Pediatrics and Child Health

Permanent URI for this collection

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

Browse

Now showing 1 - 20 of 54

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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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
Clinico-pathologic Profile and Treatment Outcome of Children with Non-Hodgkin’s Lymphoma seen at Hemato-oncologic unit ,Tikur Anbessa Specialized Hospital, Addis Ababa ,Ethiopia.
(Addis Abeba University, 2021-11) Jemal, Dureti; Dr.Memirie, Solomon Tessema(MD, Ph.D.); Dr.Gidey, Abdurkadir
Background: Lymphoma is general term for cancers that develop in the lymphatic system and is the third most common childhood mali gnancy. It is classified into two broad categories, different mani festations and treatment approach: Hodgki n and non-Hodgkin l ymphoma. Non- Hodgki n lymphoma accounts for approxi mately 60% of all lymphomas in children and adolescents with a hi gher incidence in sub-Saharan African (SSA) countries. With the current modality of treatment, localized NHL (stage I to II) has an approxi mate 95% to 100% 5-year event-free survival (EFS) and more than 80% for children with advanced-stage disease (stage III to IV). Despite the increasing burden, i nfrastructure for diagnosis and treatment of hematolymphoid mali gnancies remains inadequate i n SSA. To our knowledge there is no study done in Ethiopia on NHL survival. Objective: To assess the clinico-pathologic profile and treatment outcome of children with NonHodgki n’s Lymphoma who sought care at pediatric oncology unit i n Ti kur Anbessa Specialized Hospital (TASH). Method: We conducted a hospital-based retrospective cross sectional study at the pediatric oncology uni t at TASH. The study period was from Jul y 1st to August 31st, 2021. Data of 149 children who meet the i nclusion criteria were analyzed using Statistical Package for Social Sciences (SPSS) version 25. We conducted both descriptive and anal ytical statistics. We run Chi square test, Log Rank test and Cox regression to assess association among the variables of interest. Kaplan Meier esti mates were used for five-year overall survival analysis. P-values of <0.05 were considered statistically significant differences or association. Result: Most (44.3%) childhood cases of NHL occurred between five to ten years of age, more commonl y affecti ng males than females (2.38:1 ratio). More than half of the patients presented with advanced stage and commonest presentation is abdominal swelling. Burkitts lymphoma is the commonest histologic type. Advanced disease stage is signi ficantl y associated with low hemoglobin level, high LDH and older age.. In this study we did not find signi ficant differences in the EFS rate by different prognostically relevant variables. The five year OS was 66.5% and EFS was 63.1%. Conclusion Five year over all and event free survival for childhood NHL at TASH is lower than what has been reported elsewhere including the average i n developing countries.
Cotrimoxazole Prophylaxis Treatment Adherence and Challenges in Implementation among HIV Exposed Children in the Public Hospital in Ilubabor Zone, South West Ethiopia, 2018.
(Addis Ababa University, 2018-06) Nigatu, Dessalegn; Getahun, Negalign (BSc,MSc)
Background: Worldwide, over two million children are infected with HIV, ninety percent of who live in sub-Saharan Africa in 2011. Many HIV-infected infants and children die from HIV-related causes without their HIV status being known or receiving HIV care. Without access to cotrimoxazole prophylaxis and supportive care, about a third of all HIV-infected infants die by 1 year of age and about half of all HIV-infected infants die by age 2 years. Ethiopia is one of low income county in sub-Saharan Africa that suffers a lot. For instance, out of an estimated 135,000 children who are in need of cotrimoxazole prophylaxis, only fifty six percent are currently receiving this intervention. Objective: the aim of this study is to assess adherence and challenges in implementation of CPT among children born from HIV infected mother Methods: Retrospective cross - sectional study design was conducted from January 2016 – April 2018. A total of 293 samples were collected using semi - structured data collection format. The data were cleaned manually, coded and entered into Epi – data version 3.1 and analyzed using SPSS version 20. Bivariate and Multivariate logistic regression, crude and adjusted odds ratio with their 95% confidence interval and p-value <0.05 were used to identify Variables which had significant association with CPT adherence and challenge in its implementation. Result : The strongest predictors of poor adherence to CPT are long procedure in getting the drug (OR=9.913 (2.825-34.731), p=
