Pediatrics and Child Health

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Magnitude and Associated Factors of Autism Spectrum Disorder Among Patients Attended at Psychiatry Clinic in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2025-04-15) Selam Alemtsehay; Tewodros Hailemariam
Background: A complicated developmental condition, autism spectrum disorder is characterized by repetitive behavior, limited interests, and ongoing difficulties with social communication. About 1 in 100 people worldwide has autism. This lifelong condition presents varying challenges that can affect daily life. In Ethiopia, Autism Spectrum Disorder is a growing issue that lacks attention, this is evidenced by the absence of appropriate laws or policies, insufficient facilities, and a scarcity of literature on the topic. Objective: Assessing the magnitude and associated factors of autism spectrum disorder in patients who visit psychiatry clinic at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, is the goal of this study. Method: At Tikur Anbessa Specialized Hospital, a two-year retrospective cross-sectional study was carried out with a randomly chosen sample of 422 patients who visited the psychiatry clinic between September 11, 2022, and September 10, 2024. A Google checklist was used to gather the data, which was then converted to SPSS Windows version 26 for analysis. We used the percent mean, standard deviation and frequency to characterize our findings. The relationship between each explanatory variable and the outcome variable was evaluated using binary logistic regression. Variables with a p-value of less than or equal to 0.25 in the bivariable analysis were included in the multivariable logistic regression analysis. Adjusted odds ratios and their associated 95% CIs were computed for the multivariable binary logistic regression analysis. A p-value of less than 0.05 was deemed statistically significant, and odds ratios and their 95% CIs were used to show how strong the connections were. Result: The Magnitude of autism spectrum disorder in the study population was found to be 23% (95% CI: 95% CI: 19.9- 28.3), The study identified several significant factors influencing the odds of having autism spectrum disorder. Males were found to have 2.02 times higher odds of having ASD compared to females. while asphyxia increased the odds by 2.23 times. Preterm infants were 2.4 times more likely to have autism spectrum disorder, and each year of age was associated with a 19% decrease in the odds of having autism spectrum disorder . Later-born children had 2.03 times higher odds of autism spectrum disorder compared to their older IX siblings. However, occupational status and Down syndrome did not show significant effects after adjusting for other factors. Conclusion: In comparison to what has been documented in the literature, the severity of autism spectrum disorder is high. Males made up a larger percentage of the population than females, and most of the participants were older than five. The majority of children had one comorbidity, and a sizable portion had multiple comorbidities. Intellectual disability, attention deficit hyperactivity disorder, and epilepsy were the most prevalent related comorbidities. Autism is linked to maleness, birth asphyxia, preterm birth, and late born. Males are more likely than females to be impacted. Keywords: Autism, associated factors, Tikur Anbessa Specialized Hospital, magnitude, Ethiopia
Clinical Profile and Risk Factors Associated in Global Developmental Delay Children at Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia
(Addis Ababa University, 2025-02-10) Suzy Kiden; Atsede Teklehaimanot
Background: The length of stay in pediatric emergency departments (PED) is a critical factor in providing timely and efficient care to children in need of immediate medical attention. Various factors, including operational, clinical, and social elements, influence the duration of stay in these departments. Research has shown that the introduction of dedicated pediatric emergency rooms can help reduce the average length of stay, despite an increase in patient volume (2). Additionally, family characteristics, such as primary language spoken at home, socioeconomic status, and insurance status, also play a role in determining the length of stay (7). Resource constraints in healthcare settings, such as limited availability of diagnostic tools and pediatric specialists, can further complicate these factors, potentially leading to longer wait times and lengths of stay (1). Objective: This study aimed to examine the length of stay and the various factors influencing this duration in the Pediatrics Emergency Unit at Tikur Anbessa Specialized Hospital from September 11 to November 9, 2024. Methods: Hospital-based cross-sectional study was employed from September 11 to November 9, 2024 G.C. at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A total of 302 selected patients were studied. Data were collected by using a standard checklist through google sheet and analyzed using SPSS version 27 software package. Mean, and standard deviation were used to describe Continuous data; and frequency and percentage were used to describe categorical data. To identify factors associated with Pediatrics emergency department length of stay. Bivariable and Multivariable binary logistic regression analyses were done. Statistical significance was considered at level of significance of 5%, and adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to present the estimates of the strength of the association. Result: The prevalence of prolonged stays in the pediatric emergency department was found to be 84.4% (255); 95% CI: 79.8 - 88.3%. seeking care for Surgical reasons 0.16[0.06-0.43], who had no prior treatment 0.45[0.22-0.95], comatose mental status 0.09[0.01-0.64], illness duration longer than 24 hours 4.6[2.11-10.2],Investigation ordered 14[2.19-98.7], two/more investigation ordered 19.2[1.5-236.6], surgical intervention P age 5 | 43 preformed 0.14[0.02-0.81], observation as an intervention 0.11[0.02-0.48], Delays in diagnostic services 0.17[0.06-0.47], Staff shortages 0.034[0.005-0.23] and not dedicated staff 4.12[1.49-11.3] were significantly associated with Pediatrics emergency departments length of stay. Conclusion: The study found that the prevalence of prolonged stays in the pediatric emergency department at Tikur Anbessa Specialized Hospital was high (84.4%). Several factors were significantly associated with length of stay, including clinical, operational, and resource-related elements. Patients with illness durations exceeding 24 hours, those requiring investigations, and those needing multiple investigations were more likely to experience prolonged stays, while surgical intervention and observation were associated with shorter stays. Additionally, the absence of prior treatment, comatose mental status, and delays in diagnostic services contributed to longer stays. Resource limitations, such as staff shortages and lack of dedicated staff, were also significant factors. Addressing these challenges through improved resource allocation, timely diagnostics, and staff management may help reduce prolonged stays and enhance pediatric emergency care efficiency. Key words: Pediatrics emergency department length of stay, TASH, Pediatric Emergency Unit, factors
