Pediatric Nursing

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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(PhD); ,Berhan, Yeshiwork
Background: Intraventricular hemorrhage is one of the most severe brain injuries in preterm neonates, especially in VLBW and ELBW, and is associated with some perinatal risk factors, such as antepartum hemorrhage, urogenital tract infections, chorioamnionitis, and some neonatal risks, 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 the neonatal 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 neonates admitted to selected public hospitals in Addis Ababa from February 27 to March 27, 2023. The study was conducted in five randomly selected public hospitals in Addis Ababa. Data was collected using a pretested data extraction tool (Kobo) chart reviewed by the data collector. The collected data was exported to SPSS version 26 for analysis. Descriptive statistics to describe the variables were conducted for bi-variable logistic regression and multi-variable logistic regression analysis. Variables with a P-value < 0.05 in the multivariate analysis (final model) were considered significantly associated. The tables, figures, and graphs were used to present the findings. Result: The magnitude of Intraventricular hemorrhage was reported in 93 (25%), with 37.6% 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 found that 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 and recommendation: The magnitudes of Intraventricular hemorrhage were low compared to reports of other studies in Africa and globally, while the severity of Intraventricular hemorrhage was relatively high. Therefore, a further large-scale study with the same title is required to understand factors associated with Intraventricular hemorrhage among preterm neonates.
AssessmentofPostnatalWeightGainAndItsPredictorsAmong Preterm Low BirthWeightNeonatesAdmitted InNeonatalIntensiveCareUnitAt Selected Public Hospitals:Retrospective Study,Addis Ababa,Ethiopia,2023
(Addis Ababa University, 2023) Temesgen, Afomia; Berhane, Emebet(Ass. prof.); Admasu, Mekonnen
Background:Preterm low birthweightisoftenchallengingindevelopingcountries. Implementing specialized care including properfeeding practice isessentialfor treatingneonatestobringthem intoanormalrangeofweight.However,thereisa lackofresourcesforalternative feeding practicesinlow-income countrieswhich resultsinpoorpostnatalweightgainatdischarge.Thereisalsolittleornoevidence ofpostnatalweightgainandtheinfluencingfactorsinEthiopia Objective:theaim ofthisstudywastoassessthepostnatalweightgainandits predictorsamongPretermLowBirthWeightneonatesadmittedinneonatalintensive careunitatselectedpublichospitalsunit,2023 Method:ARetrospectivestudywasconductedon242neonateswhowereadmitted inneonatalintensivecareunitinthelast5years,inAddisAbabaselectedpublic hospitals.Thecalculatedsamplesizeforeachhospitalwasassignedproportionally. Thedatawerecollectedthroughstructureddataabstractionchecklistanddescriptive andinferentialanalysiswerecomputed.Usingdescriptivestatisticalanalysisthedata weresummarizedinmeanandstandarddeviation(SD)forcontinuousvariables,and percentagesforcategoricalvariables.Abinarylogisticregressionwasusedtoseethe relationshipbetweendependentandpredictorsvariables.Significanceisdeclaredat P-value<0.05,andreportedusingAORwith95%CI Result The242samplewasanalyzed83.5%ofthe hadpoorpostnatalweightgainwiththe averageweightgainof9.77±5.602g/kg/dayafterregainofbirthweight.Neonates withoutRDS[AOR=4.155%CI(1.630-10.590)],neonatesreceivedfeedingonthefirst dayoflife[AOR=3.292%CI(1.308-8.300)],neonatesbornViaSVD[AOR=8.082(2.414- 27.259)],neonatesprolonged stayofhospital[AOR=.754% CI(.662-.839)]show statisticalsignificancewithadequatepostnatalweightgain Conclusion:Accordingtothefindingsofthisstudyindicatesthatpostnatalweightgainforpreterm low birthweightneonateswaslowerthanstandard weightgain.Modeofdelivery, initiationtimeoffirstfeeding,andrespiratorydistresssyndromelengthofhospitalstay were factorsassociated with postnatalweightgain.Therefore health professionals shouldbeabletoputtheneonateintrophicfeedinginthefirstday,preventprolonged hospitalstay,encouragemothertodeliverviaspontaneousvigainaldelivery,prevent respiratorydistresssyndrome.
