Pediatric Nursing

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    Prevalence and Associated Factors of Visual Impairment among Preschool Children in Selected Kindergarten Schools in Addis Abeba, Ethiopia. Cross Sectional Study
    (Addis Ababa University, 2024-04) Asmelash Kirubel; Gebre Hanna
    Background: A child's vision provides valuable information about the surrounding world. The eye problem in Ethiopia is among the major public health challenges. The prevalence of low vision and blindness in Ethiopia is 3.7% and 1.6% respectively. The America Academy of Pediatrics in its Recommendations for Preventive Pediatrics Health Care recommends for Ophthalmological evaluation to be started from the age of 3 years up to 6 years. With much visual impairment being due to either preventable or treatable causes, early detection or correction of visual problems at an early age is important. Objectives: To determine the prevalence and the associated factors of visual impairment among preschool-age children in selected Kindergarten schools in Addis Ababa, Ethiopia from September 29, 2023- October 29, 2023. Methods: Cross-Sectional Study was conducted at selected preschools located in Addis Ababa. The total sample size was estimated to be 238. A multistage sampling technique was used to select study participants. Data was collected by trained data collectors using a structured questionnaire and physical examination. Data collected was checked for completeness, cleaned and entered into SPSS version 25 for analysis. Descriptive Statistics was computed in frequency tables. Correlation analysis and Binary Logistic regression was done to assess factors affecting visual impairment. P value < 0.05 is taken as statistically significant. Result: Among the 229 pre-school children who participated in this study 12 of them had visual impairment making the prevalence of visual impairment in the selected kindergartens to be 5.28%. Maternal alcohol use during pregnancy (AOR=8.529, 95% CI (1.51-48.02)) and abnormal pen light evaluation (AOR=18.932, 95% CI (3.85-92.89)) were found to be significantly associated with visual impairment. Conclusion: This study has shown that visual impairment is prevalent in pre-school children. It has shown that screening at this age as per the recommendations of the AAP can be beneficial with many of the visual impairments being due to either preventable or treatable causes, Key terms: Visual impairment, Preschool children, childhood blindness
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    Assessment of Level of Hope of Parents of Children with Cancer and Associated Factors among Parents of Children Attending Cancer Treatment at Tikur Anbesa Specialzed Hospital, Addis Ababa, Ethiopia, 2024 G.C.
    (Addis Ababa University, 2024-01-13) Girma Lidiya; Sosina Workineh
    Background: Childhood cancer (also called pediatric cancer) typically means different type of cancers that are found in children and teens, and sometimes young adults. Childhood cancers initiate from genetic alterations in individual cells, triggering their uncontrolled growth into masses or tumors. If left untreated, these tumors can infiltrate other bodily tissues, resulting in significant harm and potentially fatal consequences. When a child is diagnosed with cancer, the impact reverberates through the entire family, with parents bearing a significant emotional, economical and psychological burden and it makes the family to lose hope. Objectives: To assess level of hope of parents of children with cancer and associated factor among children attending cancer treatment at Tikur Anbesa hospital, Addis Ababa, Ethiopia, 2024 G.C. Methods: Health facility based cross-sectional study was conducted from February 19 to March 19, 2024 G.C at Tikur Anbesa hospital, Addis Ababa, Ethiopia. The data was gathered using structured pretested questionnaires and patient chart review by using Kobo collector. Then the data was exported to SPSS version 26 for analysis. Bivariate and multivariable linear regression analyses were conducted. A p-value of less than 0.05 was considered statistically significant. Result: The overall score of hope level in parents of patients with cancer was 35.3 ± 4.68. Among them, 10 cases (4.1%) had a low level of hope , 134 cases (55.4%) had a medium level of hope, and 98 cases (40.5%) had a high level of hope. Multiple linear regression analysis revealed that coping level and health status were independent factors influencing level of hope. Conclusion: As we navigate the complexities of pediatric cancer care, it is imperative for healthcare providers and support professionals to recognize the pivotal role of hope in parental well-being. By fostering hope and providing targeted support interventions, we can empower parents to navigate the challenges of childhood cancer with greater resilience and optimism. And by addressing the phenomenon of unrealistic hope, healthcare providers and support professionals can ensure that parents are supported with realistic expectations and provided with the necessary resources to navigate the challenges of childhood cancer with resilience and dignity. Key words: Parents, Childhood cancer, Hope
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    Magnitude of Common Mental Disorders and its Association with School Performance in Adolescents Among Selected High Schools in Addis Ababa, Ethiopia
    (Addis Ababa University, 2024-10-05) Biruk Seid; Bezaye Abebe
    Background: A wide range of physical, mental, and social abnormalities are referred to as common mental disorders(CMDs), which include somatic manifestations of illnesses including depression and anxiety. Compared to adults, young people have the highest frequency of mental health issues. Up to 20% of adolescents are likely to suffer from mental health disorders. The intense pressure to perform well academically has produced a highly stressful atmosphere that, if ignored, may be harmful to students' physical and emotional well-being. Objective: To assess the Magnitude of common mental disorder and its association with academic performance in Adolescents among selected high schools Addis Ababa, Ethiopia Methods: From June 2023 to February 2024, a cross-sectional study was undertaken. Multistage sampling was used to select 828 students. A self-administered survey was used that included Self-Reporting Questionnaire 24, K10 psychological distress scale and other semi structured instruments for the screening of substance use. The data was gathered using ODK version 1.25.2 software and exported to SPSS version 25 for analysis.Bivariable and multivariable logistic regression analyses were done to identify factors associated with common mental disorders.AORswith 95% CIs were calculated and variables with a p value of 0.05 were considered as significantly associated with common mental disorders. Results: A total of 828 high school students were recruited with a response rate of 98.2%. The prevalence of CMD among the participants was 266 (32.1%).Being female[AOR=0.69; 95% CI:0.49-0.96].Being grade 11[AOR=1.91; 95% CI:1.23-2.96], grade 12[AOR=1.78; 95% CI: 1.16 - 2.73],care giver father only[AOR=2.11; 95% CI: 1.15 -3.86] &Students from low income family[AOR=2.97; 95% CI: 1.39–6.34] were statistically associated with CMD. CMD were 3 times higher in those who were in academic difficulties[AOR= 2.63; 95% CI:1.92–3.61].About 17.1% (142/828) of students use addictive substances.CMD were 2x higher in substance user as compared to the counter group [AOR=1.79; 95% CI: 1.19–2.70]. Conclusion and recommendation: The prevalence of common mental disorders & substance use was 32.1% &17.1% respectively among students. There was a strong correlation found between having a CMD and being female, having LSES, being a parent alone providing care, higher grade levels (grades 11 and 12), and substance usage. Considering these determinants, screening, early identification, and providing appropriate intervention for common mental disorders in the schools should be of great concern.key words:Prevalence,CMD, adolescent
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    Magnitude and Associated Factors of Intraventricular Hemorrhage among Preterm Neonates Admitted to Neonatal Intensive Care unit of Addis Ababa Public Hospitals in, Ethiopia, 2023 Cross sectional study.