Clinical and Microbiological Profiles of Infective Endocarditis in Pediatric Patients: A Cross-Sectional Study at Tikur Anbessa Specialized Hospital
(Addis Ababa University, 2022-10) Abera Bemnet; Mintesinot Helen; Sani Elham
Background: A serious infection of the heart's endocardial surface, including the heart valves,is known as infective endocarditis (IE). In young patients, IE is a rare but potentially fatal illness that needs to be diagnosed and treated right away. Improving outcomes requires an understanding of the clinical and microbiological features of IE in the pediatric context. These kinds of studies aid in the understanding of the local epidemiology of this uncommon but dangerous pediatric heart infection by physicians working in resource-constrained environments such as Ethiopia. The results can help develop diagnostic algorithms, direct empirical antibiotic therapy, and pinpoint areas where IE prevention and management in this patient population need to be improved. Objectives: - This study aimed to describe the microbiological pattern, clinical manifestation,and outcome of infective endocarditis in pediatric patients attending Ethiopia's Tikur Anbessa Specialized Hospital, a tertiary care facility. Methods: An institutional-based retrospective cross-sectional descriptive study was conducted,focusing on 61 medical records of pediatric patients admitted for infective endocarditis (IE) at TASH from January 2019 to January 2024. A self-administered and structured questionnaire was developed to encompass demographic, clinical, and echocardiography data from the medical records of the study subjects. The data were analyzed using SPSS version 27 software, and the findings were presented using tables and charts. Result: This study includes a total of 61IE patients’ more than half 35(57.4) were female. fever(52, 27.2%), shortness of breath (45, 23.6%), and cough (28, 14.7%) were the most common chief complaints .36 patients (59 %) were cured, 25 (59 %) died, with sepsis with multi-organ failure(13, 52%) being the leading cause of death. The average hospital stays for patients who died was 21.04 days (SD = 18.449), while the average stay for patients who were cured was 41.39 days (SD= 11.746). Length of hospital stay (Odds Ratio = 1.083, 95% CI = 1.030 to 1.138, p = 0.002) and presence of complications (Odds Ratio = 0.039, 95% CI = 0.005 to 0.345, p = 0.003) significantly affect the outcome
Pediatrics Emergency Unit Length of Stay and it’s Associated Factors at Tash at Tikur Anbessa Specialized Hospital, Addisababa, Ethiopia
(Addis Ababa University, 2025-02-19) Eden Beresa; Muluwork Tefera
Background: The length of stay in pediatric emergency departments (PED) is a critical factor in providing timely and efficient care to children in need of immediate medical attention. Various factors, including operational, clinical, and social elements, influence the duration of stay in these departments. Research has shown that the introduction of dedicated pediatric emergency rooms can help reduce the average length of stay, despite an increase in patient volume (2). Additionally, family characteristics, such as primary language spoken at home, socioeconomic status, and insurance status, also play a role in determining the length of stay (7). Resource constraints in healthcare settings, such as limited availability of diagnostic tools and pediatric specialists, can further complicate these factors, potentially leading to longer wait times and lengths of stay (1). Objective: This study aimed to examine the length of stay and the various factors influencing this duration in the Pediatrics Emergency Unit at Tikur Anbessa Specialized Hospital from September 11 to November 9, 2024. Methods: Hospital-based cross-sectional study was employed from September 11 to November 9, 2024 G.C. at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A total of 302 selected patients were studied. Data were collected by using a standard checklist through google sheet and analyzed using SPSS version 27 software package. Mean, and standard deviation were used to describe Continuous data; and frequency and percentage were used to describe categorical data. To identify factors associated with Pediatrics emergency department length of stay. Bivariable and Multivariable binary logistic regression analyses were done. Statistical significance was considered at level of significance of 5%, and adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to present the estimates of the strength of the association. Result: The prevalence of prolonged stays in the pediatric emergency department was found to be 84.4% (255); 95% CI: 79.8 - 88.3%. seeking care for Surgical reasons 0.16[0.06-0.43], who had no prior treatment 0.45[0.22-0.95], comatose mental status 0.09[0.01-0.64], illness duration longer than 24 hours 4.6[2.11-10.2],Investigation ordered 14[2.19-98.7], two/more investigation ordered 19.2[1.5-236.6], surgical intervention P age 5 | 43 preformed 0.14[0.02-0.81], observation as an intervention 0.11[0.02-0.48], Delays in diagnostic services 0.17[0.06-0.47], Staff shortages 0.034[0.005-0.23] and not dedicated staff 4.12[1.49-11.3] were significantly associated with Pediatrics emergency departments length of stay. Conclusion: The study found that the prevalence of prolonged stays in the pediatric emergency department at Tikur Anbessa Specialized Hospital was high (84.4%). Several factors were significantly associated with length of stay, including clinical, operational, and resource-related elements. Patients with illness durations exceeding 24 hours, those requiring investigations, and those needing multiple investigations were more likely to experience prolonged stays, while surgical intervention and observation were associated with shorter stays. Additionally, the absence of prior treatment, comatose mental status, and delays in diagnostic services contributed to longer stays. Resource limitations, such as staff shortages and lack of dedicated staff, were also significant factors. Addressing these challenges through improved resource allocation, timely diagnostics, and staff management may help reduce prolonged stays and enhance pediatric emergency care efficiency. Key words: Pediatrics emergency department length of stay, TASH, Pediatric Emergency Unit, factors
Magnitude and Associated Factors of Chronic Liver Disease in Children at Tikur Anbessa Specialized Hospital Five Years Trend Analysis, Addis Ababa, Ethiopia, 2025
(Addis Ababa University, 2025-04) Daniel Philipos; Abebe Habtamu
