Pediatrics and Child Health

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Assessment of Prevalence of Sexual abuse &Predisposing Condition of Child Sexual Abuse Among Children Treated in Tikur Anbesa Specialized Hospital Department of Pediatrics & Child Health.
(Addis Ababa University, 2014) Elfu, Teferi; Gedilu, Etsegent
BackgroundChild sexual abuse is becoming more common public health issue, only reported cases of theincidence are common source of information to get insight on how to understand the problem.The objective of this study was toassess the prevalence of child sexual abuse and predisposingconditions among children treated in Tikur Anbesa specialized hospital from a period of 2003E.C—2005 E.C. MethodsThe research was conducted by collecting reported child sexual abuse cases fromthe records ofpatients whopresented to all Out Patient department as a case of Child sexual abuse fromSeptember 2003 E.C—July 2005E.Ctreated in Tikur Anbesa specialized hospital. A total 300selected samples of victim children were included from the three years period then completeda semi-structured questionnaire and data were analyzed. ResultsAll children are at risk of sexual abuse irrespective of their age, sex, socioeconomic status and degree of relationship between the perpetrators and victims.The prevalence of childsexual abuse at Tikure Anbesa specialized hospital is estimated 0.56%, Majority of the victim’sfemales, their peak age is middle child hood age (6-11yr). 2/3rd of the victims live with their both parents, followed by single parent care taker and presence of family problem is prone forCSA.Nearly half of the cases were victimized attheir neighbour oodfollowed by their ownhome. Even though half of them have normal physical finding at presentation, minor lacerationand major bleedings were also common. Almost all the perpetrators are male and majority ofthe perpetrators are known by the child and most of them use force during attack. Conclusion: From the study itshows all children are at risk of sexual abuse irrespective of their age, sex,socioeconomic status and degree of relationship between the perpetrators and victims. The prevalence of child sexual abuse at Tikure Anbesa specialized hospital is estimated 0.56%,Majority of the victims females, their peak age is middle child hood age(6-11yr). 2/3 of the victims live with their both parents , followed by single parent care taker and presence of family problem is prone for CSA. Almost all the perpetrators are male & known by the child.
Quality Assessment of Facility Based Medical Certification of Cause of Death in the Department of Pediatrics and Child Health at Tikur Anbessa Specialized Hospital Between July-August 2021 Addis Ababa, Ethiopia: A Cross-sectional Study
(Addis Ababa University, 2021-11) Abebe, Hiyaw; Ahmed, Hayat(MD, Consultant Pediatrician and Fellow Pediatric Cardiologist); Mekonnen, Wubegzier( PhD, Associate Professor of Public Health, School of Public Health)
Background : As one of the vital events of interest death must always be certified by a person authorized by law to issue a document, stating the causes of death. In order to ensure the universal application of this principle World Health Organization has recommended an international form of medical cause of death certification that is adopted by most countries of the world. A good quality death certificate should fulfill the criteria put forth including a correct documentation of causes of death, with the correct sequence and time intervals. In Ethiopia, however, the internationally recommended death certificate guidelines have not been utilized until now. Objective : The purpose of the study is to assess quality of facility based medical certification of cause of death in the Department of Pediatrics and Child Health at Tikur Anbessa Specialized Hospital. Methods: A hospital based cross-sectional study was conducted with retrospective data collection by reviewing medical death certificates of deceased patients who were admitted at the Department of Pediatrics and Child health before their death. A structured pretested questionnaire with details of the deceased, WHO formatted death certificate and Rapid Assessment Tool were used. Medical death certificates were reviewed by the primary investigator. Errors were identified by the rapid assessment tool and classified as Major and Minor errors. Disparities in the magnitude of errors as compared to age, sex, duration of stay, time of death; qualification of certifier and place of death were assessed. Result: From the 423 reviewed medical death certificates that were reviewed, 100% of them had errors. The commonest major error was a missing time interval between diseases. The commonest minor error was use of abbreviations. Duration of stay of less than 24 hours and certification by a second year resident were associated with a higher chance of error. Death in the Pediatric Intensive Care Unit and Hemato-oncology wards was associated with a lesser incidence of errors. Conclusion: As observed by the percentage of medical death certification errors, this study confirms that there is a high magnitude of error among all of the issued medical death certificates. There is a collectively similar quantity of poor quality certificates regardless of the attributes of the deceased, as well as determinant factors of certifiers. It also demonstrates some of the factors associated with higher or lower proportions of errors. In addition, it has also picked the magnitude of ill-defined Underlying Cause of Death. These are all crucial inputs into hospital and national data.
