Pediatrics and Child Health

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Utilizing Preoperative Laboratory Indicators to Mitigating Postoperative Multiorgan Dysfunction Following Cardiac Surgery in Children with Congenital Heart Disease at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia
(Addis Ababa University, 2026-09-16) Mohammed Ali; Tamirat Moges
Background: Postoperative multiorgan dysfunction syndrome (MODS) is a serious complication following pediatric congenital heart surgery and is associated with high mortality. In resource-limited settings, advanced monitoring tools are often unavailable, making early risk identification challenging. Preoperative laboratory indicators may provide simple and accessible predictors of postoperative organ dysfunction. Objective: To determine the prevalence of postoperative MODS and evaluate whether preoperative laboratory indicators predict postoperative organ dysfunction among children undergoing congenital heart surgery at Cardiac center and Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A retrospective cohort study was conducted among 166 pediatric patients who underwent congenital heart surgery with cardiopulmonary bypass between January 2023 and September 2025. Preoperative laboratory parameters, including serum creatinine, hemoglobin, platelet count, liver enzymes, INR, and arterial blood gas values, were extracted from medical records. Postoperative organ dysfunction was assessed using an adapted and modified PELOD-2C score, with a score >6 defining MODS. Bivariable and multivariable linear regression analyses were performed to identify independent predictors of postoperative organ dysfunction severity. Results: Postoperative MODS occurred in 4 patients (2.4%). Although infrequent, MODS was strongly associated with prolonged ICU stay, longer mechanical ventilation, increased vasopressor use, and higher mortality (75% vs. 0.6%, p < 0.001). In multivariable analysis, higher surgical complexity (RACHS-1 Category 3; β = 3.83, p < 0.001), elevated preoperative INR (β = 1.30, p < 0.001), lower platelet count (β = −0.0022 per 10³/μL increase, p = 0.032), and severe preoperative malnutrition (β = 1.22, p = 0.006) were independently associated with higher postoperative PELOD-2C scores. Preoperative serum creatinine and hemoglobin were not independently predictive after adjustment. Conclusion: Postoperative MODS was uncommon but highly lethal in this cohort. Surgical complexity, coagulation abnormalities, thrombocytopenia, and severe malnutrition were significant predictors of postoperative organ dysfunction. Incorporating simple preoperative laboratory markers and nutritional assessment into perioperative risk stratification may improve early identification of high-risk children in resource limited settings.
Assessing the Knowledge, Attitude, and Practices of Surgical Residents Regarding Surgical Antimicrobial Prophylaxis at Tikur Anbessa Specialized Hospital, Ethiopia
(Addis Ababa University, 2026-08-09) Bezawit Mulat; Melat Tesfaye; Tewodros Hailemariam
Background: Inappropriate use of surgical antimicrobial prophylaxis (SAP) contributes significantly to surgical site infections and antimicrobial resistance in developing countries. At Tikur Anbessa Specialized Hospital (TASH), Ethiopia's largest pediatric referral center, the quality of SAP for children is a significant concern. The knowledge, attitudes, and practices of surgical residents regarding pediatric SAP have not been systematically studied. Objective: This study aimed to assess the knowledge, attitudes, and practices of surgical residents regarding pediatric surgical antimicrobial prophylaxis at TASH and to identify barriers and facilitators to appropriate SAP use. Methods: An institution-based cross-sectional study was conducted from September to December 2025 at TASH. A census approach was used, inviting all eligible surgical residents who operate on pediatric patients across five surgical departments. Data were collected using a structured, self-administered questionnaire. Knowledge, attitude, and practice were assessed using composite scores and dichotomized at the sample mean. Descriptive statistics, chi square tests, and binary logistic regression were performed using SPSS version 27. Results: Eighty-nine surgical residents participated in the study, representing a response rate of 76.7%. The mean knowledge score was 4.6 out of 9, with 50.6% classified as having good knowledge. The mean attitude score was 34.6 out of 45, with 47.2% demonstrating favorable attitudes. The mean practice score was 3.3 out of 5, with 46.1% reporting good practice. Single-dose sufficiency (94.4%) and vancomycin for MRSA coverage (89.9%) were the most correctly answered knowledge items, while first-line agent identification (38.2%) and penicillin allergy alternatives (38.2%) were the weakest. Senior residency status was independently associated with good knowledge (adjusted odds ratio 5.49, p = 0.001). The most frequently reported barrier was lack of clear hospital guidelines (66.3%), and the most endorsed facilitator was availability of clear SAP guidelines (80.9%). Conclusion: Approximately half of surgical residents at TASH demonstrated adequate knowledge, favorable attitudes, and good practices regarding pediatric SAP. However, substantial gaps remain, particularly in knowledge of appropriate antibiotic selection and timing. The convergence of lack of guidelines as both the primary barrier and the most desired facilitator indicates a clear need for development and implementation of standardized, pediatric-specific SAP protocols at TASH. Educational programs targeting identified v knowledge gaps, establishment of audit and feedback systems, and integration within an antimicrobial stewardship program are recommended to improve SAP practices and reduce surgical site infections.