Background: Chronic liver disease (CLD) in children, characterized by progressive liver dysfunction lasting over six months, poses significant global health challenges. Pediatric CLD incidence is notably high in Africa (9.9–14.7 per 100,000), with Ethiopia reporting 24 adult CLD deaths per 100,000 population in 2019 [6,9,12]. Limited local data contribute to diagnostic delays, underreporting, and inadequate health policies. This study assessed the magnitude and associated factors of pediatric CLD at Tikur Anbessa Specialized Hospital (TASH), Ethiopia, to address epidemiological and diagnostic gaps. Methods: A hospital-based cross-sectional study was conducted at TASH from December 2024 to January 2025, involving 240 children with CLD. Retrospective data were extracted from medical charts and the digital iCare system using structured questionnaires. Bivariate and multivariate logistic regression analyses identified factors associated with cirrhotic CLD. Results: Among participants (55% male, mean age 6.4 years ±4.4 SD), CLD magnitude was 4.8%. Cholestatic liver disease was the most common etiology, yet 60% of cases had undetermined causes. Portal vein thrombosis (5.8%) and autoimmune hepatitis (5.5%) were other etiologies, alongside chronic viral hepatitis (HBV/HCV/CMV: 4.1%) and rare causes like congenital hepatic fibrosis, Gaucher’s disease, and schistosomiasis. Factors significantly associated with cirrhotic CLD included age 5–10 years (P=0.02), symptom duration 6–12 months (P=0.007), variceal bleeding (P=0.001), elevated alkaline phosphatase (ALP; P=0.024), prolonged INR/prothrombin time (P=0.037), APRI score >2 (P=0.001), and undetermined etiology. Mortality was 10.8 %, with cirrhosis and undetermined etiology strongly linked to death (AOR=3.2, 95% CI: 0.5–5, P=0.001). Conclusion: Pediatric CLD burden and mortality are substantial in Ethiopia, with a high proportion of cases remaining etiologically undefined. Findings underscore the urgency for enhanced diagnostic capacity and tailored public health interventions. Prospective multicenter studies with larger samples are recommended to inform national policies for CLD prevention and management.
Outcome of Bubble CPAP for the Management of Preterm Neonates with RDS and Associated Factors at NICU, TASH, Addis Ababa; Hospital Based Cross-Sectional Study
(Addis Ababa University, 2025-04-13) Elham Jemal; Semienew Ambachew
Background: Respiratory distress syndrome is among the major complications of preterm birth. In developed countries the infant mortality rate from RDS has significantly reduced. But in resource restricted setting RDS is still among the commonest cause of mortality among preterm neonates(1) Continuous positive airway pressure ( CPAP ) has become a useful modality in management of respiratory distress in preterm babies. It is found to be safe and effective means of treating mild and moderate RDS and apneas of prematurity(2). CPAP started at birth is as effective as prophylactic or early surfactant and is associated with a reduction in BPD(3). Bubble CPAP , when used appropriately , is more cost effective , less intensive , requires less training and has lower risk of complications(4) Method: A hospital based cross- sectional study was conducted on preterm neonates with RDS on bubble CPAP admitted at TASH ,NICU . Participants were selected using a simple random sampling technique. Data was collected through chart review . Data was entered into the statistical package for social sciences version 25 ( SPSS ) for subsequent descriptive and analytical statistics where applicable . Statistically significant association was taken for p value of < 0.05. Result: Among the 186 neonates included in the study, the occurrence of death as an outcome of bubble CPAP was 33 (17.7 %) . And being very preterm (28-31+6 weeks ) and having sepsis as a concomitant illness were identified as a statistically significant association with having death as an outcome of bubble CPAP. Conclusion: This study revealed a relatively higher level of death as an outcome of bubble CPAP and the factors associated were being very preterm ( 28 - 31 +6 weeks ) and having sepsis as a concomitant illness.
Functional Disability and Health Related Quality of Life Among Juvenile Idiopathic Arthritis Patients Attending the Pediatric Rheumatology Clinic at Tikur Anbessa Specialized Hospital, A Prospective Study
(Addis Ababa University, 2025-04-05) Etsegenet Bekele; Hana Lishan
Background: Juvenile idiopathic arthritis (JIA) is an idiopathic inflammatory arthritis which includes different types of chronic arthritis and also extra-articular structures. It has a wide presentation and different clinical subtypes. It is a long standing disease associated with many complications including permanent damage to joints with or without joint destruction, interference with bones and growth resulting in disability and loss of function which in turn results in problem in functional ability and health related quality of life of the child. Methods: 57 JIA patients were included in cross-sectional study at Tikur Anbessa Specialized Hospital (TASH), department of pediatrics and child health pediatrics rheumatology follow-up clinic from September 1- December 30, 2024. A standard questionnaire were used to collect the datas, questionnaire of Paediatric Quality of Life Inventory (PedsQL) and the Childhood Health Assessment Questionnaire (CHAQ) to assess the health related quality of life and functional status of the patient respectively. The collected data using SPSS statistics (25) were checked, organized and analyzed. Descriptive statistics were used for presenting summary data using tables and graphs. Independent variables and outcomes were checked using mean score comparison test. Statistical significance was declared at a p-value of 10years of illness duration were found to have a lower functional status. The overall mean of the total scores of both the parental and child proxy shows that there is an optimal health related quality of life. Key words: HRQOL, CHAQ, JIA
A Quality Improvement Project to Improve the Knowledge of Nurses Working at Tikur Anbessa Specialized Hospital Neonatal Intensive Care Unit (NICU): A Pre - and Post - Test Studyl
(Addis Ababa University, 2025-10-19) Firehiwot Markos; Asrat Demtse