    (Addis Ababa University, 2023) Alemu Mihret; Sebsibie Girum; Berhan Yeshiwork
    Background: Intraventricular hemorrhage is one of the most severe brain injuries in pretermneonates, especially in VLBW and ELBW, and is associated with some perinatal risk factors,such as antepartum hemorrhage, urogenital tract infections, chorioamnionitis, and some neonatalrisks, such as mechanical ventilation, continuous positive airway pressure, intubation, asphyxia,respiratory distress, sepsis, and thrombosis. Objective: To assess the magnitude of Intraventricular hemorrhage and associated factors among preterm neonates admitted to theneonatal intensive care unit of public hospitals in Addis Ababa in 2023.Method: An institution-based cross-sectional study was carried out. The final sample size was 381 preterm neonatesadmitted to selected public hospitals in Addis Ababa from February 27 to March 27, 2023. Thestudy was conducted in five randomly selected public hospitals in Addis Ababa. Data wascollected using a pretested data extraction tool (Kobo) chart reviewed by the data collector. Thecollected data was exported to SPSS version 26 for analysis. Descriptive statistics to describe thevariables were conducted for bi-variable logistic regression and multi-variable logistic regressionanalysis. Variables with a P-value < 0.05 in the multivariate analysis (final model) wereconsidered significantly associated. The tables, figures, and graphs were used to present thefindings. Result: The magnitude of Intraventricular hemorrhage was reported in 93 (25%), with37.6% of patients having grade II, which was the most frequent, followed by severe grade III(24.7%), grade IV (20.4%), and grade I (17.2%), which was the least prevalent. Our study foundthat very low birth weight (AOR: 7.45; 95% CI: 2.12, 26.21), hypothermia (AOR: 2.53, 95% CI:1.36, 4.47), Thrombocytopenia (4.03, 95% CI: 1.73, 9.40), and blood transfusion (AOR: 2.85;95% CI: 1.18, 6.90) were independent factors for Intraventricular hemorrhage. Conclusion andrecommendation: The magnitudes of Intraventricular hemorrhage were low compared to reportsof other studies in Africa and globally, while the severity of Intraventricular hemorrhage wasrelatively high. Therefore, a further large-scale study with the same title is required to understand factors associated with Intraventricular hemorrhage among preterm neonates.
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    Assessment of Postnatal Weight Gain and its Predictors among Preterm Low Birth Weight Neonates Admitted in Neonatal intensive Care unit at Selected Public Hospitals:Retrospective Study, Addis Ababa Ethiopia,2023
    (Addis Ababa University, 2023) Temesgen Afomia; Berhane Emebet; Admasu Mekonnen
    Background:Pretermlowbirthweightisoftenchallengingindevelopingcountries. Implementingspecializedcareincludingproperfeedingpracticeisessentialfor Treatingneonatestobringthemintoanormalrangeofweight.However,Thereisa Lackofresourcesforalternativefeedingpracticesinlow-Incomecountrieswhich Resultsinpoorpostnatalweightgainatdischarge.Thereisalsolittleornoevidence Ofpostnatalweightgainandtheinfluencingfactorsinethiopia Objective:Theaimofthisstudywastoassessthepostnatalweightgainandits Predictorsamongpretermlowbirthweightneonatesadmittedinneonatalintensive Careunitatselectedpublichospitalsunit,2023 Method:Aretrospectivestudywasconductedon242neonateswhowereadmitted Inneonatalintensivecareunitinthelast5years,Inaddisababaselectedpublic Hospitals.Thecalculatedsamplesizeforeachhospitalwasassignedproportionally. ThedatawerecollectedthroughstructureddataabstractionchecklistanddescriptiveAndinferentialanalysiswerecomputed.UsingdescriptivestatisticalanalysisthedataWeresummarizedinmeanandstandarddeviation(SD)Forcontinuousvariables,AndPercentagesforcategoricalvariables.AbinarylogisticregressionwasusedtoseetheRelationshipbetweendependentandpredictorsvariables.Significanceisdeclaredat. Keywords:Lowbirthweight,Preterm,Postnatalwei Ghtgain,Gestati Onalag
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    Determinants of Speech and Language Development Delay among Children inYekatit 12 Hospital, Addis Ababa, Ethiopia, 2023: a Case Control Study
    (Addis Ababa University, 2023) Yeshitila Feven; Mengistu Zuriyas