Dietary Pattern and Its Association with Glycemic Control Among Children and Adolescents with T1dm At Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2026-07-22) Hanna Yirdaw; Seminew
Background: One common long-term metabolic condition is diabetes mellitus (DM). One unique biochemical feature of this illness is elevated blood sugar levels. The term "diabetes mellitus" refers to a complex metabolic disorder in which an individual has persistently high blood sugar due to a malfunction in the production or secretion of insulin. Objectives: To evaluate the relationship between glycemic control and dietary habits in kids and teenagers with type 1 diabetes. Methodology: The current study was conducted using a cross-sectional study design that involved a hospital-based approach between October, 2025 and January, 2026 G.C among patients in the follow-up clinics for diabetic children of the Tikur Anbessa specialized hospital. Sample size calculation was done by using a single population proportion formula with 95% confidence level and 5% precision which resulted in 129 respondents. The collected data was first analyzed using excel, and then entered to SPSS version 27 for data analysis. Both bivariable and multivariable linear regression analysis were used. All variables were considered in bivariable linear regression analysis while those with p-values <0.2 were considered for multivariable linear regression analysis. Results; The study involved a sample size of 129 subjects who were aged between 10 and 18 years. They accounted for 77.5% of the total sample population. Majority (93%) of the patients dwelled in urban settings. The nutritional state of most of the participants was within acceptable limits with 89.1% being well-nourished. However, their glycemic control was not satisfactory, evident in the higher average HbA1c (10.25 ± 2.35%). Multivariate regression analysis revealed that poor adherence to diet, low education level of care-givers, and reduced frequency of insulin administration were predictors of increased HbA1c levels. Other variables like age, disease duration, and exposure to glycemic index were not associated independently with HbA1c. Conclusion: Many children and adolescents with type 1 diabetes visiting Tikur Anbessa Specialized Hospital are faced with inadequate glycemic control. This condition is highly influenced by modifiable risk factors such as dietary intake, insulin administration, and educational level of the care providers. Despite the general adequacy of the nutritional status among those affected, the study revealed problems in diabetic-related dietary intake and insufficient patient empowerment. These results imply the necessity of specific actions towards improving dietary knowledge among patients and their caregivers, as well as enhancing diabetes
Risk Factors and Outcomes of Hyperleukocytosis In Pediatric Acute Leukemia: A Five-Year Retrospective Case-Control Study at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia.
