PhD fellow)
    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.
  • No Thumbnail Available
    Item
    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(Dr.)
    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 structured questionnaire 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's academic performance. After being examined and cleaned, the data was encoded into SPSS version 27.0 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 show no 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.
  • No Thumbnail Available
    Item
    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(MSc, PhD, Associate professor); Alem,Mekdes(MSc); Dendena,Yonas(MD,Ass.Prof.)
    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 November 2023. 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 each participant. 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 a diet 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.
  • No Thumbnail Available
    Item
    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.
  • No Thumbnail Available
    Item
    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( MD, Pediatrician and Neonatologist)
    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.
  • No Thumbnail Available
    Item
    Barrier’s and Enablers for the Implementation of Standardized Blood culture Specimen Collection in Hospitalized Children, TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia:Prospective Cross Sectional Study.
    (Addis Ababa University, 2024-03) Assefa,Elias; Abebe, Workeabeba(Prof.)
    Background: Clinical culture specimen collection plays a vital role in diagnosing and managing infectious disease in hospitalized children. Obtaining accurate and reliable culture specimens is crucial for guiding appropriate antimicrobial therapy and preventing the spread of infections. However, there is often a lack of standardization in clinical culture specimen collection practices, leading to potential barriers and challenges in obtaining high quality samples. Objectives: To identify the practice standardizing blood culture specimen collection and associated factors in hospitalized children at TikurAnbessa Specialized Hospital, Addis Ababa Ethiopia. Methods: This study was conducted using a hospital- based prospective cross-sectional study design from July 2023 – October 2023 GC. Descriptive statistics was presented with frequency tables and charts. Binary logistic regression model was used to assess the association between the independent variable and treatment outcomes. All statistical tests were significant at P-value less than 0.05. Result: In this study a total of 400 nurses were participated. More than half of them 233 (58.3%) were in the age group of 30-39 years with the minimum age of 26 and the highest age 44 years. The mean age of the study participants was 31.64 years with a standard deviation of 4.09. Only 104 (26%) with (95%CI, 21.8-30.3) blood collection specimen technique among the study participants was according to the standard. Those who had good understanding about the enablers and scored above the mean (AOR=1.68, 95%CI, 1.01-2.81) and those who had good understanding about the barriers and scored above the mean (AOR=95% CI, 1.75(1.04-2.95) were significantly associated with standardizing blood culture specimen collection practice. Conclusion and recommendation: According to the findings, several enablers and barriers negatively influenced blood collection practice according to the standard. To achieve successful increased awareness and efforts by the individual professional are necessary. However, facilities must facilitate for its achievement by providing adequate resources, clear task statements and follow up.
  • No Thumbnail Available
    Item
    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.
  • No Thumbnail Available
    Item
    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
  • No Thumbnail Available
    Item
    Clinico Pathological Patterns and Treatment Outcomes of Pediatric Germ Cell Tumors Treated at Tikur Anbessa Hospital: A 10-Year Single Tertiary Hospital Experience
    (Addis Ababa University, 2024-04) Gebrehiwot,Mihret; Arega,Gashaw(MD, MPH)
    Background:Pediatric Germ Cell Tumors (GCTs) are rare heterogeneous neoplasms with a peak incidence in children younger than 4 years old and during adolescence. The clinical presentation and treatment outcomes of GCTs are not well-studied in developing countries. The main aim of this study was to assess the clinic-pathological patterns and treatment outcomes of Pediatric Germ Cell Tumor (GCT) patients treated at Tikur Anbessa Specialized Hospital. Methods: A retrospective, cross-sectional study was conducted at Tikur Anbessa Specialized Hospital on Pediatric Germ Cell tumor patients treated from January 1, 2014, to December 31, 2023. The collected data were analyzed using a statistical package for social sciences (SPSS) version 25. The Kaplan–Meier Survival estimate was used to assess the Overall Survival (OS) and Event-Free Survival (EFS). Results: A total of ninety-one patients were included in the study. The median age at diagnosis was 4 years with a female-to-male ratio of 2.3:1. Most patients were under five years of age; constituting 61.6% (n=56). The duration of the illness from the onset of symptoms to the oncologic treatment center ranged from 2 days to 12 months with a mean duration of four months. Sacrococcygeal swelling was the commonest presenting symptom accounting for 38.2% (n=34) followed by abdominal mass (36%). Most of the patients had extracranial GCTs constituting 93.4% (n=85). Mature teratoma was the most common histology of GCTs constituting 52.6% followed by dysgerminomas (17.1%, n=13). About 42% of patients received a combination of chemotherapy and local control measures either surgery or radiotherapy. The Kaplan-Meier survival estimates showed the first and five-year OS was 95.7% and 85%, respectively. The first and five-year EFS was 95% and 84 % respectively. Conclusion:Our study showed the mean duration of the illness from the onset of symptoms to the oncologic treatment center was 4 months. Mature teratoma was the commonest histology. The 1-year and 5- year OS probabilities were better than other studies in similar settings.