    Background: Speech and language development delay occurs when a child isn’t attaining speech and language milestones at the expected age and it can lead to poor social interaction,attention difficulties, reduced writing and reading skills, cognitive and behavioral problems. Despite increasing speech and language development delay in the country, literary works do noaddress determining factors for the delay. Objectives: The study was aimed to identify the determinants of speech and language development delay among children in Yekatit 12 Hospital, Addis Ababa, Ethiopia, 2023 Method: Institutional-based unmatched case-control study was conducted from April 5 – April30, 2023, on 50 cases and 100 controls aged between 1 and 12 years in Yekatit 12 Hospital.Interviewer-administered questionnaires were used to collect data from children’s parents or caregivers. The cases were selected consecutively while the controls were selected by simplerandom sampling. The collected data was entered by Epi info version 7 and cleaned and analyzed by SPSS version 26. Bivariate and multivariate logistic regression analysis was conducted and the significant association was identified based on the Adjusted odds ratio (AOR), with 95% CI and p-value (<0.05). Results: In this study, 50 cases and 100 control were included with a 100% response rate. The mean age of the cases was 50.84 (SD ±34.43) months while the control children’s mean age was 51.42 (SD ±32.21). Among the cases, 46% were males and 54% were females, whereas amongthe controls, 54% were males and 46% were females. Mothers of 82% of the cases and 72% ofthe control were below diploma level. Around one-third of the fathers in the cases (32%) and controls (35%) had high school and diploma and above education respectively. A significantproportion of the mothers were housewives, with 74% of cases and 69% of controls found in thiscategory. The majority of the fathers were employed or self-employed (72% of the cases and85% of the controls). Most of the participants reside in urban areas, with 82% of cases and 89%of controls falling under this category. Monthly income between 5001 to 10,000 ETB was foundin 64% of the cases and 36% of the controls. The majority of both the cases (90%) and controls(86%) had at least one sibling. More than half of the controls (57%) and a significant of thecontrols (42%) of the cases were firstborns. In both the cases and control groups, around 50% ofthe fathers age at birth were between the ages of 31 and 40. Half of the cases and 64% of thecontrols have mothers in the age group of 31 to 30 and 21 to 30 at their birth respectively.After the multivariate analysis older father’s age at birth (>40 years) [AOR=3.38, 95 CI (1.05-10.90)], birth asphyxia [AOR=4.58, 95CI (1.23-16.99)], bottle-feeding [AOR=4.54, 95CI (1.29-16.04)], mother-child separation [AOR=2.6, 95CI (1.05-6.43)], multilingual family [AOR=2.31,95CI (1.03-5.18)] and screen time of two or more hours [AOR=3.06, 95CI (1.29-7.28)]. Conclusion: Older father’s age at birth, birth asphyxia, bottle-feeding, mother-child separation multilingual family and screen time of two or more hours were found to be associated withspeech and language development delay. Thus, interventions that target the modifiabledeterminants should be devised and early diagnosis and treatment should be available
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    Assessment of Hand Hygiene Practice and Associated Factors among Health Care Workers Working in Neonatal Intensive Care Units in Selected Public Hospitals , Addis Ababa, Ethiopia, May 2023 G.C.
    (Addis Ababa University, 2023) Deressa Melat; Boka Abdissa
    Background Hand hygiene is the act of cleaning hands with water and soap and/or alcohol-based hand sanitizers to eliminate microbes. Practicing better hand hygiene decreases the spreadof illnesses linked to healthcare, it is always been considered one pillar of infection control.According to the world health organization 2019 healthcare-associated infection fact sheetreport, in underdeveloped nations, neonates are at a significant risk of getting infections relatedto healthcare. Objective: The aim of the study is to evaluate hand hygiene practice and associated factors among health care workers working in NICU of selected public hospitals, Addis Ababa,Ethiopia, 2022. Methods: A facility-based cross-sectional study design was done from March 21, 2022 - June 30, 2022. All health care workers working in selected hospital’s NICU in a study period included in the study. Data was collected through a self-administered questionnaire adapted from world health organization and a previous similar study. Data were entered into Epi dataversion 3.1 and transferred to a statistical package for social science SPSS version 20 for data analysis. Bivariate logistic regression and multivariate logistic regression used to see the association factors with dependent variable. Statistical significance was assured by a p-value<0.05. Figures, tables, and graphs were used to display the results. Results: The research included 140 healthcare personnel, with a 100% response rate. 31.4% of them practiced proper hand hygiene. Receiving training, accessibility of soap and water,personal towel/tissue, and poster near hand washing sink were found significantly associated with the dependent variable. Conclusion: There is a significant gap in hand hygiene practice by NICU health care workersin Addis Ababa. Possible explanations for this gap include a shortage of training, lack of soapand water, lack of personal towel and poster. As a result offer training as well as outfit theworkplace with resources that promote good hand hygiene.