(Addis Ababa University, 2026-03-13) Haimanot Chala; Daniel hailu
Background: Hyperleukocytosis is a pediatric oncologic emergency in acute leukemia associated with leukostasis, tumor lysis syndrome, and early mortality. Despite its clinical importance, the data on risk factors and outcomes of hyperleukocytosis in children with acute leukemia are limited in low-resource settings. Objective: To identify risk factors and early outcomes of hyperleukocytosis among pediatric acute leukemia patients at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A five-year case-control study took place at the pediatric hematology-oncology unit of Tikur Anbesa Specialized Hospital from April 1, 2020, to March 31, 2025. The study included children under 18 years with newly diagnosed acute leukemia. Cases were patients with hyperleukocytosis (white blood cell count ≥100,000/μL) at diagnosis, and controls were patients without hyperleukocytosis in a 1:2 ratio. Researchers collected data using a structured checklist and analyzed it with SPSS version 29. They calculated descriptive statistics and made comparisons between groups using chi-square and Mann-Whitney U tests. They used multivariable logistic regression analysis to find independent risk factors and predictors of early mortality. The study reported adjusted odds ratios (AOR) with 95% confidence intervals, and a p-value of less than 0.05 was considered statistically significant. Results: A study of 153 patients diagnosed with pediatric acute leukemia indicated that 51 of these patients presented with hyperleukocytosis and the remaining 102 served as the control group for this study. The association between hyperleukocytosis at the time of presentation and respiratory symptoms, peripheral blast percentage, uric acid concentration, and leukemia subclass was found to be statistically significant. Multivariate analysis demonstrated that respiratory symptoms (AOR = 5.74), acute myeloid leukemia (AOR = 4.23), peripheral blast percentage (AOR = 1.045), and uric acid level (AOR = 1.213) were independent risk factors for hyperleukocytosis. Patients with hyperleukocytosis had significantly more complications than patients without hyperleukocytosis (88.2% vs 57.8%) and greater than the patients without hyperleukocytosis (25.5% vs 5.9%). Our study further demonstrated that hyperleukocytosis (AOR = 19.31), respiratory symptoms (AOR = 10.37), low platelet count (AOR = 0.942), and elevated uric acid (AOR = 1.302) were independent predictors of early mortality. Conclusion: Pediatric acute leukemia patients who have hyperleukocytosis, have a much higher risk of developing 10 complications and dying shortly thereafter. The factors that independently predict response to treatment in these patients include respiratory symptoms, AML type, high number of peripheral blasts in the blood, and the presence of elevated uric acid levels. To reduce mortality in any sub-group of high-risk patients, they need to be identified early, and appropriate supportive care should be started quickly.
Dental Health Status and Determinants in Pediatric Pa Tints with Heart Disease: A Cross-Sectional Analysis at Tikur Anbessa Specialized Hospital”
(Addis Ababa University, 2026-08-24) Melat Shewabera; Hayat Ahemed
Background: Children who are born with a cardiac problem are more vulnerable worldwide to poor oral health, which can lead to potentially fatal complications such as infective endocarditis. In Ethiopia, despite limited research, clinical information regarding this susceptible group's oral health is very lacking. Objective: To assess the magnitude of dental diseases and identify factors associated with them among children with heart disease at TASH. Methods: A facility-based cross-sectional study will be carried out among a calculated sample of child-parent dyads chosen using a systematic random sampling technique. Data were collected through clinical oral examinations (using dmft/DMFT and GI indices) and structured interviewer administered questionnaires assessing socio-demographic, medical, and KAP factors. Data were analyzed using STATA/SPSS. Results: A total of 315 caregivers were involved in the research. The findings showed that 67.0% of children had poor dental status, with gingival inflammation observed in 40.6% and dental caries affecting both primary (44.6%) and permanent teeth (31.2%). Despite over half of the participants reporting access to nearby dental clinics, 93.3% had never visited a dentist, mainly due to lack of referral and low awareness. Most caregivers had poor knowledge (68.3%) and poor oral health practices (97.8%). Multivariable analysis identified caregiver knowledge and child age as signifi cant predictors of dental status. Conclusion and recommendations: The study demonstrates a high prevalence of poor oral health among children with heart disease, with very low utilization of dental services. Poor caregiver knowledge and lack of referral systems were key contributing factors, indicating a gap between awareness and practice. Strengthening caregiver education, integrating oral health assessment into routine cardiac care, and establishing structured referral systems between cardiology and dental services are essential to improve outcomes.