Knowledge, Attitude and Practice of Caregivers of Children with Cerebral Palsy Attending Follow up at Neurology Clinic in TASH, Addis Ababa, Ethiopia
(Addis Ababa University, 2021-11) Yibrah, Firehiwot; Dr.Moges, Ayalew(MD, Associate professor of pediatrics and child health, consultant pediatrician & Pediatric Neurologist); Dr.Tsegie, Selamenesh(Consultant pediatrician and assistant professor of pediatrics and child health)
Background: Cerebral palsy (CP) is one of the most severe disabilities in childhood and makes heavy demands on health, educational, and social services as well as on families and children themselves. The complex and chronic nature of the multiple impairments that contribute to the diagnosis of CP has a substantial impact on the functional level and quality of life of the child, which, in turn, can result in a significant physical, financial, and psychological health burden on the family. Most parents of children with CP lack basic knowledge of the disease, its cause, prognosis, treatment modality, and outcome. There are also a limited number of studies Carrying out any intervention and evaluating the response of that intervention to parental knowledge of CP. The overall point of this study is to depict and analyze the knowledge, attitude, and practice of parents and guardians with CP in, Ethiopia where children who require neurologist assessment get referred to from all over the nation Methods: A hospital based descriptive cross-sectional study conducted on 144 Primary care givers of children with CP who are attending on follow-up at pediatrics neurology clinic. Every patient coming for follow up during the study period fulfilling the inclusion criteria were asked to be included in the study. The diagnosis of CP confirmed using the SCPE decision tree before inclusion to the study. The data obtained from the questionnaire was entered into the computer and analyzed using statistical package of social sciences (SPSS) 25. Binary logistic regression was used in assessing the effect of general characteristics on attaining the required knowledge, attitude and practice of care givers Result : In this study among 144 participant,137 were willing, making a response rate of 95.1% and 56.2% of the primary caregiver were mother and half of the participants were in the age group of 30-40 years and more than three-fourth of the participants were married and 28.6% of caregiver learned up to collage level and 51.1% caregiver had inadequate income and the overall Knowledge, Attitude and Practice of Caregivers of Children with Cerebral Palsy attending Follow up at Neurology Clinic in TASH is (66%,64% and 34%) respectively. Conclusion : Caring for a child with cerebral palsy is a big task requiring mental fortitude and physical vitality as well as community involvement. In order to improve outcomes for children with CP and to maintain the health of caregivers, necessary support systems must be in place. Social welfare and other organizations should support mothers with cerebral palsy children to help lift the huge financial burden required for care of their children. Governments should also create an enabling and supportive environment through the establishment of rehabilitation centers and social protection policies for cerebral palsy children. A multi approach is needed to assist caregivers on all fronts to deal with day-to-day challenges.
Assessment Knowledge, Attitude and Practice of Nurses towards Neonatal Pain Management and Determinant factors at Public Hospitals in Addis Ababa, Ethiopia, 2021.
(Addis Abeba University, 2021-08) Marelign, Solomon; Dr.Moges, Tamirat(MD, Pediatrician, Pediatric Cardiologist, Associate Professor Of Pediatrics And Child Health)
Background: Pain is a significant global problem in the field of health.Recent advances in neurobiology, clinical medicine and neonatal research have established that the fetus and newborn may experience acute, established, and chronic pain and that controlling pain has short- and long-term benefits for all newborns (1)(2). Despite the growing knowledge about pain assessment and intervention, the neonatal pain remains unrecognized and undertreated (3). Appropriate management of neonatal painprevents unnecessary hospital stay and suffering them from pain. In clinical settings, nurses play a vital role in pain assessment and management and must be knowledgeable regarding how to best access and manage the pain. Objective: The aim of the study was to assess the neonatal ICU nurses’ knowledge and practiceand factors associated regarding neonatal pain management at public hospital of Addis Ababa,Ethiopia, 2020. Method: -Institutional based cross-sectional study design will be used to collect data from fourselected public hospitals in Addis Ababa, from 21July-22August 2021. Simple random samplingwill be used to recruit study participants using structured, self-administered questionnaire. Data will be cleaned and entered using SPSS version 26.0 software and data will analysis. Result:Majority (98(87.5.0%)) and (87(77.7%)) of the nurse had good overall knowledge and attitude. However, one third (42(37.5%) of the respondents have good practice. Conclusion:Most nurses had poor practice in managing neonatal pain but majority of nurses had adequate knowledge concerning neonatal pain management. There was gap between their knowledge and practice.