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    Survival Status and Predictors of Mortality among under five Children with Severe Acute Malnutrition Admitted to Stabilization Centers in Selected Government Hospitals in Addis Ababa, Ethiopia,2022
    (Addis Ababa University, 2023) Nuredin Amanuel; Murugan Rajalakshm
    Background: Malnutrition is a medical disorder that causes the body's physical functioning to deteriorate due to an imbalance, shortage, or excess of energy and/or nutrients. Nearly a quarter of the world's malnutrition was found in Sub-Saharan Africa, and undernutrition was responsible for roughly half of all under five children mortality. Among different types of malnutrition, severe acute malnutrition is a major killer and a serious public health issue thatrequires attention, especially when complicated, because it causes morbidity and shortens thesurvival of children under the age of five. Objective: The aim of this study was to assess the survival status and predictors of mortality among children under the age of five admitted with severe acute malnutrition in selected government hospitals in Addis Ababa, Ethiopia, 2022. Method: A hospital-based retrospective cohort study was carried out on 422 severely malnourished children who had been admitted to four selected hospitals in the last three years.The study unit was selected using a systematic sampling technique, and a structured questionnaire was gathered using an open data kit collect app. Using STATA version 17, the analysis was carried out. The Kaplan-Meier survival curve and the log-rank test were used todescribe the survival function and each predictor. To find the independent factors affectingmortality, a bivariate and multivariate cox proportional hazard regression model was used. Result: In this study 44(10.4%) died with an incidence rate of 10.3%/1000 person days. Themedian hospital stay was 8 days and vaccination status (AHR=0.227,95%CI,0.088-0.583),Feeding 75(AHR=0.20195%CI,0.062-0.651), supplement, Intra venous fluid administration (AHR=3.65295%CI,1.525-8.743), presence of Human Immune deficiency virus(AHR=2.159,95%CI,1.001-4.65),pneumonia(2.15995%CI,1.001-4.65), and shock(AHR=3.47595%CI,1.451-8.321) were identified as significant predictors of mortality. Conclusion: The recovery rate was found to be within the social and public health economicsstudy group's acceptable range, although the mortality rate was only slightly beyond it. Anumber of factors, including vaccination, the human immunodeficiency virus, pneumonia,shock, intravenous fluid administration, and not taking supplements like Feeding 75, wereindependent predictors of mortality.
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    Human Papillomavirus Second dose Vaccine uptake and its Associated factors among Adolescent Girls in Worabe,2023. Mixed Study.
    (Addis Ababa University, 2023) Mamuye Ephrem; Wordofa Berhanu; AlemuTsion
    Background; Cervical cancer is caused by HPV and it is the primary cause of illness andmortality in females around the globe. It ranks the second most common cancer-related cause ofdeath for women in Ethiopia. Although ministry of Health recommends two doses of HPVvaccine, the uptake status of HPV-2 is very low as compared to HPV-1 that hinder of the fullprotection from HPV Infection. Objectives: To assess the uptake of second dose HPV vaccine and factors associated with itamong adolescent girls in Worabe town, Southern Ethiopia, 2023. Methods: Institution-based mixed study design was conducted from February 20 to March 20,2023. A total of 406 female students were recruited by computer generated simple random sampling for quantitative study and 8 female students were recruited by purposive samplingmethod for qualitative study and data saturation was used as a guide to decide number of participants. The data was entered into Epi Data version 4.6. and analyzed by the use of SPSSversion 26 for quantitative data and manual thematic analysis was done for qualitative data. Tofind associations, both bivariate and multivariate logistic regression analysis were used. Result: At all a lower level 128(31.5%) of adolescent girls had received second dose HPVvaccine. Primary educational level of adolescents[AOR =3.70, 95%CI:(1.58-8.68)], fathers who had no formal education [AOR=0.12,95%CI:(0.03-0.52)], fathers attended primary educationallevel [AOR=0.30,95%CI:(0.14-0.67)], not aware towards HPV-2[AOR=0.46,95%CI:(0.24-0.89)],poor knowledge of HPV and its vaccine[AOR=0.57,95%CI:(0.33-0.99)] and negative attitudetowards HPV vaccine[AOR =0.37,95%CI:(0.21-0.65)] were the factors associated with the uptakeof HPV-2 in the quantitative study. In addition to this poor perception of severity, lack of pre-information, lack of awareness of the gap between HPV-1 and HPV-2, absence of health workerfor the second vaccine, fear of injection, fear of side effects, misunderstanding about HPV vaccineand poor awareness of HPV-2 were the explored factors in the qualitative study. Conclusion and Recommendation; Generally, there was low uptake of second dose HPV vaccinein the study area. Therefore, in order to increase second dose HPV vaccination uptake level,awareness raising and behavior modification education are essential in the community.
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    Knowledge and Practice of Oxygen Therapy and its Associated Factors among Nurses working in Pediatric Unit of Selected Hospitals in Hawassa City,Ethiopia
    (Addis Ababa University, 2023) Berhanu Bezawit; Murugan Raja; Admasu Mekonnen
    Background: - Oxygen is one of the most essential medications. Oxygen therapy is a medicalprocedure used to treat tissue hypoxia. It has the potential to improve medical outcomes andsave lives when used correctly, but it can also cause harm when wrongly used. However, thereis limited evidence on nurses’ knowledge of oxygen therapy in the study area. Therefore, thisstudy fills the research gap. Objective: The objective of this study is to assess the knowledge and practice of oxygentherapy and its associated factors among nurses working in a paediatric unit in selectedhospitals in Hawassa. Method: - An institutional-based cross-sectional study design was employed during February27–March 27, 2023 in six selected hospitals among 174 nurses working in paediatric units. Asimple random sampling technique and self-administered structured questionnaire was usedfor data collection. Data was entered and analysis was done with Epi-data 3.1 and SPSS v26,Frequency and percentages were expressed in texts, tables, and charts, whereas logistic regression was conducted to check the association of dependent variables with factors andvariables. A p-value ≤ 0.05 in multivariate analysis was considered significant in the 95% CI. Results: The ages of the study subjects were in the range of 23–49. The mean age was 30.6(SD = 4.8 years). The knowledge and practice levels of the study participants in oxygentherapy were 55.7% and 51.1%, respectively. The factors associated with knowledge ofoxygen therapy among nurses were educational level of degree [AOR: 0.108; 95% CI (0.012–0.98)] and training [AOR: 4.07; 95% CI (1.8–9.2)] and practice being diploma [AOR: 0.04;95% CI (0.004–0.05)], training [AOR: 3.77; 95% CI (1.48–96)] were significantly associatedfactors in the p value of less than 0.05. Conclusion: The knowledge and practice level of nurses towards oxygen therapy were poor.Therefore, this study recommended that nurses who are all working in paediatrics units must receive training to update the KP oxygen therapy.