Background: The first 28 days of life – the neonatal period – is the most vulnerable time for a child’s survival. Globally 2.3 million children died in the first 28 days of life in 2022. Children who die within the first 28 days of birth suffer from conditions and diseases associated with lack of quality care at birth or skilled care and treatment immediately after birth and in the first days of life. The neonatal intensive care unit (NICU) is the home to a fragile patient population consisting of babies born prematurely or with congenital anomalies and newborns requiring surgical intervention. These patients need special medical attention and support. The medical staff must provide quality care and implement evidence-based nursing practices to improve outcomes for the neonatal population. Objective of the study: The aim of this study is to improve the knowledge of NICU nurses by training on common neonatal problems. Method and Materials: A Quasi Experimental Pre- and Post- Test study design was used to assess knowledge of NICU nurses in Tikur Anbessa Specialized Hospital(TASH). A structured knowledge questionnaire in the form of Multiple Choice Questions(MCQs) was administered to obtain data regarding the knowledge of NICU nurses on common neonatal problems. Statistical analysis included differences in the knowledge scores before, immediately after the training and after 1 year of the training sessions and between the three periods. Result: A total of 35 NICU nurses were trained on common newborn problems with a majority of female participants(82.9%). Seventeen(48.0%) of the nurses have Bachelor's degree in nursing and 14(40%) have Masters in Neonatal Nursing.The majority of them 14 (40.0%) had over 10 years of nursing experience. The participants' mean knowledge score during pre-test was 6.97 ±1.85 which increased to 9.23 ±1.09 immediately after the training and dropped to 6.94 ±1.51. This increase in mean scores indicates the effectiveness of the training in enhancing participants' performance in the short term. Conclusion: The training programs are effective and significantly improve knowledge of nurses on common neonatal problems. Key words: Neonatal Resuscitation, Hypothermia, Training, Pre-test, Post-test
Comorbidity of Attention Deficit/Hyperactivity Disorder in Children with Epilepsy in TASH,2024
(Addis Ababa University, 2025-02-15) Firezer Milashu; Ayalew Moges
Background: Children with epilepsy frequently have comorbidities; about half of kids have at least one condition. The psychiatric condition known as attention deficit hyperactivity disorder (ADHD) is typified by hyperactivity and inattention that are out of proportion to the child's developmental stage. ADHD has a significant impact on the clinical results, psychosocial characteristics, and quality of life of children with epilepsy. In clinical practice, comorbid ADHD is still not well acknowledged. Comorbid ADHD must be identified and treated early in order to improve prognosis and lower the chance of negative long-term neurodevelopmental effects Objectives: To investigate the comorbidity of ADHD among children diagnosed with epilepsy in TASH. Methods: This is a prospective cross-sectional study which Is carried out in TASH, pediatric neurology clinic on children fulfilling the inclusion criteria between October 2024 and January 2025.Children with epilepsy 3 to 18 years of age with duration of epilepsy more than 6 months duration were included in the study. Patients were selected by convenient sampling method. The trained data collectors filled the pre structured questionnaire and Diagnostic and Statistics Manual of mental disorders V text revision is used to diagnose ADHD. Results: 205 children were enrolled in the study. From these 121 patients (59%) has ADHD. Among the subtypes 49.8% had inattentive type while 40.1 % has hyperactive/impulsive type. In this study age of the children, presence of seizure in the last 6months and ASM were an association with ADHD by bivariate logistic regression. The multivariate logistic regression found that the odds of children age 1-5 years and 6-10 years had 3.4 and 2.5 times increase the risk of ADHD compared to age >=10 years respectively (AOR=3.4, 95%CI=1.34, 8.68 & AOR=2.5, 95%CI=1.17, 5.19). The odds of children having seizure in the last 6months had 4.2 times increase risk ADHD compared to those of its opposite compartment (AOR=4.2, 95%CI=2.14, 8.41) and study participants who use polytherapy were 2.4 times increase its risk of ADHD compared to monotherapy (AOR=2.4, 95%CI=1.21, 4.82). Conclusion: There is high prevalence of ADHD 59% among children with epilepsy in TASH pediatric neurology clinic. Yet, those who are having follow up at psychiatric clinic are 36 (29%). This shows under diagnosis of ADHD in children with epilepsy.
Prevalence and Associated Factors of Phenytoin Induced Gingival Over growth (Pigo) among Children Receiving Phenytoin Treatment in Selected Addis Ababa Governmental Hospitals,Ethiopia, Cross-Sectional Study
(Addis Ababa University, 2025-02-05) GebreEgziabher Kassa; Behaylu Yibe
Gingival overgrowth (GO) is a frequent complication associated with various medications, including anticonvulsants such as phenytoin, which is a medication commonly prescribed to treat epilepsy. Other drugs, such as immunosuppressant and calcium channel blockers can also cause GO. Phenytoin is a particularly concerning medication, as it is estimated that 30–50% of patients taking it experience significant gum enlargement. This side effect, known as phenytoin-induced gingival overgrowth (PIGO), can cause considerable cosmetic and functional problems, especially for children, because phenytoin remains widely used, particularly in developing countries. This is reflected in research conducted at Tikur Anbessa Hospital in Addis Ababa, Ethiopia. Among children with epilepsy who were on monotherapy, phenytoin was the most commonly used medication, accounting for 33.6% of the cases. This study investigated the prevalence of PIGO and associated factors among children in Addis Ababa-selected governmental hospitals, which is highly relevant. Objectives This study aims to address the prevalence and associated factors of phenytoin-induced gingival overgrowth (PIGO) among children receiving phenytoin treatment in selected Addis Ababa governmental hospitals, in Ethiopia. Methodology This study was conducted using a hospital-based cross-sectional study design from August 2024 to January 2025 GC at Tikur Anbessa Specialized Hospital and Yekatit 12 Hospital pediatric neurology follow-up clinics. Using a single population proportion formula with 95% confidence and 5% precision, the required sample size was 328. The data were entered into the Statistical Package for Social Sciences version 27 (SPSS) for subsequent descriptive and analytical statistical analysis where applicable. Descriptive statistics were employed to summarize the data, and the results were presented using tables and figures. All variables were included in the bivariate logistic regression analysis. Variables with a p-value of less than 0.2 were further considered for multivariate logistic regression to identify potential predictors of PIGO. A statistically significant association was defined as a p-value of < 0.000, AOR = 5.704, 95% CI = 3.060–10.633). Additionally, children using other AEDs had a 3.26-fold higher risk than those on phenytoin alone (p < 0.000, AOR = 3.259). Conclusion In this study, the prevalence of PIGO was 52%, slightly above half .Age, duration of phenytoin use, dosage, and the use of additional antiepileptic drugs (AEDs) were identified as significant predictors of PIGO.