Psychological Outcomes and Coping Mechanisms in Parents of Critically Ill Children Admitted in PICU at TASH: Hospital
(Addis Ababa University, 2026-09-21) Bisrat Enedeg; Addishiwot Melese; Haileleul Mekonen
Background: Parents of critically ill children admitted to the Pediatric Intensive Care Unit (PICU) often experience high levels of psychological distress, including anxiety, depression, and stress. These psychological outcomes not only affect parental well-being but also influence the child’s recovery and family functioning. Despite the critical impact, limited data exists from Ethiopia on the psychological burden faced by parents of PICU patients. Objectives: To assess the psychological outcomes (anxiety, depression, and stress) and coping mechanism of parents of critically ill children admitted to the PICU at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa University, Ethiopia, and to identify associated factors. Methods: A hospital-based cross-sectional study was conducted from September 2025 to February 2026. A total of 83 parents of children admitted to the PICU was prosepctively enrolled. Data was collected using a structured questionnaire, including the validated Depression, Anxiety, and Stress Scale (DASS-21). Socio-demographic and clinical variables were assessed. Outcomes were measured as magnitudes and severity of anxiety, depression, and stress. Data was entered and analyzed using R software. Descriptive statistics, frequency tables, and graphs were used for summary, while logistic regression was used to identify factors associated with adverse psychological outcomes. Results: In a study of 83 parents in the Pediatric Intensive Care Unit, 68.7% exhibited poor psychological outcomes, characterized by high rates of depression and anxiety. Multivariate analysis revealed that mechanical ventilation, surgical interventions, and shorter durations of stay were significant independent predictors of increased parental distress. Parents primarily utilized emotion-focused coping mechanisms, though many also employed dysfunctional strategies that could potentially exacerbate their psychological burden. The study concludes that intensive medical procedures significantly heighten emotional trauma, highlighting a critical need for early psychological screening and intervention. Conclusion: Integrating dedicated psychosocial support services into the PICU is essential to safeguard the mental health and resilience of families.
Magnitude and Risk Factors of HBV and HCV infection among Children and Adolescents in Tikur Anbesa Specialized Hospital Pediatric and Adult GI Clinic
(Addis Ababa University, 2026-11-04) Mitiku Kuma; Abebe Habtamu
Title: Magnitude and Risk Factors of Hepatitis B and C Among Children and Adolescents in Ethiopia Objective: This study aimed to assess the prevalence, identify risk factors, and explore challenges related to Hepatitis B (HBV) and Hepatitis C (HCV) infections among children and adolescents in Ethiopia. Study Design: We did this study at Tikur Anbessa Specialized Hospital. We looked at records and asked people questions over a period of six to twelve months. We did blood tests to see if people had Hepatitis B or Hepatitis C. Results: We found out that a lot of kids and teenagers in Ethiopia have Hepatitis B. Not as manyhave Hepatitis C but it is still a problem. Some of the reasons people get these diseases are because their mothers had it when they were born they did not get the Hepatitis B vaccine they got bad medical care and they did not know about the disease. Weal so saw that not many people get checked for Hepatitis B and C and it is hard for somepeople to get treatment. Proposed Solutions: We think it is very important to make sure all babies get the Hepatitis B vaccine when they are born. We also need to check people for Hepatitis B and Especially pregnant women and kids. Doctors and nurses need to be more careful when taking care of patients so they do not spread the disease. We need to tell people more about Hepatitis B and C so they know how to protect themselves. It is also very important to make sure people can get the treatment they need and to make hospitals better at taking care of people with Hepatitis B and C. Hepatitis B and C are still problems for kids and teenagers, in Ethiopia. We need to make sure people get vaccinated get checked for the disease and get treatment if they need it. We also need to tell people more about Hepatitis B and C. If we work together wecanprevent people from getting these diseases and help people who already have them.