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    Survival Status and It’s Associated Factors Among Under Five Children Managed with Congenital Heart Diseases in Tikur Anbessa Specialized Hospital and Cardiac Center, Addis Ababa, Ethiopia, 2022/2023: A Retrospective Cohort Study
    (Addis Ababa University, 2023) Suyum Daba; Sebsibie Girum
    Background: Congenital heart disease CHD is the most prevalent significant congenitalabnormality, affecting around 9 out of every 1000 live infants. The aggregated 1-year and 5-year survival rates for patients with congenital heart disease from 6 and 8 studies for all CHDwere 87.0% and 85.4%, respectively. Objective: The purpose of this study is to assess survival status and related factors amongunder-five infants with congenital heart disorders treated at TASH, Addis Ababa, Ethiopia,and Cardiac Centre from January 2018 to December 2022. Methods: An Institution based retrospective follow-up study design was used among under-five children managed with congenital heart disease that were admitted at TASH and CardiacCenter, Ethiopia; registered from Jan 2018 to Dec 2022. Data was collected by pretestedchecklist from 224 randomly selected charts. The Kaplan-Meier survival analysis, the log-ranktest, and the effect of each covariate on mortality using cox proportional hazard are used to measure survival status in various groups. For data analysis, SPSS version 26 was employed. Result : Total of 224 charts with 95.32% response rate were analyzed to determine survival status and associated factors of under-five children managed with CHD and 34 of them died whereas 190 of them were censored during the study period. The survival status of all infants born with CHD in this study was 84.8% to five years. Cox regression analysis identifiedcovariates significantly associated with mortality as weight at admission (AHR 19.023,95% CI[2.542,142.925]; P = 0.004), types of interventions (AHR73.016,95% CI [3.226,1652.2]; P =0.007), pre-operative condition (AHR 65.097,95% CI [11.322,374.25]; P =0.0001), familyhistory of heart disease (AHR 10.81,95% CI [2.218,52.673]; P = 0.003), maternal history ofsubstance use (AHR 46.67,95% CI [4.405,494.31]; P = 0.001) and maternal history of viral infection (AHR 52.034,95% CI [7.320,369.83]; P< 0.0001). Conclusion and recommendation: The survival status of all infants born with CHD in thisstudy was 84.8% to five years. Weight at type of interventions, preoperative condition, othermaternal condition are associated with survival. The early cardiac intervention and priority for critical CHD are among recommendation to improve survival.
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    Time to Recovery from Diabetic Ketoacidosis and its Predictors among Children with type 1 Diabetes at Selected Governmental Hospitals in Addis Ababa, Ethiopia, 2023: Retrospective Follow-up Study
    (Addis Ababa University, 2023) Tefera Shimeles; Gebreyohannis Tigistu
    Background: Diabetic ketoacidosis (DKA) is one of the most severe clinical features of diabetesmellitus, which can result in morbidity and mortality. The prevalence of DKA is increasingworldwide and nationwide. There is a discrepancy of time to recovery from DKA betweendeveloped and developing country. The Ethiopian government aims to decrease prematuremortality from noncommunicable diseases, including diabetes, by one-fourth by 2025. To achievethis target plan, more research should be conducted in this area. Objective: To assess time to recovery from DKA and its predictor among children with diabeticketoacidosis at selected governmental hospitals in Addis Ababa, Ethiopia, 2023 Methods: A five years retrospective follow-up study design was employed among 391 childrenadmitted with DKA to selected governmental hospitals in Addis Ababa, Ethiopia from January 1,2018 to December 30, 2022. Simple random sampling technique was used to select the hospitalsand participants. Preliminary survey of the study hospitals was done to determine flow and thesample was proportionally allocated. Structured data collection checklist was adapted from similarstudies in the literature. Data was checked for completeness, and exported into Stata version 16for analysis. A variable with P value < 0.05 in the multivariate Cox proportional hazards modelwas considered as significant predictors of time to recovery from DKA. Results: a total of 391 (92.4%) children with DKA were included in the final analysis. Out ofthese 370, recovered and discharged. The left 21 cases were censored. The overall median timetaken for resolution of DKA was 27hrs, IQR (16-38). DM history (AHR=0.41, 95% CI:0.30-0.56),severity of DKA (AHR=2.35, 95% CI:1.36-4.1), presence of comorbidity (AHR=1.76, 95%CI:1.37-2.26), and blood sugar level were (AHR= 0.61, 95% CI:0.39-0.96) all independentpredictors of time to recovery from DKA. Conclusion: Though the total median time to recovery from DKA was in the accepted range(<36hrs), it was significantly associated by the identified predictors in this study. Thus, increasingpublic awareness on symptoms of DKA, giving emphasis, enhancing quality of care, prioritize andtreating children with identified predictors is important.