Determinants of inappropriate birth weight for gestational age among neonates born at Dessie Referral hospital, northeast Ethiopia, 2018
(Addis Ababa University, 2018-06) Mihret, Setegn; Wondosson, Kalkidan (BSC, MSC)
Background: Inappropriate birth weight for gestational age is neonates with birth weight below 10th and /or above 90th percentiles of reference population. Globally ten percent of newborns are large for gestational age, while 23.3 million newborns are small for gestational age in low-middle income countries. Neonates with inappropriate birth weight for gestational age are proxy of serious perinatal morbidity and mortality. Objectives: The study was aimed to assess determinants of inappropriate birth weight for gestational age among neonates born at Dessie referral hospital, Northeast Ethiopia. Methods: A retrospective facility based cross-sectional study was conducted at Dessie referral hospital among 422 systematically selected mother charts (gave birth from 2013- 2017). Epi-data version 3.1 & SPSS version 20 were used to data processing and analysis. Binary logistic regression analysis and adjusted Odds ratio with 95%CI were used to see the possible association between determinants and dependent variables. Texts, tables and graphs were employed to present the results. Result: The prevalence of inappropriate birth weight for gestational age was 34.36%. Maternal age 35 year or more (AOR = 2.079, 95%CI(1.100,3.929), inadequate prenatal care (AOR = 2.387, 95%CL(1.326,4.299), maternal anemia during pregnancy (AOR = 2.00195%CI(1.062,3.768), gestational diabetes mellitus (AOR = 3.035, 95%CI(1.413,6.519), and chat chewing during pregnancy (AOR = 2.390, 95%CI(1.319,4.329) were significantly increased IBWGA births. Conclusion and recommendation: Inappropriate birth weight for gestational age was outpaced. Advanced maternal age, inadequate prenatal care, anemia, gestational diabetes mellitus and chat chewing during pregnancy are determinants of inappropriate birth weight for gestational age births. Prevention of gestational diabetes mellitus, anemia, and giving proper prenatal care may improve maternal and neonatal outcomes.
Determinants of neural tube defect among children, at zewditu memorial hospital, Addis Ababa, Ethiopia ,2018 a case control study
(Addis Ababa University, 2018-06) Aynalem, Filmawit; Aga, Fekadu (PhD Fellow)
Background: Neural tube defects (NTDs) are one of the commonest malformations with worldwide prevalence of 1-3 per1000 live births. They are resulted by failure of neural tube to close during neurulation in 21-28 embryonic days and it’s a multi-factorial in etiology. Currently in Ethiopia there is no published data regarding the determinants of NTDs. Therefore this study was used to assess the determinants of NTDs in Addis Ababa and will serve as base line reference for further studies.Objective: the objective of this study was to assess the determinant of Neural tube defects (NTDs) among children at Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Method; A hospital based unmatched case control study was conducted from November to May 2018.The sample size was determined by statistical Openepi version 3by considering 95% CL at 80% power(case to control ratio of 1:2) and gave a total of 180,out of this60 cases and 120 controls were selected by lottery method. Data was collected by structured questioner& SPSS version 23 software was used for analysis; results were summarized by descriptive statistics. Bivariate and multivariate logistic regression analysis was done at p-value < 0.05 and OR with 95% CI was used to control for possible confounders. Results: The bivariate analysis shows that oral contraceptive use, young maternal age, parental low educational status, sauna/hot tab use, passive smoking, caffeine consumption ≥3 cup/day, maternal occupation, planned pregnancy, family history of neural tube defects, fever/febrile