Prevalence, Risk factors and Health Impacts of Substance Abuse Among Street Children in Addis Ababa, Ethiopia
(Addis Ababa University, 2026-06-16) Henok Tafere; Rajalakshmi Murugan; Yosief Tsige
Introduction: Street youth are generally categorized into children on the street (who work but return home), children of the street (who live on the street without family contact), Psychosocial stress, chronic hunger, and violence of the street environment frequently drive street-involved children to use accessible substances like volatile inhalants (glue/benzene) and khat as survival coping mechanisms. Where toxic chemical exposure and addiction directly trigger acute gastrointestinal and respiratory pathology, cognitive deficits, and aggressive social behaviors. Objective: This study aimed to assess the prevalence, risk factors, and health impacts of substance abuse among street children in Addis Ababa, Ethiopia. Methods: A community-based cross-sectional study was conducted among 626 street children across selected sub-cities from February 15 to March 5, 2026. A multistage sampling technique followed by consecutive sampling was employed. Data were collected via interviewer-administered questionnaires by trained nurses, entered into Epi Info 7.2, and analyzed using SPSS 27. Binary logistic regression was used to identify factors associated with substance abuse (p < 0.05, 95% CI). Results: The overall prevalence of substance abuse was 62.6%. The most commonly abused substances were inhalants (80.6%), khat (67.1%), alcohol (44.4%), and cigarettes (44.1%).the strongest independent predictors significantly associated with substance abuse were using substances to cope with emotional problems AOR = 3.012 (1.702, 5.330), finding it difficult to refuse substances when offered AOR = 2.835 (1.396, 5.757), engaging in risk-taking or dangerous activities AOR = 2.367 (1.169, 4.795), and believing that substances help them survive street life AOR = 2.127 (1.053, 4.293)The most prevalent physical health impacts were stomach pain (51.0%), while difficulty concentrating (39.5%) was the leading psychological impact. Socially, physical altercations (29.7%) and engagement in illegal activities (22.7%) were highly reported. Conclusion and recommendation: Substance abuse is a severe public health crisis in Addis Ababa, affecting nearly two-thirds (62.6%) of street children. The strong association with past trauma and easy substance access underscores the urgent need for multi-sectoral interventions focusing on trauma-informed rehabilitation, psychological support, and stricter regulation of volatile inhalants.
Growth Trajectories and Chronic Kidney Disease Burden in Boys with Posterior Urethral Valves: A 10 years Retrospective Study at TASH, Addis Ababa, Ethiopia.
(Addis Ababa University, 2026-09-27) Worku Hobasa; Bezaye Abebe
Background and Objective: Posterior urethral valve, the most common cause of severe obstructive uropathy in children, is PUVs, affecting 1 in 4,000- 8,000 males. This study aimed to identify the prevalence and independent predictors of stunting and CKD among patients with PUV at a tertiary Ethiopian hospital. Methods: We conducted a retrospective cross-sectional study of 112 patients receiving PUV surgical treatment at Tikur Anbessa Specialized Hospital during the study period. All male pediatric patients with confirmed PUV who had surgical management at TASH during the study period were selected. The primary outcome was stunting and CKD. Multivariable logistic regression was performed to identify independent predictors. Results: At baseline, the majority of boys had normal growth, with 82 participants (73.2%) classified as normal based on height-for-age Z-score (HAZ). Stunting was observed in 18 boys (16.1%), while 12 boys (10.7%) were severely stunted. In multivariable analysis, two factors demonstrated independent associations with stunting: Pre-op creatinine ≥0.8mg/dl (adjusted OR 4.84, 95% CI 1.85-12.66, p=0.001) and post-op hypertension (adjusted OR 3.09 (1.14–8.40) 95% CI, p= 0.0027). Among the 112 patients, nearly half (47.3%) had normal renal function, while 45.5% had chronic kidney disease (CKD) and 6.3% had end-stage renal disease (ESRD). In multivariable analysis, two factors demonstrated independent associations with CKD. Pre-op creatinine ≥0.8mg/dl (adjusted OR 4.8, 95% CI 2.1-11, P<0.001) and post-op nadir creatinine ≥0.8mg/dl (adjusted OR 12, 95% CI 4.0-36.0, p=0.001). Conclusions and Recommendations: This study confirms that PUV is a chronic progressive renal disease with significant long-term morbidity. Growth impairment is closely linked to renal dysfunction. Nearly half of the patients developed CKD. Renal functional markers, particularly pre-operative creatinine, post-operative nadir creatinine, and hypertension, are the strongest predictors of adverse growth and renal outcomes.