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    Quality of Pediatrics Emergency Triage and Associated Factors Nurses Working at Pediatric Unit of Public Hospital in Addis Ababa,Ethiopia: Institutional Based Cross-Sectional Study
    (Addis Ababa University, 2023) Endris Seid; Murugan Rajalakshmi
    Background: Triage is a way of categorizing patients based on their specific needs and theresources available to treat their medical condition. Since misclassifying high-urgency patients aslow urgency levels slows diagnosis and treatment, which may raise the risk of morbidity orfatality, the proper categorization of high-urgency patients is crucial for patient safety. Objective: To assess the quality of triage and associated factors among nurses working inpediatrics units of public hospitals in Addis Ababa, Ethiopia. Method: Institutional-based cross-sectional study design was used to conduct this study inselected public hospitals of Addis Ababa from March 3 to 27, 2023. The sample size wasdetermined by single population proportion formula by using correction formula and a total of165 samples were included in the study. Data was collected by using a self-administeredquestionnaire and observational checklist and then the data was coded, entered, and cleaned byEpi data version 4.6 and exported to IBM SPSS Version 26 for analysis. . Bivariate logisticregression analysis was used to check variables association with dependent variable individually.Variables found to have association with the dependent variable (p-value up to 0.25) were entered in to multiple logistic regression models for further analysis. Significant association wasconsidered with a P- value of 0.05 and confidence interval of 95%. Result: This study has a 100% response rate and the quality of pediatric emergency triage is31.5%. Only 52 (31.52%) respondents have good quality on triage whereas the majority113(68.48%) have poor quality. Level of qualification (AOR = 4.72, 95% CI (1.19 – 18.7)),Working experience (AOR=0.16, 95% CI (0.05-0.57)), Triage knowledge (AOR=0.02, 95% CI(0.003-0.08)), Training on ETAT (AOR= 0.02, 95% CI (0.002-0.13)), Time taken to triagepatient (AOR=0.003, 95% CI (0.000-0.3)) were strongly associated with outcome. Conclusion and Recommendation: The overall quality of Pediatric emergency triage servicesin the study area was poor. To increase triage quality, it is essential to teach nurses on ETAT+guidelines, and additional research on patient is preferable to increase triage quality
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    Survival Status and Predictors of Mortality among Neonates Admitted with Hyperbilirubinemia in Neonatal Intensive Care units of Public Hospitals in Addis Ababa, Ethiopia, 2023
    (Addis Ababa University, 2023) keto Terefe; Aga Fekaduh
    Background: Neonatal jaundice is a major cause of neonatal intensive care unit admission and isone of the leading causes of morbidity in neonate. However, little is known about the time to deathand its predictors among neonates with hyperbilirubinemia. Therefore, this study aimed to assesssurvival status and predictors of mortality among neonates admitted with hyperbilirubinemia inneonatal intensive care units of public hospitals in Addis Ababa. Methods: This retrospective cohort study was conducted in public hospitals in Addis Ababa,Ethiopia, and included 380 neonates admitted with hyperbilirubinemia from January 2021 toDecember 2022. The data was collected from patient cards using a simple random samplingmethod with a pretested checklist between March 16 and April 16, 2023. Data entry was performedusing Kobo toolbox, and analysis was conducted using SPSS version 26. Kaplan Meier analysiswas used to estimate the median survival time and cumulative probability of survival, while thelogrank test was used to compare survival curves among different predictor groups. Therelationship between independent and outcome variables was analyzed using the Cox proportionalhazard regression model, with statistical significance set at a p-value of <0.05 and a 95%confidence interval. Results: The overall incidence density of mortality was 18 per 1000 person-day observations (CI:13-25) with 1980 follow-up days. Several factors were identified as significant predictors ofmortality, including maternal age below 20 years (AHR = 18.2, 95% CI: 3.2–102.7), living in arural area (AHR = 4.16, 95% CI: 1.64-10.52), premature rupture of membranes (AHR = 3.49, 95%CI: 1.14-10.66), gestational age below 37 weeks (AHR = 7.3, 95% CI: 1.84-28.8), birth weightbelow 2500gm (AHR = 15.1, 95% CI: 3.85-59.5), requiring both phototherapy and exchange bloodtransfusions (AHR = 48.6, 95% CI: 7.30-323.4), and presence of sepsis (AHR = 3.03, 95% CI:1.17-7.9). Conclusion: The neonatal mortality among neonates admitted with hyperbilirubinemia in Addis Ababahospitals is high. This suggests that there is a room for improvement in order to meet the 2030 WHOtarget of 12 or less deaths per 1,000 live births. Therefore, special emphasis should be given forneonates who were born from mother whose age is <20 years and from rural settings, present withPROM and neonates with GA <37 weeks, Birth weight <2500gm and neonates with sepsis
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    Knowledge, Atitude, Practice and Associated Factors towards Newborn Resuscitation among Graduating Health Science Students of Health Science Colleges in Hadiya Zone Southern Ethiopia, 2023
    (Addis Ababa University, 2023) Oshine Woldetsadik; Murugan Rajalak
    Background: Neonatal resuscitation is a set of actions taken at the time of birth to help in thereestablishment of breathing and circulation. In the first four weeks of life, more than 2.4 millionnewborn babies die globally, of which newborn asphyxia is the main cause of their deaths. Poorknowledge and skill neonatal resuscitation by practitioners has a visible negative effect onneonates like bronchopulmonary dysplasia, neurodevelopmental delay and pneumothorax. But there is no evidence about health science students' competence in neonatal resuscitation. Objective: To assess knowledge, attitude, practice and associated factors toward neonatal resuscitation among graduating students of health science college in Hadiya Zone, Southern Ethiopia, 2023. Method: An Institution based cross-sectional design was used to conduct the study among 213graduating health science students from February 27 to March 27, 2023. A simple random sampling technique was used and data was collected using self-administered structuredquestionnaire. Data entry and analysis were done with Epi-data 3.1 and SPSS 27. Frequency and percentages were expressed in texts, tables and charts whereas logistic regression was conducted to check the association of dependent variables with factors and variables. A p-value< 0.05 in the regression model was considered significant. Result: The respondents neonatal resuscitation knowledge was 58.2%, and their attitude and practice were 53.1% and 55.9% respectively. Simulation based demonstration teaching was asingle factor which has significant effect on the good knowledge and practice of the students incommon with [AOR: 0.377, 95%CI: (0.19-0.73)] and [AOR: 0.28, 95%CI: (0.145-0.53)], respectivelyand educational level on knowledge [AOR: 3.49, 95%CI: (1.24-9.7)] and on the attitude ofstudents towards neonatal resuscitation. Conclusion: Knowledge, attitude and practice of graduating health science students toward newborn resuscitation were poor therefore adequate simulation-based class and demonstration in well-equipped set up was needed to improve the participant’s knowledge, attitude practicetoward neonatal resuscitation.