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,Zuriyash(BSc, MSc, PhD),Tilahun,Sosina W (BSc, MSc)
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 not address 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 – April 30, 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 simple random 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 among the controls, 54% were males and 46% were females. Mothers of 82% of the cases and 72% of the 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 significant proportion of the mothers were housewives, with 74% of cases and 69% of controls found in this category. The majority of the fathers were employed or self-employed (72% of the cases and 85% 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 found in 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 the controls (42%) of the cases were firstborns. In both the cases and control groups, around 50% of the fathers age at birth were between the ages of 31 and 40. Half of the cases and 64% of the controls 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 with speech and language development delay. Thus, interventions that target the modifiable determinants should be devised and early diagnosis and treatment should be available
Assessment of Hand Hygine Practice and Associated Factors among Health Care Workers Working inNeonatal Intensive Care Units inSelected Public Hospitals , Addis Ababa, Ethiopia, May 2023 G.C.
(Addis Ababa University, 2023) Deressa,Melat; Boka,Abdissa(Ass. Prof.),Tesfayes,Tewodros(Ass. Prof.)
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 spread of 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 sheet report, in underdeveloped nations, neonates are at a significant risk of getting infections related to 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 data version 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 workers in Addis Ababa. Possible explanations for this gap include a shortage of training, lack of soap and water, lack of personal towel and poster. As a result offer training as well as outfit the workplace with resources that promote good hand hygiene.
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,Rajalakshmi (PhD, Ass. Prof.), W,Sosina(MSc)
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 that requires attention, especially when complicated, because it causes morbidity and shortens the survival 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 to describe the survival function and each predictor. To find the independent factors affecting mortality, 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. The median 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 economics study group's acceptable range, although the mortality rate was only slightly beyond it. A number of factors, including vaccination, the human immunodeficiency virus, pneumonia, shock, intravenous fluid administration, and not taking supplements like Feeding 75, were independent predictors of mortality.
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; Alemu,Tsion
Background; Cervical cancer is caused by HPV and it is the primary cause of illness and mortality in females around the globe. It ranks the second most common cancer-related cause of death for women in Ethiopia. Although ministry of Health recommends two doses of HPV vaccine, the uptake status of HPV-2 is very low as compared to HPV-1 that hinder of the full protection from HPV Infection. Objectives: To assess the uptake of second dose HPV vaccine and factors associated with it among 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 sampling method 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 SPSS version 26 for quantitative data and manual thematic analysis was done for qualitative data. To find 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 HPV vaccine. 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 educational level [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 attitude towards HPV vaccine[AOR =0.37,95%CI:(0.21-0.65)] were the factors associated with the uptake of 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 worker for the second vaccine, fear of injection, fear of side effects, misunderstanding about HPV vaccine and 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 vaccine in 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.
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,Rajalakshmi (PhD,Associate professor); Admasu,Mekonnen (Lecturer)
Background: - Oxygen is one of the most essential medications. Oxygen therapy is a medical procedure used to treat tissue hypoxia. It has the potential to improve medical outcomes and save lives when used correctly, but it can also cause harm when wrongly used. However, there is limited evidence on nurses’ knowledge of oxygen therapy in the study area. Therefore, this study fills the research gap. Objective: The objective of this study is to assess the knowledge and practice of oxygen therapy and its associated factors among nurses working in a paediatric unit in selected hospitals in Hawassa. Method: - An institutional-based cross-sectional study design was employed during February 27–March 27, 2023 in six selected hospitals among 174 nurses working in paediatric units. A simple random sampling technique and self-administered structured questionnaire was used for 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 and variables. 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 oxygen therapy were 55.7% and 51.1%, respectively. The factors associated with knowledge of oxygen 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 associated factors 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.