The Practice of Iron Supplementation and Degree of Anemia for Pre-terms and Low Birth Weight Infants at High-risk Infant Clinic at TASH and GMH,Addis Ababa, Ethiopia from January 1,2019 to December 31, 2020
(Addis Abeba University, 2021-08) Fikad, Getasew; Dr.Mintesnote, Helen(MD)
Background: Eternal Iron supplementation is providing of prophylaxis’s iron for pre-terms and low birth weight infants to supply sufficient iron for growth and development without increasing the risk of iron overload .Preterm infants are deprived of the significant iron accretion that occurs in the third trimester of pregnancy and have reduced iron stores at birth compared with term infants .Iron deficiency in infancy is associated with a range of clinical and developmentallyimportant issues including neurodevelopmental deficits, delayed maturation of the auditory brainstem response, risk for poor cognitive, motor, social–emotional and neurophysiological development. Objective:The primary objective of this study is to evaluate thecurrent iron supplementation practice and anemia for pre-terms and low birth weight infantsat Tikur Anbessa spatialized hospital and Gandhi memorial hospital fromJanuary 1,2019 to December 31, 2020 Method:A cross sectional study was done by using patient charts review that wereevaluated at newborn intensive care unit,wards and high-risk infant clinicof Tikur Anbessa spatialized hospitaland gandy memorial hospital.Datawas collected through retrospective chart review which meet the inclusion criteria by using structured check list which is prepared from previous literature with few amendments. The data was coded, cleaned and entered in to Epi data version 4.6 and then transferred to SPSS version 26 software program for further analysis. Descriptive summary measures were presented using Tables and Figures. The data was categorized and summarized with descriptive statistics Result:There were 245 pre-terms and low birth weight infants included in this study. Iron prophylaxis supplementation practice was 53.1%, where 54.6% of supplemented infant was females. Mean iron prophylaxis starting time was 7.4 weeks and average dose of supplementation was1.94mg/k/day.Mean duration of iron supplementation was 5.4 months. One hundred thirteen (86.9%) of supplemented infants were below 34 weeks GA. Ninety-four (72.3%) of iron supplemented infants birth weight were below 1500 grams. Around 65.4 % of infantes were started iron prophylaxes in the rage of (3 -8) weeks of post-natal age and 65.4 percent of infants supplemented 2 to 4mg/kg/day of elementary iron. According to this study prevalence of anemia was 39.6% and 4.1 % severe anemia,20.6% moderate and 75.3% had mild anemia where all of severe anemia was non-supplemented infants. Conclusion:Iron prophylaxis practice was low in TASH and GMH and a great variability in the timing of beginning, dose, and ending of iron prophylaxis which needs standardization. prophylaxis iron supplementation practice is imperative to protect anemia in preterm and low birth weight infants. Anemia was high for those non supplemented infants whereas preventive iron prophylaxis prevents severe anemia significant.
Assessment of Health –related Quality of Life of Children with Chronic Kidney Disease on Follow up at Pediatric Renal Clinic Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia.
(Addis Abeba University, 2021-11) Chekol, Getasew; Dr.Abebe, Bezaye(MD,Assistant professor of pediatrics and child health); Dr.Pais, Priy(MD,Associate professor, Pediatric Neurologist)
Background Children with chronic kidney disease face lifelong increases in morbidity, mortality, and decreased quality of life. As most of other chronic illnesses, CKD has hard impact on ill children's and care givers life style, peer relationship, pain interference and social functioning moreover CKD has impact on intellectual functions and behavioral characteristics including anxiety and depression. Objective- To assess health related quality of life of children with CKD as well as their caregivers‟ perception on their Childs performance and to determine the factors that adversely affect it. Methods and material: A cross-sectional analytical study conducted using a pre coded, pretested structured questionnaire including PedsQoL TM 4.0 scale score generic core and family impact module. Data obtained for demographic and clinical parameters of children and for each domain of generic core and family impact module and data was analyzed using IBM SPSS version 26. Results- 105 children with CKD aged 2-18 years, 61(58.1%) males and 44(41.9%) females were included in this study. Among the child self reported domains of generic core scale, child‟s „school performance‟ was most affected with mean of 74.91 (SD±22.29) followed with child „physical performance‟ 77.6±26.41. In the family impact module domains with mean also, the most affected being „school performance‟ with 75 (SD±19.89) followed with „physical functioning‟ with 78.13 (SD±24.96). Recommendation: „School performance‟ and „physical functioning‟ were the most affected domains in child generic scale and family impact modules. Optimal care requires attention not only to medical management, but also to an assessment of health related Quality of Life factors, that may help promote pediatric CKD patient‟s health like Implementation of a standardized tool and Multidisciplinary approach in addressing HRQoL in all CKD patients on follow up.