Assessment of Clinical Presentations, and outcome of Patients Admitted to Pediatrics Intensive Care Unit, Saint Paul’s Hospital Millennium Medical College: A Two-Year Retrospective Cross-Sectional Study
(Addis Ababa University, 2025-04-13) Gemechu Edae; Tigist Bacha
Introduction: A pediatric intensive care unit is a separate physical facility or unit specifically designated for the treatment of pediatric patients, because of shock, trauma, or other life threatening conditions, require intensified, comprehensive observation and care. Knowledge of the characteristics and outcomes of critically ill children admitted to PICU in low income countries may help with the identification of priorities and the resources required for improvement of the care of critically ill patients. Objective: - To assess the clinical presentations, and outcome of children admitted to the pediatric intensive care unit of Saint Paul’s Millennium Medical College. Methods: - Data were collected through chart abstraction of pediatric patients who were admitted to the PICU during the period from January 2017 to December 2018. Data were analyzed using Statistical Package for Social Sciences version 20.0 for windows. Data were summarized by using frequency tables, figures and odds ratio with its 95% confidence interval was determined when it is appropriate. A retrospective cross-sectional study design was used. Results: From 400 admitted patients, 260 patients were analyzed. Average age at admission was 48.13 ± 53.65 months, with M: F ratio of 1.4:1. Overall (from infectious and non-infectious) the most commonly affected systems were central nervous system (79/260 pts, 33.2%) and respiratory system (55/260 pts. 23.1%). The mean duration of stay was 7.26 ±6.87, the median being 6.0 days. Binary logistic regression shows, need for mechanical ventilation (p = 0.04), and post cardiopulmonary resuscitation admission (p=0.001) were independent predictors of mortality. The major causes of death being septic shock in a total of 24 (43.6%), followed by respiratory failure in 14 (25.5%) secondary to severe chest infection, GBS and various central causes. Cardiogenic shock accounted for 7 (12.7%). The overall mortality rate was (21.1%). Conclusion: The mortality rate of our PICU was 21.1 %, with the most common cause of admission, and death being infectious causes mostly affecting CNS and respiratory, and septic shock respectively. The mean duration of stay of 7.26 ±6.87 days. The statistically significant predictor of mortality in this study was need for mechanical ventilation and post cardiopulmonary resuscitation admission. Key Words: SPHMMC, Pattern, Intensive care unit, outcome
Phenotypic Classificationand Risk Factorsassociated with Recurrentwheeze among Preschoolchildren in A Tertiaryteaching Hospital in Addisababa, Ethiopia; A Casecontrol Study
(Addis Ababa University, 2025-02-05) Melat Tesfaye; Rahel Argaw
Factorsassociated with Recurrentwheeze among Preschoolchildren in a Tertiaryteaching Hospital in Addisababa, Ethiopia; a Casecontrol Study
Parental Satisfaction with Neonatal Intensive Care unit Services and its Associated Factors at Tikur Anbessa Specialized Hospital. Addis Ababa, Ethiopia, 2024/25 G.C.
(Addis Ababa University, 2025-12-13) Samuel Asrat; Asrat Dimtse
Background: Satisfaction is a reflection of one’s preferences, expectations, and the care received. Parental Satisfaction, shows how well the service meets their needs and perspective (3). Having a baby is always a challenging experience for parents. However, it gets even more stressful and emotional when a baby is born prematurely or with problems and is taken to a neonatal intensive care unit (4). When parents are dissatisfied, they may not adhere to the treatment/advice of the health professional. Thus, they under-utilize important health services. This may lead to poor utilization of health services and pose critical challenges to the success of universal health coverage and increased neonatal readmission, morbidity, and mortality (2). Method: A facility-based cross-sectional study was conducted on 271 parent whose neonate was admitted to TASH NICU. Participants were selected using a simple random sampling technique. Data was collected through face-to-face interview by using Neonatal Satisfaction Survey (NSS-8) tool. Data were cleaned, entered, and analyzed using SPSS version 25.The demographic and clinical characteristics of the neonate and the parents were computed using descriptive statistics such as frequencies and percentage. Overall satisfaction was calculated by summing all items (50) measuring satisfaction and it was determined by the cutoff point, which is the mean score. Bivariable and multivariable logistic regression was done to assess the association between the overall satisfaction and the independent variable. Statistically significance was taken for p values. Result: Overall satisfaction towards NICU services at TASH were 59.4% (95% CI, 53.1, 66.1). Moreover, the study revealed the factors associated with overall satisfaction are shorter duration of hospital stay (less than 7 days) (AOR=5.81 95% CI (2.39, 14.1)), place of interview (NICU) (AOR=3.11, 955 CI (2.446, 3.3)) and admission diagnosis of neonatal Sepsis (AOR=2.8, 95% CI (1.29, 6.165)) and Jaundice (AOR=6.3 95% CI (1.155, 35.0)). Conclusion: This study revealed a moderate level of overall satisfaction towards the NICU services in TASH. The factors associated with overall satisfaction are shorter duration of hospital stay(less than 7 days), admission diagnosis (Neonatal Sepsis and Jaundice) and place of interview (NICU).