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 (BScN, MSc, PHD),Berhan,Yeshiwork (BScN, MSc)
Background: Congenital heart disease CHD is the most prevalent significant congenital abnormality, 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 CHD were 87.0% and 85.4%, respectively. Objective: The purpose of this study is to assess survival status and related factors among under-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 Cardiac Center, Ethiopia; registered from Jan 2018 to Dec 2022. Data was collected by pretested checklist from 224 randomly selected charts. The Kaplan-Meier survival analysis, the log-rank test, 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 identified covariates 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), family history of heart disease (AHR 10.81,95% CI [2.218,52.673]; P = 0.003), maternal history of substance 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 this study was 84.8% to five years. Weight at type of interventions, preoperative condition, other maternal condition are associated with survival. The early cardiac intervention and priority for critical CHD are among recommendation to improve survival.
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 (Ass. Prof.),Mulugeta,Feven(BSc, MSc)
Background: Diabetic ketoacidosis (DKA) is one of the most severe clinical features of diabetes mellitus, which can result in morbidity and mortality. The prevalence of DKA is increasing worldwide and nationwide. There is a discrepancy of time to recovery from DKA between developed and developing country. The Ethiopian government aims to decrease premature mortality from noncommunicable diseases, including diabetes, by one-fourth by 2025. To achieve this target plan, more research should be conducted in this area. Objective: To assess time to recovery from DKA and its predictor among children with diabetic ketoacidosis at selected governmental hospitals in Addis Ababa, Ethiopia, 2023 Methods: A five years retrospective follow-up study design was employed among 391 children admitted 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 hospitals and participants. Preliminary survey of the study hospitals was done to determine flow and the sample was proportionally allocated. Structured data collection checklist was adapted from similar studies in the literature. Data was checked for completeness, and exported into Stata version 16 for analysis. A variable with P value < 0.05 in the multivariate Cox proportional hazards model was 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 of these 370, recovered and discharged. The left 21 cases were censored. The overall median time taken 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 independent predictors 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, increasing public awareness on symptoms of DKA, giving emphasis, enhancing quality of care, prioritize and treating children with identified predictors is important.
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 (Ph.D., Associate Professor),Berhan,Yeshy(BSc, MSc, Lecturer)
Background: Triage is a way of categorizing patients based on their specific needs and the resources available to treat their medical condition. Since misclassifying high-urgency patients as low urgency levels slows diagnosis and treatment, which may raise the risk of morbidity or fatality, 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 in pediatrics units of public hospitals in Addis Ababa, Ethiopia. Method: Institutional-based cross-sectional study design was used to conduct this study in selected public hospitals of Addis Ababa from March 3 to 27, 2023. The sample size was determined by single population proportion formula by using correction formula and a total of 165 samples were included in the study. Data was collected by using a self-administered questionnaire and observational checklist and then the data was coded, entered, and cleaned by Epi data version 4.6 and exported to IBM SPSS Version 26 for analysis. . Bivariate logistic regression 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 was considered 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 is 31.5%. Only 52 (31.52%) respondents have good quality on triage whereas the majority 113(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 triage patient (AOR=0.003, 95% CI (0.000-0.3)) were strongly associated with outcome. Conclusion and Recommendation: The overall quality of Pediatric emergency triage services in 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
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(PhD, Associate Professor),Admasu,Mekonen(MSc, Lecturer)
Background: Neonatal jaundice is a major cause of neonatal intensive care unit admission and is one of the leading causes of morbidity in neonate. However, little is known about the time to death and its predictors among neonates with hyperbilirubinemia. Therefore, this study aimed to assess survival status and predictors of mortality among neonates admitted with hyperbilirubinemia in neonatal 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 to December 2022. The data was collected from patient cards using a simple random sampling method with a pretested checklist between March 16 and April 16, 2023. Data entry was performed using Kobo toolbox, and analysis was conducted using SPSS version 26. Kaplan Meier analysis was used to estimate the median survival time and cumulative probability of survival, while the logrank test was used to compare survival curves among different predictor groups. The relationship between independent and outcome variables was analyzed using the Cox proportional hazard 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 of mortality, including maternal age below 20 years (AHR = 18.2, 95% CI: 3.2–102.7), living in a rural 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 weight below 2500gm (AHR = 15.1, 95% CI: 3.85-59.5), requiring both phototherapy and exchange blood transfusions (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 Ababa hospitals is high. This suggests that there is a room for improvement in order to meet the 2030 WHO target of 12 or less deaths per 1,000 live births. Therefore, special emphasis should be given for neonates who were born from mother whose age is <20 years and from rural settings, present with PROM and neonates with GA <37 weeks, Birth weight <2500gm and neonates with sepsis