illness, antipyretic use& being multiparous shows significant association to neural tube defects. The multivariate analysis shows that maternal fever/febrile illness (OR 65.5 CI 4.4 -957.9), family history of neural tube defects (OR 43.5 CI 1.2-1506.9), coffee consumption (OR 18.5 CI 3.7-91.1), antipyretic use (OR 0.01 CI .00 -.53) maternal age <19 (OR 33.3 CI 2.5-448.4) & 25- 29(OR 9.7 CI 1.3-67.6) shows association to neural tube defects. Conclusion: in conclusion this study shows that maternal fever /febrile illness, family history of NTDs, coffee consumption, young maternal age, were associated with the increasing risk of NTDs whereas antipyretic drug use had protective effect to NTDs. therefore periconceptional maternal screening for genetic factors and medical illness is important for women’s of child bearing age.
Emotional and behavioral problems and its associated factors among children and adolescents on highly active antiretroviral therapy in governmental public health institutions in west Gojjam zone, Amhara regional state, Ethiopia, 2018
(Addis Ababa University, 2018-06) Kefale, Demewoz; Boka, Abdesa (BSc, MSc)
Background: Children and adolescents under age 20 are projected to grow by about 33 percent accompanied with high vulnerable period for human immune virus-infection and high risk behaviors. The impact of human immune virus to emotional and behavioral problems that remains untreated may result in long-term problems. HIV-related mortality among HIV-positive children and adolescents has risen by 50% despite the scale up of antiretroviral therapy. Those with HIV are significantly more likely to have emotional and behavioral problems than the general population. This problem needs effective and safe therapies to support their emotional and behavioral development and to avoid functional impairment and social deficits. Objective: To assess the prevalence and associated factors of Emotional and Behavioral problems among children and adolescents on highly active antirethrotherapy in Governmental public health institutions in West Gojjam Zone, Amhara regional state, Ethiopia, 2018. Methods: An institutional based cross sectional study design was conducted from March 30 to April 30, 2018. Four hundred twenty three Study subjects were selected by systematic random sampling. Data was cleaned manually, coded and entered into Epi -data version 4.2 and exported to SPSS version 23 software for analysis. Descriptive statistics was used to describe the study population in relation to relevant variables. Multiple logistic regression, AOR, 95% CI and p-value<0.05 was used to identify Variables which had significant association. Result: The prevalence of EBPs in the study area was found to be 43.6%. Low age (AOR= 5.33, 95%CI: 2.56- 11.04), Having non-kin care giver other than parent and relative (AOR= 4.64, 95%CI: 1.20- 17.90),Both parental lose (AOR= 2.15, 95%CI: 1.03- 4.49), Non-disclosure of HIV sero status to self(AOR= 1.99,95%CI: 1.16- 3.41) and having distressed care giver (AOR= 1.64, 95%CI: 1.04- 2.57) were significantly associated with emotional and behavioral problems. Conclusion and recommendation: The prevalence of emotional and behavioral problems in the study area was high. Care giver mental distress, age, disclosure status, care giver type and parental lose were associated with it. Early disclosure of children for their HIV status and mental distress screen of care giver is recommended.
Factors Determining Rheumatic Fever Recurrence Among Rheumatic Heart Disease Patients Who Are Taking Monthly Benzanthine G Penicillin Prophylaxis
(Addis Ababa University, 2014) Dagmawi, Fitsum; Mekasha, Amha
Introduction: Rheumatic fever is a major cause of acquired heart disease in children worldwide, with the disease occurring most frequently in underdeveloped countries. ARF and its chronic sequela RHD remain significant causes of morbidity and mortality in Ethiopia. The main priority of long-term management of ARF or RHD is to ensure secondary prophylaxis is adhered to. Despite its importance, the rate and risk factors of rheumatic fever recurrence is not known in Ethiopian children with ARF/RHD. This study will identify ARF recurrence rates and the extent to which ARF is concentrated in certain populations based on age, sex, education, income, and types of valves involved. Objectives: The objective of this