Assessment of Nutritional Status and Associated Factors of Children with Chronic Kidney Disease in Tikur Anbessa Specialized Hospital Pediatric Renal Clinic 2024/25 Addis Ababa, Ethiopia
(Addis Ababa University, 2025-02-15) Adino Melkamu; Damte
Back ground: Poor growth in children with CKD, which is a marker of disease severity, is associated with significant morbidity and mortality. We studied nutritional status and associated factors in our children with CKD. The study aims were to evaluate the nutritional status and associated factors among children with CKD at the Pediatric Renal Clinic at Tikur Anbessa Specialized Hospital 2024/25. Methods: This study was conducted at Tikur Anbessa Specialized Hospital/TASH/. An institution based cross-sectional study employed among 86 children with CKD. Data was collected from medical records and by taking history and physical examination of CKD children receiving follow up care in the pediatric renal clinic using a pre-tested structured checklist. Statistical software Epi Info (7.2.5.0) was used for data entering and (SPSS 26 version) was employed for data analysis clearance. For variables that were statistically significant, descriptive statistics, ordinal logistic regression statistical analysis was used. Data was presented with frequency, percentage, and tables. Result: Out of the 88 children with chronic kidney disease who were chosen for the study; the questionnaire was completed for 86 children, yielding a response rate of 97.7%. About 36.2% of patients were in the active age group of >10 years, and 37.2% of children were in the 5–10-year age range. Males outnumbered females, with a male-to-female ratio of 1.61:1. Among a total 86 children with CKD, 44.2% had stunting, and about 45.3% had wasting. Monthly income of the family, duration CKD from diagnosis, address (residence where the child live) and presence of comorbidity were strongly associated with malnutrition. The longer the duration illness the higher the risk of development of malnutrition with respective -14.5(95% CI: -16.564, -12.468, p-value= 0.000). Conclusion: Malnutrition was seen in a considerable portion of our children with CKD, Malnutrition status was strongly associated with their age, gender, place of residency(address), caregivers’ income, duration of illness and presence of associated comorbidity. Standard guideline needs to be prepared to diagnose and manage malnourished children with CKD. Keywords: malnutrition, CKD, children, stunting
Trends and Referral Patterns of Ethiopian Pediatric Patients Seeking Treatment Abroad at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study
(Addis Ababa University, 2025-06-15) Arif Abdujebar; Workeabeba Abebe
Background: Referral is the process by which a health worker transfers care responsibility to another professional due to limitations in providing necessary treatment. In developing countries like Ethiopia, pediatric referral patterns for treatment abroad have received insufficient attention. Understanding these patterns can help address treatment-related health issues and improve patient quality of life. This study aims to provide valuable data that informs policy and practice regarding demographic characteristics, primary diagnoses, referral trends, and patient outcomes. Objective: To assess the trends and referral patterns of Ethiopian pediatric patients seeking treatment abroad at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A facility-based, retrospective, cross-sectional study was conducted from 2022 to 2024 G.C, at Tikur Anbessa Specialized Hospital. Data were collected on demographics, diagnoses, medical and surgical interventions provided abroad, and patient outcomes using medical board-approved referral papers and phone interviews with attendants. The study included all children with referral papers during the study period. Data were analyzed using SPSS version 26, employing descriptive analysis, with results presented in tables & figures. Result: The study surveyed 298 children with referrals for treatment abroad. Most participants were aged 1-5 years, with 52.5% male (male-to-female ratio of 1.1:1). Notably, 94% underwent imaging, primarily chest X-rays (73.1%) and echocardiograms (68.5%). Most referrals (63.8%) came from the Cardiac Unit, followed by the Hemato-Oncology Unit (21.8%). Congenital Heart Disease (CHD) was the most common diagnosis, with Acute Lymphoblastic Leukemia (ALL) prevalent among oncologic conditions. The main reason for referral was surgical management (63.4%), followed by Hematopoietic Stem Cell Transplantation (HSCT) (12.1%). Referral rates significantly increased over the study period, with 161 participants seeking treatment abroad, primarily in India (70.2%) and Israel (13%). While 95% of treated patients returned alive, the study revealed a concerning 15.1% mortality rate during treatment and a 20.8% rate of unknown outcomes, indicating critical gaps in follow-up care. Conclusion- The steady increase in pediatric referrals abroad, particularly for CHD and childhood cancers, underscores an urgent need for enhanced local healthcare infrastructure to provide specialized interventions often unavailable in Ethiopia. Ideally, as hospital care improves, the need for referrals should decrease; however, the data suggests otherwise. Policymakers must prioritize pediatric health in national agendas, ensuring funding for local healthcare infrastructure to enhance access to essential treatments and reduce reliance on international referrals. The 20.8% of cases with unknown outcomes represents a significant data gap that limits our understanding of referral effectiveness. Improved follow-up care and robust patient tracking systems are essential for addressing these gaps, for monitoring the long-term impacts of these interventions on health outcomes. Furthermore, ongoing research for overall healthcare accessibility and enhancing pediatric patient management Keywords: Pediatric referrals, congenital heart disease, childhood cancer, healthcare infrastructure, treatment abroad, Ethiopia, patient outcomes, referral patterns.