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,Rajalakshmi(PhD, Associate professor),Abebe,Fikrtemariam (Msc, Lecturer)
Background: Neonatal resuscitation is a set of actions taken at the time of birth to help in the reestablishment of breathing and circulation. In the first four weeks of life, more than 2.4 million newborn babies die globally, of which newborn asphyxia is the main cause of their deaths. Poor knowledge and skill neonatal resuscitation by practitioners has a visible negative effect on neonates 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 213 graduating health science students from February 27 to March 27, 2023. A simple random sampling technique was used and data was collected using self-administered structured questionnaire. 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 a single factor which has significant effect on the good knowledge and practice of the students in common with [AOR: 0.377, 95%CI: (0.19-0.73)] and [AOR: 0.28, 95%CI: (0.145-0.53)], respectively and educational level on knowledge [AOR: 3.49, 95%CI: (1.24-9.7)] and on the attitude of students 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 practice toward neonatal resuscitation.
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 (Associate Professor, PhD Candidate),Alemu,Tsion(MSc, Lecturer)
Background:.Anxiety is described as a sensation of impending dread and a connection of emotions in circumstances that cause anxiety because a bad thing could happen, while also taking into account one's perception of one's abilities. Self-confidence is the belief and feeling of confidence in one's abilities and capabilities to plan and carry out the courses of action necessary to achieve goals. Objective: To assess perceived anxiety and self-confidence among undergraduate nursing students 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 perecived anxiety 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. Bivariate analysis 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 was 46.9%. The sex of the students, the thinking of clinical instructors were prepared well during clinical attachments, think of the shortage of staff in the hospital affect clinical learning, and the perceived self-confidence of nursing students were significant predictors of the perceived anxiety of the students. The students who had poor perceived self-confidence were 5 times more likely to be more anxious than those having good perceived self-confidence Conclusion and recommendation:. This research strongly recommends that students should be motivated and evaluated regularly for anxiety and self-confidence during clinical practice.
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 (Assistant Professor),Abebe,Fikrtemariam(Lecturer)
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 little is known about KAP of parents towards oral health. Objectives: The aim of this study was to assess the knowledge, attitude, and practices of parents toward 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 27/2023 among parents with their 6-12 years old schoolchildren who visited public health facilities of Butajira town. A total of 371 parents with their 6-12 years old child were taken through a simple random sampling technique using table of random numbers. Data was collected through face to face interview of parents using the questionnaire to assess KAP towards their children oral health. Dental examination of the children was done using DMFT and deft index to assess the dental 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 dental caries 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 dental caries among 6 to 12 years of age in study population was found to be 85.4% in primary dentition by deft index while it was 78% in permanent teeth by DMFT index. The mean DMFT was 2.19(±1.793) and mean deft was 6.12(±3.399). As KAP increased there was decrease in DMFT and deft score. The association between KAP and DMFT score was statistically significant (P-value = 0.001) while the association between KAP and deft score was not statistically significant (P-value = 0.452). Conclusion: Majority of parents in the study had poor KAP and parental KAP was in inverse relationship with DMFT and deft score of the child. Recommendations: It is evident that the data gathered from this study stresses upon conducting oral health educational programs directed towards parents.
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(RN, PhD Fellow) ,Adimasu,Mekonen (BSc, N, MSc, N,)
Background: The most common cause of morbidity and mortality in neonatal intensive care units around the world is nosocomial or healthcare associated infections. Up to 40% of reported 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 governmental hospitals in Addis Ababa, Ethiopia. Data was entered using EPI info version 7.0 statistical software and analyzed using SPSS version 26 statistical package. Bivariate and multivariable logistic regression analysis was also carried out to identify factors associated with the dependent variable. A p-value less than 0.05 were used to declare statistical significance. Result: Around half (53.5%) of nurses were found to have good knowledge and 56.9% of respondents demonstrated a good practice on infection prevention. Reading guide lines, receiving formal training, working experience, marital status, availability of personal protective equipment and hand hygiene equipment, and availability of infection prevention guide lines were significantly associated (P < 0.05) with knowledge and practice of nurses towards 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 personal protective equipment and hand washing equipment, and encouraging nurses to read and use infection prevention guideline.