Trends in Inpatient Admissions and The Magnitude of Early Mortality Among Pediatric Haemato-Lymphoid Cancer Patients At Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2025-10-13) Bereket Genta; Gashaw Arega
Background Cancer is a major cause of childhood morbidity and mortality worldwide. Each year, nearly 273,000 children and adolescents under the age of 20 are diagnosed with cancer. While the overall survival rate for children with cancer has reached 80% in many high income countries (HICs), in lower-middle-income countries (LMICs) and low-income countries (LICs), figures are significantly lower with rates falling below 30%. Globally, leukemia is the most common childhood cancer, followed by brain tumors and lymphomas, though the distribution varies geographically. Early mortality (EM), defined as death within the first 42 days of diagnosis or admission. Early mortality reflects limitations in timely diagnosis, supportive care, infection management, and treatment access. Objective: To asses Early Death (ED) at TASH, Pediatric Hematology and Oncology Unit And to analyze the types and causes of mortalities across different Cancer types Method: A facility-based Cross-sectional study will be conducted on All children with newly diagnosed childhood cancer who admitted at the TASH PHOC unit. Data will be collected from charts. Data will be entered into Statistical Package for Social Sciences version 25 (SPSS) for subsequent descriptive and analytical statistics where applicable. Statistically significant association will be taken for p value of <0.05. Budget and Work plan: The study will be conducted from 1 January, 2023 to 31 January, 2025.G.C with estimated total cost of 36,825 Birr, the cost will be sponsored by Addis Ababa University, College of health science.
Magnitude and Predictive Factors of Acute Malnutrition In Children With Patent Ductus Arteriosus And Short-Term Postoperative Nutritional Outcomes At Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2026-03-20) Bereket Legesse; Helen Mintesnot
Background: Patent Ductus Arteriosus (PDA) is a common congenital heart defect that predisposes children to malnutrition due to increased metabolic demands and poor nutrient intake. In Ethiopia, the prevalence and predictors of malnutrition in children with specific defects like PDA, as well as their postoperative nutritional recovery, remain poorly characterized, hindering the development of targeted interventions. Objectives: To assess the prevalence and predictive factors of malnutrition and determine the short-term postoperative nutritional outcomes among children with PDA at Tikur Anbessa Specialized Hospital (TASH). Methods: A hospital-based comparative cross-sectional study was conducted at the pediatric cardiac clinic of TASH. A total of 87 children aged 1-month r=to 18 years who underwent surgical PDA correction in the past 3 years the latest being 3 months prior to the data collection were included. Data on demographics, clinical history, and PDA severity was collected via chart review. Preoperative and 3-month postoperative anthropometric measurements (weight and height/length) was converted into Z-scores (WAZ, HAZ, WHZ) using WHO standards (WHO Anthro Pluss application) to define malnutrition (wasting, stunting, underweight, over weight and obesity). Frequency and percent were used for categorical data and mean and SD was used to describe continuous data. Bivariate and multivariable logistic regression was used to identify predictive factors for acute malnutrition. Paired samples t-tests was used compared to pre- and post-operative Z-scores to assess nutritional recovery. Result: A total of 87 children with PDA were included; the median age was 5years (IQR: -8), and 60 (69.0%) were female. Acute malnutrition was identified in 52 children (59.8%; 95% CI: 48.7 70.1). in multivariable analysis, female sex was associated with significantly lower odds of acute malnutrition (AOR= 0.33; 95% CI: 0.15-0.98; p=0.04), whereas the presence of other comorbidities was independently associated with higher odds of acute malnutrition (AOR= 10.2; 95% CI: 1.21-97.85; p=0.03). Conclusion: This study reveals a high prevalence of preoperative malnutrition among children with Patent Ductus Arteriosus included in this study. The findings further demonstrate that the presence of additional comorbidities is a major contributor to poorer postoperative outcomes. x Most importantly, this research provides compelling evidence that surgical correction of PDA leads to a significant improvement in the nutritional status of these children, as assessed three months postoperatively. These results highlight the critical need for targeted nutritional interventions and comprehensive management of comorbidities to optimize surgical outcomes and support healthy growth in this vulnerable population.