study was to identify risk factors for rheumatic recurrence in patients receiving monthly benzanthine G penicillin prophylaxis. Method: We conducted a retrospective review of medical records of 211 eligible patients with rheumatic heart disease at TASH, pediatric cardiac clinic from April /2014 to Aug. 2014. A descriptive and analytic statistics was used as applicable. Statistically significant associations were set at P-value of <0.05. Results: A total of 211 children’s medical records were reviewed. Rheumatic fever recurrence occurred in 22 (10.4%) of the 211 patients. Patients with recurrence of RF were less adherent to monthly BGP prophylaxis than patients without recurrence of RF the odds of nonadherent patients was 19.42 (odds ratio= 19.42, CI= (6.885, 54.766) P= 0.000). Non-adherence to BGP prophylaxis at any time during follow up was detected in 10.9% (23 of the 211) of study subjects. Rates of non-adherence were higher in the group of patients that were younger (27.3%, 9.6%, and 7.4% for children less than or equal to 5 year, 6 to 10 year, and 11 to 15 year of age, respectively) than in the group of patients who were older (p=0.046). Conclusion: We recommend implementation of a registry, and a system of active search of missing patients in every service responsible for the follow-up of RHD/RF patients. Measures to increase adherence to secondary prophylaxis need to be implemented formally, once non-adherence to secondary prophylaxis is the main cause of RF recurrence. Key words: Rheumatic fever recurrence, rheumatic heart disease.
Incidence and predictors of lost to follow up among children on antiretiroviral therapy at east and west Gojjam zone referral hospitals, amhara regional state, 2018: a retrospective cohort study
(Addis Ababa University, 2018-06) Fetene, Tamene; Gebremichael, Bereket (BSc, MSc)
Background: Globally, 36.7 million people were living with HIV up to midd-2017 of which 2.1 million were children less than 15 years. Antiretroviral therapy is introduced to maintain maximal suppression of viral replication, to restore immune function, to reduce HIV-related morbidity and mortality and to prolong survival. However, effectiveness of highly active ART could vary from region to region because of the difference in the retention of patients on antiretroviral therapy. Objectives: The main aim of the study is to asses incidence and predictors of lost to follow up among children on antiretroviral therapy at East and West Gojjam Zone referral hospitals, 2018. Methods: Six years of retrospective follow up study was conducted among 561 children aged less than or equal to 14 years who were newly enrolled in HIV care clinic from 1st of January 2012 to December 31, 2017 after gating ethical clearance from institutional review board of Addis Ababa University. Data was entered into and cleared using Epi-Data version 3.1 and then was exported to STATA version 14 for further statistical analysis. Kaplan Meier survival curve was used to estimate the cumulative survival time and Log rank test was used to compare the survival time between different categories of the explanatory variables. Multivariable Cox proportional hazards model was fitted to identify predictors of lost to follow up (LTFU). Results: Out of the 561 charts reviewed, 533 children records were included in the final analysis. A total of 46 new LTFU cases were observed during the 15288 Person months follow up period. Hence, the overall incidence rate of LTFU was 3.6 per 100 person years. Baseline age <1 year (AHR; 3.7, 95% CI: 1.08, 12.68), and 1-5 years (AHR:3.86, 95% CI:1.73,8.61),OIs at baseline (AHR:2.26,95%CI:(1.08,4.71),hemoglobin level<10gm/dl(AHR:3.57,95% CI:1.54,8.24),baseline malnutrition in the form of underweight(weight for age Z score (WAZ)<-2)(AHR:5.67,95%CI :2.11,15.21)were independent predictors of LTFU occurrence. Conclusion and Recommendation: The first 18th months of ART initiation is the time of high LTFU .Baseline age <1 year and 1-5 years, WAZ<-2, OIs at baseline, not taking cotrimoxazole preventive therapy and Hgb <10gm/dl were an independent predictor of LTFU. Hence, Special emphasis and close follow up should be given to patients in the first 18th months of ART initiation and to those children having the above predictors.

Browse

Browsing Pediatrics and Child Health by Title

Results Per Page

Sort Options