Barriers and Self-reported Practices towards the use of Continuous Positive Airway Pressure (CPAP) Machine in Newborns among Pediatrics’ Residents in Tertiary Hospital, Addis Ababa, Ethiopia: A Cross Sectional Study
(Addis Abeba University, 2021-12) Arega, Gashaw; Demtse, Asrat( MD, Pediatrician and Neonatologist)
Introduction: - Child survival should remain at the heart of global health and development goals. The leading causes for neonatal death in Ethiopia are prematurity, asphyxia, and neonatal sepsis. Premature newborns with RDS can be managed effectively with breathing support, such as mechanical ventilation or continuous positive airway pressure (CPAP), as well as surfactant replacement therapy. CPAP is strongly recommended by the World Health Organization (WHO) for the treatment of preterm newborns with RDS. Objective: The objective of this study is to assess barriers and self-reported practices towards the use of Continuous Positive Airway Pressure (CPAP) machine in newborns among Pediatrics Resident’s at Tikur Anbessa Specialized Hospital Methods: Cross sectional study was conducted from July 1 – September 30, 2021 G.C to assess barrier’s and self-reported practices towards the use of Continuous Positive Airway Pressure (CPAP) in newborns among Pediatrics Resident’s at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. Self-administered questionnaire used to collect data among Pediatrics residents of TASH. Data was analyzed using descriptive statistics by SPSS version 25. Result: Of the total 112 participants 57.1% (64/112) have any form of formal teaching, learning or training session on CPAP in their Newborn care practice. 80.4 % of Participants used improvised water bottle system. The most common reported barriers to the usage of CPAP at NICU are availability of CPAP machine, availability of oxygen, availability of nasal prong and shortage of staff. There was significant difference in the practice of CPAP safety check lists between residents with different year of residency. Recommendation: - The current findings suggest that there is significant room for improving CPAP usage in NICU by optimizing teaching and training session on CPAP, by enhancing and increasing the knowledge and practice of health care workers, tackling perceived barrier’s that hamper the practice of using CPAP, preparing manuals that can be a guide for fostering CPAP usage and creating a smooth working environment for experience sharing among health workers practicing in NICU.
Magnitude of Early Postoperative Arrhythmias after Cardiac Surgery in Children at the Cardiac Center-Ethiopia, Ethiopia
(Addis Abeba University, 2021-11) Fesseha, Bezamariam; Moges, Tamirat (Associate Professor of Pediatrics and Pediatric Cardiology)
Background: Early postoperative arrhythmias are a widely recognized complication of cardiothoracic surgery in the pediatric populations with CHDs. They have potentially grave consequences, particularly if they are not managed promptly. However, there remains lack of information in Ethiopian setting regarding postoperative cardiac rhythm disturbances although cardiothoracic surgeries have been performed since recently. Objective: To assess the magnitude of early postoperative arrhythmia and its associated factors among CHD patients who underwent cardiac surgery at the Cardiac Center-Ethiopia, Addis Ababa, Ethiopia from January 1 st , 2018 to December 31 st , 2020. Methodology: A facility-based, cross-sectional study was conducted at Cardiac CenterEthiopia, Addis Ababa. Data was collected using a structured checklist, and then entered and analyzed using SPSS version 26. Descriptive analysis along with chi square test and Student t test analyses were employed to identify factors associated with development of arrhythmia. A p-value <0.05 was considered significant. Tables and figures were used to present the results. Results: The study evaluated medical records of 202 pediatric CHD patients who underwent cardiothoracic surgery. Their age ranged from 1 month to 14 years, and of all, females represented 54.5% (110). Arrhythmia was documented in 16 (7.9%) of the patients, and junctional ectopic tachycardia was the most common form of arrhythmia (43.8%). Statistically significant difference between the arrhythmic and non-arrhythmic group were noted in relation to cardiopulmonary bypass time (132.87 vs. 84.63mins) and aortic clamping time (89.47 vs. 51.40 mins), with p value <0.05. Chi square test showed that cyanotic CHDs and patients with TOF are at higher risk of developing post-surgery arrhythmia. Conclusion: Early postoperative arrhythmias following surgery for congenital heart disease are not uncommon in the paediatric population. Longer ischemic time, bypass time, cyanotic heart diseases and presence of TOF were all risk factors that increased the incidence of postoperative arrhythmias.