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-increasing number of hospitals, clinics, diagnostic laboratories and other health care services. Although health care workers are one key personnel for the proper management of medical wastes at any health facilities, their level of performance depends on their level of knowledge, practice and some related factors regarding medical waste management. A Quantitative institutional based cross sectional study and a qualitative observational study was conducted and a total of 627 health care workers from 4 public hospitals at Addis Ababa, Ethiopia, were included. Study participants were allocated proportionally based on the number of healthcare workers from each hospital and profession. Data were collected using pre-tested self-administered structured questionnaires and observational checklists. The collected data was analyzed using SPSS version25.0. Multivariable logistic regression model was used to identify factors associated with knowledge and practice of healthcare workers. Out of the total respondents, 52.7% and 51.5% of health care workers had adequate 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)] and adequate practice score [AOR = 2.14, 95% CI (1.50, 3.02)] were significantly associated with the knowledge level of health care workers. On the other hand, HCWs working at Saint 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 from others[(AOR=0.49,95%CI(0.25,0.95)], presence of MWM guidelines in hospital[(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 of health care workers. In this study, both knowledge and practice level of health care workers towards medical waste management were not satisfactory. To improve better, proper and intensive job training is recommended.
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 Geneti; Sr. Wondwossen, Kalkidan(Assistant Professor); Adimasu, Mekonen(BSC, MSC)
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 selfmanagement 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. A variable that has a P-value of <0.2 in bi-variable logistic regression analysis was subjected to multivariable logistic regression analysis to control the confounding factors. The level of significance was pronounced at P-value <0.05. 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.
Prevalence and Predictors of Meconium Aspiration Syndrome among Neonates Admitted in Governmental Hospitals in Addiss Ababa Ethiopia 2021
(Addis Abeba University, 2021-05) Mihret, Soliyana; Tadelle, Nigusse(Msc, Ass't Professor); Tesfaye, Tewodros(BSc, MSc)
Background: - Meconium aspiration syndrome (MAS) is a life-threatening respiratory disease occurring when neonates aspirate meconium-stained amniotic fluid near or around birth with varying severity. An average of 8% to 25% live birth neonates with meconium-stained amniotic fluid have delivery complications and from these around 5% of them develop MAS with a 50% chance of needing for mechanical ventilation. There is a paucity of literatures in the study area regarding the study topic. Therefore, the study aimed to assess the prevalence and associated factors of meconium aspiration syndrome among neonates admitted in NICU of governmental hospitals in Addis Ababa Ethiopia.Methods: - An institutional based retrospective cross-sectional study design was employed to collect data from February to Mach 2021. A three-year chart review from January 2018 to January 2021 was conducted. The data was collected by using structured questionnaire. Systematic random sampling technique was used to involve the estimated study participants (268). Factors associated with meconium aspiration syndrome were determined using bivariate and multivariate logistic regression models. Statistically significant associations were declared at P value less than or equal to 0.05.Result: The findings from this study revealed that 30.6% were diagnosed to have meconium aspiration syndrome. Factors associated with meconium aspiration syndrome included being post term (Adj OR=17.548 95% CI (2.894,106.413)), first minute APGAR score of 7-10 (Adj OR=17.548 95% CI (2.894,106.413)), duration of labor from 12-24 hour (Adj OR=4.98 95% CI (1.677, 14.792)) and maternal blood group of AB (Adj OR=0.118 95% CI (0.029, 0.470).Conclusion and recommendation: In this study almost 1/3 of the neonates had developed meconium aspirarion syndrome which indicates for the initiate delivery before 40 completed weeks of gestation and anticipation of neonatal resuscitation for neonates born from blood group of AB mothers. Key words: -MAS, neonate, respiratory distress and MASF.