The Magnitude and Associated Risk factors of Lipodystrophy among Type 1 DM Children and Adolescents on follow up at Black Lion Hospital Pediatric Endocrinology Unit
(Addis Ababa University, 2025-04-04) Henock Hailu,; Sewagegn Yeshiwas
Background- Type 1 diabetes(T1DM) is chronic autoimmune disease that results from the progressive destruction of pancreatic beta cells, insulin deprivation and therefore, the patients require insulin therapy throughout their lives. Lipodystrophy is a common side effect of insulin use in T1DM patients, characterized by changes in distribution and volume of subcutaneous fat stores. Lipodystrophy therefore can also be lipohypertrophy experienced when fat starts accumulated at the areas where one applies insulin and lipoatrophy which is actually experienced when one loses his or her fat tissue. Severe clinical consequences may include insulin resistance in case of Lipodystrophy, episodes of poor glycemic control and worsened diabetes complications. Research recognizes the lipodystrophy’s prevalence among T1DM patients to be 28-66%. Potential risk factors associated with lipodystrophy include duration of the diabetes, insulin use and incorrect method of insulin administration. Nevertheless, lipodystrophy epidemiology and risk factors in T1DM individuals can differ depending on geographical location and some settings. Objective- The primary objective of this cross-sectional study is to determine the magnitude and risk factor of lipodystrophy, including both lipoatrophy and lipohypertrophy, among T1DM patients under 18 years of age receiving insulin therapy through subcutaneous injections with follow up at Black Lion Specialized Teaching Hospital Pediatric Endocrine clinic. Methodology- A cross-sectional study will be conducted among Type 1 DM patients visiting pediatrics endocrine unit from Aug 2024 to Sep 2024. The data will be collected by trained interns with face to face interview by using pretested questioner. Data will be entered using Epi data version 3.5.1 and will be analyzed by SPSS version 26.0 and frequencies and percentages will be calculated to all variables. Binary Logistic regression was used to analyze the data. Results: The study involved 140 participants, including 13 children (9.3%) under 5 years old, 30 (21.4%) aged 6 to 10, and 97 (69.3%) who were older than 11. There were 63 females (45.0%) and 77 males (55.0%), showing a slightly higher number of males in the group. The average BMI of the children was 20.5 ± 6 kg/m². On average, the participants had been living with Type 1 Diabetes for 6.71 years, with 93.6% using a mixed insulin regimen (NPH + Regular Insulin) and 6.4% on a Basal-Bolus regimen (Glargine + Regular Insulin). On the same token , 39 participants (27.9%) selected the thigh and arm as their preferred injection sites, while only 6 5 (4.3%) selected the abdomen. Of the participants, 43 (30.7%) did not rotate their injection sites on a regular basis, whereas 97 (69.3%) did. Lipodystrophy was more common in children with diabetes for more than five years (53 cases) than in those with less than five years (33 cases), according to the study.
Prevalence of Sleep Disorders and Associated Factors in Children with Cerebral Palsy in Black Lion Hospital Neurologic and Developmental Clinic, Addisababa, Ethiopia; A Cross-Sectional Study
(Addis Ababa University, 2025-04-15) Kalkidan Mekuanint; AtsedeTeklehaimanot
Introduction:Sleep is critical for optimal growth and developmental outcomes in children. Those with cerebral palsy (CP) experience sleep disorders (SDs) at higher rates than neurotypical peers, with disruptions in sleep initiation/maintenance, sleep-wake transitions, excessive daytime sleepiness, and night awakenings being prevalent. These disturbances significantly impair quality of life. This study assessed the prevalence of SDs and associated factors among children with CP at Black Lion Hospital’s Neurologic and Developmental Clinic in Addis Ababa, Ethiopia. Objective:To evaluate the prevalence of SDs and identify contributing factors in children with CP attending Black Lion Hospital’s Neurology and Developmental Clinic. Methods:An institutional cross-sectional study was conducted from October 2024 to February 2025, involving 119 children selected via systematic sampling. Data were collected using the validated Sleep Disturbance Scale for Children (SDSC), administered by trained personnel, and analyzed in SPSS v25. Descriptive statistics (mean/median for continuous variables; percentages for categorical variables) and logistic regression (bivariate and multivariate models) were used to determine associations, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported. Results: Among 119 participants, SD prevalence was 37% (95% CI: 26.0–47.9%). Disorders of initiating/maintaining sleep were most common (52.9%, n=63). Significant predictors included:- Spastic CP subtype (AOR=10.60; 95% CI: 1.34–83.47; *p*=0.025)- Male sex (AOR=13.23; 95% CI: 1.84–95.08; *p*=0.010)- Urban residence (AOR=3.15; 95% CI: 0.68–14.53; *p*=0.014)-Severe motor impairment(GMFCS Level V: AOR=5.70; 95% CI: 0.97–33.53; *p*=0.034; Level IV: AOR=3.55; 95% CI: 1.03–12.16; *p*=0.044)-Bed-sharing (AOR=8.39; 95% CI: 1.21–58.13; *p*=0.031) Conclusion and Recommendation: SD prevalence among children with CP at Tikur Anbessa Specialized Hospital (TASH) is substantial, with spastic CP, male sex, urban residence, severe motor dysfunction, and bed sharing identified as key factors. Routine objective sleep assessments for CP patients are recommended to guide targeted interventions. Keywords: Sleep disorders, Sleep Disturbance Scale for Children (SDSC), Cerebral Palsy, Tikur AnbesaSpecializedHospital(TASH),Ethiopia
Quality of Life of Patients Under 15 Years of Age with Myelomeningocele on Follow up at Zewditu Memorial and Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia; A Multicenter Cross-Sectional Study
(Addis Ababa University, 2025-02-15) Kefele Elias; Damte Shimelis
Background – Africa was shown to have a high pooled birth prevalence of neural tube defects. Despite the use of preventative measures, the prevalence of neural tube defects in Ethiopia is seven times higher than in other Western nations. Despite the heavy burden, there have been relatively few studies on the quality of life of children with myelomeningocele, particularly at the multidisciplinary level. The long-term quality of life is impacted by MMC. Objective: The objective of this study was to assess quality of patients under 15 years of age with Myelomeningocele On follow-up at Zewditu Memorial and Tikur Anbessa Specialized Hospitals. Methods: The study was a multicenter cross-sectional study that was carried out at the neurosurgery clinics of Zewditu Memorial and Tikur Anbessa Specialized Hospital between September 2024 and February 2025. Data was gathered from patients who met the requirements using a simple random sampling method and questionnaires that the parents completed with the researcher's help. Version 25 of the Statistical Package for Social Sciences (SPSS) was used to enter the data for any ensuing descriptive and analytical statistics. In terms of statistics, a p-value of less than 0.05 was considered to indicate a significant association . Result: A total of 215 study participants participated during the study period, yielding a 95.9% response rate. 54 percent of the children were female, and the majorities (89.8%) were between the ages of 0 and 7. The study's overall QoL result was 45.1±20.24. Comparing school functioning (33.43±18.56) and emotional functioning (36.5±16.85) to other general scoring measures, the QoL values were lower. With a mean score of 56.6±30.71, physical functioning was the highest, followed by social functioning (38.17±23.78). Our research reveals a strong relationship between household income and HRQoL, with higher-income households reporting higher HRQoL ratings. When compared to patients with concomitant conditions, MMc patients without comorbidity have a higher overall quality of life. Conclusion In conclusion, the results of this study demonstrated that, in comparison to several studies conducted in other nations, children with MMC at Zewditu and Black Lion Hospital Neurosurgery unit had usually low quality of life assessment scores. Additionally, when compared to other generic scoring scales, the QoL ratings were higher for physical functioning and lower for school functioning.