Assessment of Platelet Increment and Refractoriness to Platelet Transfusion in Pediatric Cancer Patients, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia : A Prospective Cross-sectional Study
(Addis Abeba University, 2021-11) Yilma, Misrak; Shimelis, Damte (Professor of Pediatrics, Consultant Pediatric Nephrologist); Hailu, Daniel (Assistant professor of Pediatrics, Consultant Pediatric HematoOncoligist)
Background: Platelet transfusion is an essential supportive component of the treatment of oncology patients with survival benefit. Platelet transfusion refractoriness is an important challenge in pediatric cancer patients who require repeated transfusions. Objectives To assess platelet increment and refractoriness after platelet transfusion in pediatric cancer patients, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia Methods: In this study, 113 eligible patients were included and data was collected by oriented nurses and physicians using structured questionnaire. Data completeness assessment and coding was done and it was processed and analyzed by SPSS version 25 using frequency tables, Chi Square and Regression analysis tools. Result: In this study, 113 pediatric cancer patients were included. Most of the patients are in the age group of 5-10 years (46.9%) followed by under 5 years (43.4%). The majority are male sex accounting for 57.5 %. There is a significant association between platelet increment after transfusion with the type of cancer(p=0.001) and being on chemotherapy (p 0.018) on Chi square analysis. Regression analysis revealed negative correlation between age of patient and platelet increment(p=0.14). There is also significant association between splenomegaly and previous platelet transfusion with platelet increment (p=0.003 for both). The incidence of platelet transfusion refractoriness is 12.5%. Conclusion: Based on the findings of this study, increment of platelet in pediatric cancer patients in TASH is affected by age of patient, Type of cancer, Splenomegaly, Previous platelet transfusion history and Chemotherapy. Platelet transfusion refractoriness is seen in 12.5% of the patients. Recommendation We recommend a larger-scale study with better organized methodology to be conducted to draw more representative results.
Assessment of Pediatric Residents’ Knowledge, Attitude and Practice Regarding Oxygen Therapy and its Complications at, TASH and SPMMC, Addis Ababa
(Addis Abeba University, 2021-11) Beza, Kalkidan; Gebre, Hanna (MD; assistant professor of pediatrics and child health)
Background: Oxygen therapy is a medical treatment used for tissue hypoxia. It has the potential to improve medical outcomes and save lives when used appropriately and to cause harm if used inappropriately. Objective: To assess knowledge, attitude and practice of residents and about oxygen therapy and its complications in pediatrics department of TASH and SPMMC. Methodology: A cross-sectional descriptive design was employed. All Pediatrics residents working in will be used as a source population. The total sample was determined by using single population formula by considering the assumptions 95% confidence interval with margin of error 5% the calculated final sample size is 141 by adding 10% non respondent. Level of knowledge was grouped by Bloom‘s original cutoff points into good (80-100%), moderate (60-79%) and poor (< 60%). Result and discussion: Out of the 141 pediatric residents who responded, 13.5 % had a level of knowledge classifiable as poor, 68.8% moderate and 17.7% good. There is significant relation between the experience as a GP and whether there is previous training on oxygen therapy during administration of oxygen (p value= 0.026 and 0.041). Conclusion: The majority of participants had moderate to poor level of knowledge of oxygen administration and positive attitude. However their practice was generally poor. Their knowledge could be boosted with regular education and training on oxygen administration.
Knowledge, Attitude and Practice on Neonatal Seizure Management among Pediatric Residents in Teaching Hospitals in Addis Ababa, Ethiopia: - A Cross-sectional Study
(Addis Abeba University, 2021-11) Bayu, Hanna; Dr.Moges, Ayalew(MD, Associate professor of pediatrics and child health, consultant pediatrician & Pediatric Neurologist); Dr. Ambachew, Simenew(MD, Assistant professor of pediatrics and child health)
Background: - Neonatal seizures are a neurological emergency that are difficult to diagnose and treat. The clinical presentation of neonatal seizures is variable and clinical features of a seizure are often absent or non-specific. This has led to under-diagnosis and occasional over-diagnosis of neonatal seizures. Objective: - To assess the knowledge, attitude and practice of pediatric resident on neonatal management who are learning in SPMMC and AAU, Ethiopia, 2021. Method: - Facility based Cross-sectional study design was employed with facility based selfadminister question among pediatrics resident with sample size of 134. Data were checked, cleaned and entered in to SPSS version 25.0 software for analysis. The magnitude of the association between the different independent variables in relation to dependent was measured and 95% confidence interval (CI) and P values below 0.05 were considered statistically significant. Result: - The study finding of this research showed that, the overall knowledge, attitude and practice of study participants on neonatal seizure management was 55%, 41% and 41% respectively. The determinant of participant’s knowledge was female sex, year of residency, having experience on pediatric unit during General practitioner and attitude on neonatal seizure management were statistically significant variable and the determinant of attitude was sex of the participant and the determinate of practice on neonatal seizure management were sex and year of residency. Conclusion and recommendation: - As seen in the above finding the KAP of study participants on neonatal seizure management was significantly low. Therefore, the researcher recommends for the study participates: - update by reviewing the national and international neonatal seizure management protocol and made activity strictly by following the protocol or guideline. For the institution: - prepare training, work shop, seminar on neonatal seizure management. For the researcher: - this research made as clue for further studying.