Survival Status and Predictors of Mortality among Low Birth Weight Neonates Admitted in Selected Governmental Hospitals of Addis Ababa, Ethiopia, 2021.
(Addis Abeba University, 2021-01) Guadu, Jemal; Sr.Berhe, Semarya (Asst, professor, PHD fellow); Abere, Kerebeh (MSc)
Introduction: The World Health Organization (WHO) defines low birth weight (LBW) as a newborn weighing is less than 2,500 grams. The UNICEF (united nations international children’s emergency fund) and WHO estimates indicate that one in seven live births globally suffered from low birth weight in 2015. The prevalence of low birth weight varied widely across regions from 7.2 per cent in more developed regions to 17.3 per cent in Asia, in Ethiopia neonatal mortality accounts 30 per 1000 live births from 55 per 1000 live birth children deaths, LBW neonates were responsible for most deaths. Objective: To assess survival status and to identify predictors of mortality of low birth weight neonates admitted in selected governmental hospitals of Addis Ababa, Ethiopia. Methods: A retrospective cohort study will employed among 404 neonates with LBW admitted to neonatal intensive care unit (NICU) of selected four governmental hospitals in Addis Ababa, between January 2018 and January 2021. The data will be collected from randomly selected records from each year. Data will be entered to Epi-Data version 7.2.2.6 and exported to SPSS Version 24 for analysis. The Kaplan Meier survival curve will used to estimate the cumulative survival time. Log rank tests will used to compare probability of hazard among variables. Bivaraite and multivariate Cox proportional hazards models will used to identify predictor variables and variables having p value < 0.05 will considered as statistically significant. Budget: This study will require a total budget of 32,640 birr with 10% contingency added.
Prevalence and Associated Factors of Suicidal Behaviour among Postpartum Mother Attending at Public Health Centre, Addis Ababa, Ethiopia,2021.
(Addis Abeba University, 2021-05) Tilahun, Selamawit; Wordofa, Berhanu(BSc, MSc, Assistant professor); Sr.Sineshaw, Worknesh(MSc)
Background- Suicidal behaviors are one of the most common global burden of disease among women, with the exception of this in middle and low income countries few is studied about the frequency and associated factors. Suicidal behavior increase during the first year after delivery varying from 4% to 17.6% with three fold cause of maternal death in low-in- come countries.Correspondingly in Ethiopia suicidal behavior found to be high 14% among postpartum mothers. Suicidal behavior involves the deliberate attempt to take one’s own life. Objective - To assessprevalence and associated factorsof suicidal behavior among postpartum mothers attending at public health centers of Addis Ababa, Ethiopia, 2021. Methodology-A facility -based cross sectional study was conducted. The total sample size was 615.The study was conducted in ten randomly selected public health centers of Addis Ababa. After data collection, filled data were enter in statistical software Epi data 4.6 and were subjected to cleaning using simple frequency and tabulation to ensure its validity. Then, the analysis was done SPSS version 25 statistical software using a CI of 95%. To indicate the strength and statistical significance of the association of the selected independent and dependent variables, odds ratio,95% CI and p-value < 0.05were used. Results: The prevalence ofsuicidal behavioramong postnatal mothers attending at public health centers in Addis Ababa was 41.46%. Being mothers literate were (AOR=0.64, 95% CI: 0.42-0.97), verbal abuses were (AOR=2.18, 95% CI: 1.38-3.44), history of rape (AOR=3.03, 95% CI 1.14 -8.05),history of depression (AOR=4.12, 95% CI 1.21-14.03), women’s having sexually unfaithful husband were (AOR=0.34, 95% CI 0.14-0.81) and khat chewing were (AOR=8.48, 95% CI 2.52-28.50) were significantly associated with suicidal behavior. Conclusion and recommendation: Suicidal behavior was found to be the common mental health problem among postpartum women and was associated with educational status,verbal abuses, history of rape, history of depression, women’s having sexually unfaithful husband and khat chewing. Also recommend early diagnosis and intervention with possible screening of mothers for suicidal behavior during routine antenatal and postnatal care.

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