Magnitude and Predictors of Death among Neonates with Congenital Anomalies at Neonatal Intensive Care Unit of a Tertiary Referral Hospital in Addis Ababa.
(Addis Ababa University, 2026-05-19) Addis Habtamu; Hanna Gebre
Background: Congenital anomalies are a major reason newborns die, especially in poorer countries. Ethiopia is seeing more of these cases, but hospitals here still lack solid data on which affected babies are most likely to die. Objective: To assess the magnitude and maternal and neonatal factors associated with neonatal death among neonates with congenital anomalies admitted to a tertiary hospital. Methods: An institution-based cross-sectional study was conducted among neonates diagnosed with congenital anomalies and admitted to the neonatal intensive care unit (NICU). Data were extracted from medical records of patients using a structured questionnaire. Descriptive statistics were used to summarize maternal and neonatal characteristics. Binary logistic regression was performed to identify factors associated with neonatal death. Crude odds ratios (COR) and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were computed. Variables with P<0.05 in the multivariable analysis were considered statistically significant. Results: Several maternal and neonatal factors achieved significant associations with neonatal death in crude analysis, including prematurity, low five-minute APGAR score, single congenital anomaly, absence of referral delay, fewer medical interventions, and prolonged nothing per os (NPO) status. After multivariable adjustment, prolonged NPO status for more than 24 hours (AOR = 0.32, 95% CI: 0.12–0.87) compared to being NPO for less than 24 hours, shorter length of hospital stay of <1 day (AOR = 17, 95% CI: 3.37–86.2), 1–16 days ( AOR = 4.6, 95% CI: 1.79–11.8) more than 16 days, maternal age of 18-34 years (AOR = 0.39, 95% CI:0.17-0.88), compared to maternal age greater than 34 years, and primary education status (AOR =4.09,95% CI:1.52-10.97) compared to educational level of college and above were independently associated with neonatal mortality. Neonates hospitalized for longer than 176 days had an improved survival. Conclusion: Babies who went without oral feeding for over a day, those who died very early in their hospital stay, and those whose mothers were under 34 or had little education — these were the groups with the highest death risk.