Post Discharge Mortality among Preterm Newborns Admitted to Selected Public Hospitals NICU Addis Ababa Ethiopia: Cross Sectional Study
(Addis Abeba University, 2021-11) Tadesse, Abebe; Prof.Mekasha, Amha( MD, MSC)
Introduction: Worldwide, 15 million babies are born prematurely each year. Prematurity has become the leading cause of newborn deaths worldwide, resulting in more than 1 million deaths each year .Preterm birth rates around the globe are increasing and are now responsible for 35% of the world’s neonatal deaths; the condition is the secondleading cause of death among children under five. Ethiopia is among the top 15 countries that contribute to two-thirds of the world’s preterm babies with an estimated preterm birth rate of 14.1%. In Ethiopia, of the estimated 91,700 neonatal deaths in 2010, more than one-third were estimated to be due to complications of preterm birth. Objective: The objective of this study is to assess post NICU discharge mortality rate among preterm infants discharged from selected public Hospital NICU in Addis Ababa. Methods: The study design was institutional based cross-sectional descriptive study conducted in selected public hospital NICUs in Addis Ababa. The study subjects were preterm neonates who were discharged from NICU. The sampling methods were simple random sampling method. Chart review and phone call was used to collect data. Data was analyzed using descriptive statistics by software called SPSS version 25. Result: out of 406 preterm discharges 395(97.3%) survived to 28 days and 11(2.7%) died making post discharge mortality rate of preterm neonates is 2.7 %.There were no statistically significant association between post discharge mortality among preterm neonates and neonatal, maternal and sociodemographic characteristics. Recommendation :post discharge preterm mortality is low in this research , which is encouraging but critical attention should be paid on improving in hospital survival especially for extremely low and very low birth weight neonate because the vast majority did not survive to discharge. They account a significant minority in this study.
Magnitude and Outcome of Hepatoblastoma in Pediatrics Age Group in Tikur Anbessa Hospital, Addis Ababa, Ethiopia.
(Addis Abeba University, 2021-10) Kedir, Zinet; Dr.Habtamu, Abebe(Consultant pediatrician and gastroenterologist and nutritionist); Dr.Hailu, Daniel (Consultant pediatrician and pediatrics hematologist and oncologist)
Background: Hepatoblatsoma is the most common primary malignant liver tumor in pediatrics most often occurs within the first 3 years of age. Most common clinical presentation is abdominal distension or abdominal mass. It is more common in south East Asia and Africa. There are multiple associated factors which determine the magnitude and prognosis factor of hepatoblatsoma. Indeed, Knowledge about the magnitude and outcome of hepatoblatsoma will help in designing prevention and early management intervention, thereby reducing the severity of the illness and Death of patients. Methods: A cross-sectional analytical study was done by collecting retrospective data from patient charts of patient evaluated at pediatrics hemato-oncology unit at TikurAnbesaa Specialized Hospital (TASH) in Addis Ababa, Ethiopia, during the period June 2010 to July 2021GC. All patients whose records meet the inclusion were reviewed. Data cleaning and analysis was conducted by the principal investigator. The data was summarized using frequency distributions and summary tables and figures. The data was further analyzed using descriptive statistics and survival analysis by applying Kaplan Meier statistics. Conclusions of the study were drawn based on the analyses results. Result: A total of 25 patients fulfill the inclusion criteria were enrolled almost three forth of the study participant were under 2 years, around 52% were females, majority of them were delivered at term (72%) and had normal birth weight (64%).Most of the patient came from rural area (64%).All patients had abdominal ultrasound and abdominal-pelvic CT scan which is suggestive of HB and around 64% of the mass involve both lobe of the liver. Major clinical manifestations like abdominal mass and abdominal pain were present on all patients followed by weight loss (80%) and anorexia (64%). Most of the patient had elevated AFP >1000ng/ml (80%) and thrombocytosis (56%). 64% of the patients had PRETEXT stage 3 HB. Magnitude of hepatoblatsoma in the last 10 years in tikuranbesa specialized hospital were (25,2%) when we compared it with total solid tumors seen in the past 10 years . Most of the patient started chemotherapy (21, 84%) ,Cisplatin based regimen was most commonly used regimen. Surgery was done only for 20% of the patient. Almost all post-surgical patients got improved. The correlation function of tumor size decrement after treatment with serum AFP after treatment and cycle of chemotherapy had significant correlation with P –value of 0.000 and 0.034 respectively. Conclusion: hepatoblatsoma is the most common liver tumor in less than 5 year since surgery is the main stay of management most of our patients died within 6month to 1 year after hospital stay even before surgery, almost all of the survived children undergone surgical excision.