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    Perceived Anxiety and Self-Confidence among Undergraduate Nursing Students During Clinical Practice in Selected Colleges Providing Nursing Studies in Addis Ababa, Ethiopia, 2023.
    (Addis Ababa University, 2023) Gebreegziabher Ayush; Wordofa Berhanu
    Background:.Anxiety is described as a sensation of impending dread and a connection ofemotions in circumstances that cause anxiety because a bad thing could happen, while also takinginto account one's perception of one's abilities. Self-confidence is the belief and feeling ofconfidence in one's abilities and capabilities to plan and carry out the courses of action necessaryto achieve goals. Objective: To assess perceived anxiety and self-confidence among undergraduate nursingstudents during clinical practice in selected colleges providing nursing studies in Addis Ababa,Ethiopia 2023. Methods: A institutional-based cross-sectional study design was employed to assess perecivedanxiety and self-confidence among undergraduate nursing students during clinical practice. 293 students were enrolled. Six nursing colleges were selected by simple random sampling technique.The students were chosen by a simple random sampling method from each college proportionally.Data was collected using a self-administered semi-structured questionnaire through NASC-CDM.It was entered into Epidata 4.6 and then exported to SPSS version 26.0 for final analysis. Bivariateanalysis at a P-value of 0.25 and multivariate analysis at a P-value of 0.05 was applied. Result: A total of 275 students participated in this study. The proportion of perceived good self-confidence of nursing students during clinical practice was 49.1% and for perceived anxiety was46.9%. The sex of the students, the thinking of clinical instructors were prepared well duringclinical attachments, think of the shortage of staff in the hospital affect clinical learning, and theperceived self-confidence of nursing students were significant predictors of the perceived anxietyof the students. The students who had poor perceived self-confidence were 5 times more likely tobe more anxious than those having good perceived self-confidence Conclusion and recommendation:. This research strongly recommends that students should bemotivated and evaluated regularly for anxiety and self-confidence during clinical practice.
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    Knowledge, Atitude and Practice of Parents Towards their Children Oral Health and its Influence on the Dental Caries Status of 6-12 Years old School Children in Public Health Facilities of Butajira Town, Ethiopia, 2023
    (Addis Ababa University, 2023) Bamud Mohammed; Tsige Yosief
    Background: Children's oral health is greatly influenced by parents' oral health care knowledge,attitude, and practice. In Ethiopia, children's oral health has received minimal attention, and littleis known about KAP of parents towards oral health. Objectives: The aim of this study was to assess the knowledge, attitude, and practices of parentstoward their children oral health and its influence on the dental caries status of 6-12 years old schoolchildren in public health facilities of Butajira town, Ethiopia, 2023. Methods: A cross-sectional study was conducted from February 27/2023 to March 27/2023among parents with their 6-12 years old schoolchildren who visited public health facilities ofButajira town. A total of 371 parents with their 6-12 years old child were taken through a simplerandom sampling technique using table of random numbers. Data was collected through face toface interview of parents using the questionnaire to assess KAP towards their children oralhealth. Dental examination of the children was done using DMFT and deft index to assess thedental caries status. The data was entered into Epi-data (version 4.6.0.6) and exported to SPSS(version 21.0). Student’s independent T-test was used to test the association between dentalcaries status and KAP. A P-value of < 0.05 was considered to be statistically significant. Results: Majority (69.5%) of parents in the study showed poor KAP. The prevalence of dentalcaries among 6 to 12 years of age in study population was found to be 85.4% in primarydentition by deft index while it was 78% in permanent teeth by DMFT index. The mean DMFTwas 2.19(±1.793) and mean deft was 6.12(±3.399). As KAP increased there was decrease inDMFT and deft score. The association between KAP and DMFT score was statisticallysignificant (P-value = 0.001) while the association between KAP and deft score was notstatistically significant (P-value = 0.452). Conclusion: Majority of parents in the study had poor KAP and parental KAP was in inverserelationship with DMFT and deft score of the child. Recommendations: It is evident that the data gathered from this study stresses upon conductingoral health educational programs directed towards parents.
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    Knowledge,Practice and Associated Factors Towards Prevention of Hospital Acquaired Infection among Nurses Workin in Neonatal intensive Care units of Addis Ababa,Ethiopia,2022.
    (Addis Ababa University, 2023) Alemayehu Feven; Ayalew Yohanne
    Background: The most common cause of morbidity and mortality in neonatal intensive careunits around the world is nosocomial or healthcare associated infections. Up to 40% ofreported neonatal mortality in developing countries is attributed to nosocomial infections,which have a 30% incidence in neonatal critical care units. Objective: The aim of this study was to assess knowledge, practice and associated factors towards prevention of hospital acquired infection among nurses working in neonatal intensive care unit of selected governmental hospitals Addis Ababa, Ethiopia. Method: Hospital based cross-sectional study was conducted from March 21 – April 21,2022. Census method was used to obtain the study participants and self-administered questionnaires were used to collect data from 155 participants in selected five governmentalhospitals in Addis Ababa, Ethiopia. Data was entered using EPI info version 7.0 statisticalsoftware and analyzed using SPSS version 26 statistical package. Bivariate andmultivariable logistic regression analysis was also carried out to identify factors associatedwith the dependent variable. A p-value less than 0.05 were used to declare statisticalsignificance. Result: Around half (53.5%) of nurses were found to have good knowledge and 56.9% ofrespondents demonstrated a good practice on infection prevention. Reading guide lines,receiving formal training, working experience, marital status, availability of personalprotective equipment and hand hygiene equipment, and availability of infection preventionguide lines were significantly associated (P < 0.05) with knowledge and practice of nursestowards prevention of hospital acquired infection. Conclusion and Recommendation: About more than half of nurses had good knowledge and good practice on hospital acquired infection prevention. This implies significant proportion of nurses had poor knowledge and practice towards prevention of infection. Therefore,institutions should provide trainings and improving sustainable supplies like personalprotective equipment and hand washing equipment, and encouraging nurses to read and useinfection prevention guideline.