Admission Hypothermia and Neonatal Mortality: A Cross Sectional Study of Prospectively Collected Data
(Addis Ababa University, 2024-01-13) Kullehe Haddis; Asrat Demtse
Background According to a March 2024 WHO report, 2.3 million deaths occurred in newborns less than 28 days globally in 2022. Sub-Saharan Africa had the highest neonatal mortality rate, of 27 per 1000 live births [1]. Hypothermia is known to increase the risk of both morbidity and mortality. Thus maintaining a normal body temperature is one of the very important steps for survival of the newborns. Despite the different mechanisms proposed to prevent hypothermia, it remains a global problem especially for low-income countries like Ethiopia. Objective The objective of the study was to determine the effect of admission hypothermia on neonatal mortality across 20 Ethiopian hospitals discharged from neonatal units from January 1-December 31, 2021. Methodology This study is a secondary analysis of prospectively collected data. A total of twenty hospitals participating in the Ethiopian Neonatal Network (ENN) in the Vermont Oxford Network (VON) Global Health Database were included. All newborns whose temperature was recorded in one hour of birth were included in the study. The admission hypothermia was assessed in association with gestational age, birth weight, the environmental temperature, level of neonatal intensive care unit where the neonatal care provided, season of the year the newborn was born, and whether the newborn was born in the weekdays or weekends. Associations were tested for mode of delivery, birth weight, place of delivery and whether the newborn was term or preterm in relation to mortality. Effect modification by discharge diagnosis was considered. Associations were calculated using relative risk (RR) with a 95% CI. Data analysis was done using SAS 9.4. iii Results A total of 12,363 newborns were included in the study. The overall rate of hypothermia was 51.6%. Predictors for hypothermia and mortality included being part of a multiple birth, low birth weight and lower gestational age. The season of the month, mode of delivery or hospital environmental temperature did not have any impact in predicting hypothermia or death. In unadjusted analyses, the risk of death increased more than five times [RR 5.65 (95% CI: 4.31, 7.41)] when the admission temperature was less than 33.9°C, more than four times [RR 4.25 (95% CI: 3.30, 5.49)] when the temperature was between 34 - 34.9°C. In a multivariable analysis with other confounding factors controlled, the risk of death increased by two times for body temperatures less than 36.5°C. Admission temperature was not an effect modifier in the associations between perinatal asphyxia, respiratory distress, or meconium aspiration syndrome and mortality. However, admission temperature was an effect modifier in the association between any sepsis and mortality. Conclusion Admission hypothermia is high in Ethiopia and is associated with a twofold increased risk of death. Lower gestational ages, low birth weight infants, septic patients, newborns with congenital anomaly and multiple births were associated with increased risk of death. Measures to improve admission hypothermia through the use of intensive quality improvement projects should be undertaken to improve the situation in the country.
Observed outcome and Comparison to Pediatrics Index Mortality 3 Score of Patients Admitted to Pediatric Intensive Care Units at TASH, Ethiopia: A Prospective Cohort Study 2024
(Addis Ababa University, 2025-02-13) Melaku Moges; Ameha Mekasha
Background: Pediatric index of mortality 3 (PIM 3) score is an illness severity and scoring systems used for predicting outcome of children admitted to PICU. It is an integral part of providing ICU care and used as performance indicators of ICUs. Objectives: To determine outcome and comparison to pediatrics Index Mortality 3 score of patients admitted to pediatric intensive care units at TASH Hospital, Ethiopia: A Prospective Cohort Study (2024 GC). Methods: Hospital based Prospective cohort study design was employed from October, 2024 to February, 2024 to determine observed outcome and comparison to pediatrics Index Mortality 3 score of patients admitted to pediatric intensive care units at TASH Hospital, Ethiopia. Data were collected by structured checklists adapted from different pieces of literature, through history taking, patient document review, and physical examination. The PIM-3 was scored within the first hour of admission. The standardized mortality ratio (SMR) was calculated using the Mid-P exact method. The discriminatory function was assessed by the area under the receiver operating characteristic (ROC) curve. Result: A total of 74 participants with a median age of 48.5 months at admission were included in this analysis. Of those 52.7% were males. The median duration of hospital stay was four days (IQR: 1–6).A total of 19 (25.7%) children died during the study period. The overall predicted mortality rate by the PIM- 3 score was 16.4%, giving an SMR of 1.56 (95% CI: 2.11, 3.95). The area under receiver operating characteristics (AUROC =0.84,95% CI: 0.75-0.95) . Conclusion: The PIM-3 had a good discriminatory function can be used to prioritize care and for the assessment of the quality of care.

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