Knowledge and Attitude Towards Palliative Care Among Pediatric Residents in Teaching Hospitals in Addis Ababa, Ethiopia
(Addis Abeba University, 2021-11) Bellege, Tewabech; Dr.Tefera, Muluwork
Assessment of Knowledge, Attitude and Practice of Pediatrics Residents on Autism Spectrum Disorders in Three Selected Teaching Hospitals, in Addis Ababa, Ethiopia, 2021.
(Addis Abeba University, 2021-10) Hizkiel, Selamawit; Prof.Muhe, Lulu M.(Professor of pediatrics and child health); Dr.Tsige, Selamenesh(Consultant pediatrician and assistant professor of pediatrics and child health)
Background:- Autism spectrum disorders (ASD) is a spectrum of neurodevelopmental disorders occurring early in childhood that is characterized by persistent deficits in social communication and interaction and restricted, repetitive patterns of behavior, interests, or activities. However, limited knowledge among health care providers, poor community awareness, and a dearth of specialist care services are some of the issues confronting autism. Objective: - To assess knowledge, attitude and practice of pediatrics residents on autism spectrum disorder in three selected teaching hospitals in Addis Ababa, Ethiopia Method: - Institutional based Cross-sectional study was done with facility based self-administered question among pediatrics resident with sample size of 141. The data were entered and analyzed by using SPSS version 25. Data cleaning and screening were conducted exclusively by the principal investigator. Descriptive statistics was employed to summarize the data and data were presented using Tables, Figures and texts. Binary logistic regression model was used and p- value <0.05 was considered as statistically significant. Result: - In this study 138 participants contributed to a response rate of 97.9%. The overall knowledge, attitude and practice of pediatric and child heath resident on autism spectrum disorder were 70%, 59% and 51% respectively. Participants having experience in autism management had 2.6 folds increase in the knowledge than non-experienced participant. Participants having favorable attitude are 6.8 times knowledgeable than participant with unfavorable attitude. The determinant of attitude and practice were participants having formal teaching, learning or training session before on ASD, year of residency, having experience and good knowledge on childhood autism. Recommendations: - 1. For the residents: - It is important for residents to improve the KAP regarding to ASD as they are future cornerstone for the management of these cases: 2. For the department: this research may be used as a clue and better to develop protocol of standard autism assessment to increase the level of KAP on medical studies on ASD, 3. For the researcher: - suggest to study in all health professionals those involved in ASD management
Assessment of Knowledge, Attitude and Practice of Pediatric Residents towards Child Abuse in Three selected Hospitals, in Addis Abba, Ethiopia, 2021.
(Addis Abeba University, 2021-11) Gelesu, Kidist; Dr.Moges, Ayalew(Assistant Professor of Pediatrics and Child Health, Pediatric Neurologist); Dr.Tefera, Muluwork (Associate Professor of Pediatrics and Child Health, Pediatrics Emergency and Critical Care Sub - Specialist)
Background: - Child abuse is not only physical abuse, but it can be in the form of emotional abuse involving humiliating a child, coercive, constant belittling, shaming, frequent yelling, threatening, or bullying of the child, making negative comparisons to others, rejecting and ignoring the child as punishment, having limited physical contact with the child (no signs of affection), or any other demeaning acts. Obtaining a detailed history and judging parent child interaction are important tools of identification. Lack of clinicians’ knowledge or clinical experience more often results in misdiagnosis and under reporting of the cases of abuse. This study is being carried out to determine the knowledge, attitude and practice of child abuse and its management among pediatric residents. Objective: -Assessment of knowledge, attitude and practice of pediatric residents towards child abuse in three selected hospitals of Addis Ababa, Ethiopia, 2021. Method: - Institutional based Cross-sectional study design was employed with facility based self-administer question among pediatrics residents with sample size of 135.Data were checked, cleaned and entered in to SPSS version 25.0 software for analysis. The magnitude and the association between the different independent variables in relation to dependent was measured and 95% confidence interval (CI) and P values below 0.05 were considered statistically significant. Result: -The knowledge attitude and practice of pediatric and child health resident on child abuse were significantly low (50%, 56% and 43%) respectively. The determinant of knowledge was participant having formal teaching, learning or training session on child abuse attitude regarding to the topic and the determinant of attitude were married status and knowledge and the determinants of participants practice were years resident and experienced on child abuse treatment/ management. Recommendation: -the recommendation goes to : for the study participant, better to see concentrated about child abuse issues to solve and alleviate the problem as you are a ground back bone. For the institution/ department: - better to put standard protocol of knowledge measurement of pediatric resident regarding to child abuse, due to the fact of the issue community problem. For research: - better to assess by mixed study as a national level.