Pain Assessment in Patients with Cyanotic Congenital Heart Disease Undergoing Phlebotomy for Polycythemia in Tikur Anbessa Specialized Hospital
(Addis Ababa University, 2026-08-16) Lensa Habtamu; Henok Tadel
Background: Children with cyanotic congenital heart disease frequently undergo therapeutic phlebotomy to manage secondary polycythemia, yet procedural pain is rarely assessed or managed in Ethiopian healthcare settings. This study assessed the severity of phlebotomy-related pain and identified associated factors among children with cyanotic congenital heart disease at Tikur Anbessa Specialized Hospital. Methods: A cross-sectional study was conducted from October 1, 2025 to March 1, 2026 among 118 children aged 4 to 16 years with echocardiography-confirmed cyanotic congenital heart disease undergoing therapeutic phlebotomy. Pain was assessed immediately post-procedure using validated age-appropriate tools: Wong-Baker Faces Pain Rating Scale for children aged 4 to 7 years and Numeric Rating Scale for older children. Pain scores were categorized as mild for scores of 2 to 3 versus moderate-to-severe for scores of 4 or higher. Data were analyzed using descriptive statistics, bivariate analysis, and binary logistic regression in SPSS version 27. Results: Two-thirds of children experienced moderate-to-severe pain, with a mean pain score of 4.0 (SD 1.00) and a median of 4 (IQR 3–5), with scores ranging from 2 to 6. Preprocedural anxious children experienced moderate to severe pain, p< 0.001. Young children, less than 5 years of age, experienced moderate to severe phlebotomy pain, p < 0.001. Children with frequent phlebotomy attempts experienced moderate to severe pain, p<0.0001. Conclusion: Two-third of children with cyanotic CHD undergoing therapeutic phlebotomy experienced moderate to severe procedural pain. Pre-procedural anxiety, young age, and frequency of phlebotomy attempts associated with moderate to severe phlebotomy pain. Therapeutic Phlebotomy pain needs to be assessed and managed. Systematic pre-procedural psychological preparation including the use of distraction techniques, and improving competency to improve first-attempt venipuncture success recommended particularly in young children with cyanotic CHD undergoing therapeutic phlebotomy.
Development of a Clinical Risk Assessment score for Early Prediction of Neonatal Mortality at a selected hospital, Addis Ababa, Ethiopia
(Addis Ababa University, 2026-05-18) Tsegaab Fikre; Rahel Argaw
Background: Neonatal mortality remains a major public health challenge in Ethiopia despite substantial improvements in maternal and child health services. Early identification of neonates at high risk of death is essential for timely intervention and optimal allocation of limited neonatal intensive care resources. However, standardized and locally validated prognostic tools for predicting neonatal mortality are scarce in Ethiopian neonatal intensive care units (NICUs). Objective: To develop and internally validate a clinical risk assessment score for early prediction of neonatal mortality among neonates admitted to the NICUs of Tikur Anbessa Specialized Hospital (TASH) and Gandhi Memorial Hospital (GMH), Addis Ababa, Ethiopia. Methods: A hospital-based retrospective case–control study was conducted among 570 neonates admitted to the NICUs of TASH and GMH between March 2025 and January 2026. Cases were neonates who died during NICU admission (n = 189), while controls were neonates discharged alive (n = 381). Data were extracted from medical records using a structured data abstraction tool. Bivariable and multivariable logistic regression analyses were performed to identify independent predictors of neonatal mortality. Variables with p < 0.25 in bivariable analysis were entered into the multivariable model. Model performance was assessed using calibration and goodness-of-fit statistics. A simplified clinical risk score was developed from the regression coefficients of significant predictors. Results: Of the 570 neonates included in the study, 33.2% died during NICU admission. Multivariable logistic regression identified meconium aspiration syndrome (MAS) (AOR = 4.10; 95% CI: 1.61–10.40), gestational age of 28–32 weeks (AOR = 5.41; 95% CI: 1.57–18.66), birth weight of 1000–1499 g (AOR = 6.94; 95% CI: 1.88–25.64), and need for bag-and-mask resuscitation at birth (AOR = 4.83; 95% CI: 1.50–15.54) as independent predictors of neonatal mortality. A risk score ranging from 0 to 7 points was developed based on these predictors. The model demonstrated good calibration (Hosmer–Lemeshow χ² = 6.70, p = 0.570) and acceptable predictive performance, explaining 53% of the variability in neonatal mortality (Nagelkerke R² = 0.53). Conclusion: Meconium aspiration syndrome, prematurity, low birth weight, and the requirement for bag-and-mask resuscitation at birth were significant predictors of neonatal mortality among NICU admissions. The developed clinical risk score is simple, practical, and based on readily available clinical variables, making it suitable for bedside risk stratification in resource-limited settings. External validation in diverse healthcare settings is recommended before widespread implementation.
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.

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