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    Knowledge and Practice Towards Medical Waste Mangment and its Associated Factors among Health Care Workers at Public Hospitals Addis Abeba Ethiopia
    (Addis Ababa University, 2021-05) Mulat Habtemariam; Argaw Argaw
    In Ethiopia, medical waste management has become a problem due to an ever-increasingnumber of hospitals, clinics, diagnostic laboratories and other health care services.Although health care workers are one key personnel for the proper management of medicalwastes at any health facilities, their level of performance depends on their level ofknowledge, practice and some related factors regarding medical waste management. AQuantitative institutional based cross sectional study and a qualitative observational studywas conducted and a total of 627 health care workers from 4 public hospitals at AddisAbaba, Ethiopia, were included. Study participants were allocated proportionally based onthe number of healthcare workers from each hospital and profession. Data were collectedusing pre-tested self-administered structured questionnaires and observational checklists.The collected data was analyzed using SPSS version25.0. Multivariable logistic regressionmodel was used to identify factors associated with knowledge and practice of healthcareworkers. Out of the total respondents, 52.7% and 51.5% of health care workers hadadequate knowledge and adequate practice towards medical waste management,respectively. Hospital working hours of 8 per day [AOR=1.5, 95% CI (1.09, 2.18)],Getting MWM information from guidelines [AOR=1.54, 95% CI (1.087, 2.189)] andadequate practice score [AOR = 2.14, 95% CI (1.50, 3.02)] were significantly associatedwith the knowledge level of health care workers. On the other hand, HCWs working atSaint peter hospital [AOR=4.1, 95%CI (2.78-7.75)], professional categories,Doctors[(AOR=3.8,95%CI(1.2-12.70],Nurse[(AOR=4.4(1.38-13.8)]MTs [(AOR=9,95%CI(2.3-44.9)], getting medical waste management information from training[AOR=2.1,95%CI(1.58-3.50), getting medical waste management information fromothers[(AOR=0.49,95%CI(0.25,0.95)], presence of MWM guidelines inhospital[(AOR=1.73, 95%CI(1.04,2.88)] and adequate knowledge score[(AOR=2.10,95%CI(1.45-3.048)] were significantly associated with practice level ofhealth care workers. In this study, both knowledge and practice level of health care workerstowards medical waste management were not satisfactory. To improve better, proper and intensive job training is recommended.
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    Adherence to Diabetes Self –Management and Associated Factors among Adolescents with Type 1 Diabetes in Public Hospitals of Addis Ababa, Ethiopia, 2021.
    (Addis Abeba University, 2021-06) Muse Yomilan ; Wondwossen Kalki; Adimasu Mekon
    Background: Type 1 diabetes is one of the quickly growing problems in Ethiopia. Adherence to diabetes self-management of adolescents with type 1 diabetes is crucial for the control of type 1 diabetes to diminish mortality and morbidity. Prove of level of adherence to diabetes self management and associated factors in adolescents with type 1 diabetes in Ethiopia is unknown. Objectives: To determine adherence to diabetes self-management and associated factors among adolescents with type 1 diabetes in public hospitals of Addis Ababa, Ethiopia, from March 10 to April 25, 2021. Method: Institutional based cross-sectional study was done in four arbitrary chosen public hospitals of Addis Ababa. Systematic random sampling technique was used to select a total of 422 participants. A structured and pretested questionnaire was prepared and interview technique was used for data collection. The data was collected by utilizing Kobo collect version 1.30.1 and exported to excel for checking and cleaning. Later the data was exported to SPSS version 25 for analysis. Descriptive statistics, bivariable and multivariable logistic regression analysis was performed. Results: With 98.1% response rate, a total of 414 diabetic adolescents were interviewed. About 218 participants (52.7%) had poor adherence to overall diabetes self-management. The prevalence of poor adherence to insulin administration, dietary management, management of hypoglycemia, blood glucose testing, and regulation of exercise were 56.8%, 68.4%, 42%, 54.8% and 50.5% respectively. Self-efficacy (AOR=8.7, 95% CI: (1.9, 14.1) and P=0.005), social support (AOR=4.6, 95%CI: (1.5,13.5) and P=0.006), age (AOR=0.2, 95%CI: (0.1,0.4) and P=0.001), good knowledge of the disease (AOR=9.046, 95%CI: (3.83,13.5) and P=0.000), moderate knowledge (AOR=6.763, 95%CI: (2.18,12.921) and P=0.001), and time since diagnosis of type 1 diabetes (AOR=0.1, 95%CI:(0.02-0.2) and P=0.005) were significantly associated with adherence to diabetes self-management. Conclusions and Recommendations: More than half of the participants had poor adherence. Planning a comprehensive rule of adherence and expanding the recurrence of follow-up visits in diabetic clinics were profoundly suggested. Keywords: Adherence, Self-management, Adolescents