Prevalence of Benzanthine Penicillin Adverse Reaction in Patients with Rheumatic Heart Disease Taking Monthly Benzanthine Penicillin Injection:A Cross-sectional Survey
(Addis Abeba University, 2021-10) Mekonnen, Hanna; Dr.Moges, Tamrat (Associate professor of pediatrics and child health and pediatric cardiologist)
Background: Rheumatic Heart disease (RHD) is by far the most important form of acquired heart disease in children and young adults and continues to be a health problem living in many low and middle-income countries and especially in sub-Saharan Africa. Several strategies have been implemented for rheumatic fever and RHD control. These include primary, primordial and secondary prevention. Benzathine penicillin G (BPG) secondary antibiotic prophylaxis (SAP) has been shown to reduce the risk of ARF recurrences and the development or worsening of RHD with well-established effectiveness. Despite BPG favorable safety profile, a few severe adverse events have been reported and these serious adverse reactions can have a devastating effect on RHD control programs. Objective: This study was aimed at assessing the magnitude of the problem of adverse drug reaction due to benzantine penicillin and its contributing factor Method: A retrospective cross-sectional study was done among pediatric and adult patients who are diagnosed to have CRVHD(chronic rheumatic valvular heart disease) and on follow-up at pediatric and cardiac clinic respectively and taking monthly benzathine penicillin who came for follow-up from December 2020. to October 2021. The data were entered and analyzed by using SPSS version 25. Data collection was conducted exclusively by the principal investigator through telephone interview.Descriptive statistics were employed to summarize the data, and data were presented using Tables and Figures. Binary logistic regression analysis was done to assess predicting factors associated with benzathine penicillin adverse reaction. A p-value <0.05 was considered as statistically significant. Result: A total of 460 pediatric and adult patients who fulfilled the inclusion criteria were enrolled. The prevalence of benzathine penicilline adverse reaction is 21%. The strength of association of both dependent and independent variables was assessed using odds ratio and 95%CI. Accordingly, participants whose age is in the range of 15-18 years had 3.2 fold increased risk to develop benzathine penicillin adverse reaction (AOR=3.2, 95%CI=1.07, 18.62) and age range of 18-30 years had 9.2 fold times increased risk to develop adverse drug reaction when compared to age range of 5-14 years. Conclusion: In this study, Adverse drug reaction of benzanthine penicillin G is common. Factors which are significantly associated with high rate of adverse reaction are age range of 1530,female sex and self and family history of allergy.
Clinico-pathologic Profile and Treatment Outcome of Children with Non-Hodgkin’s Lymphoma seen at Hemato-oncologic unit ,Tikur Anbessa Specialized Hospital, Addis Ababa ,Ethiopia.
(Addis Abeba University, 2021-11) Jemal, Dureti; Dr.Memirie, Solomon Tessema(MD, Ph.D.); Dr.Gidey, Abdurkadir
Background: Lymphoma is general term for cancers that develop in the lymphatic system and is the third most common childhood mali gnancy. It is classified into two broad categories, different mani festations and treatment approach: Hodgki n and non-Hodgkin l ymphoma. Non- Hodgki n lymphoma accounts for approxi mately 60% of all lymphomas in children and adolescents with a hi gher incidence in sub-Saharan African (SSA) countries. With the current modality of treatment, localized NHL (stage I to II) has an approxi mate 95% to 100% 5-year event-free survival (EFS) and more than 80% for children with advanced-stage disease (stage III to IV). Despite the increasing burden, i nfrastructure for diagnosis and treatment of hematolymphoid mali gnancies remains inadequate i n SSA. To our knowledge there is no study done in Ethiopia on NHL survival. Objective: To assess the clinico-pathologic profile and treatment outcome of children with NonHodgki n’s Lymphoma who sought care at pediatric oncology unit i n Ti kur Anbessa Specialized Hospital (TASH). Method: We conducted a hospital-based retrospective cross sectional study at the pediatric oncology uni t at TASH. The study period was from Jul y 1st to August 31st, 2021. Data of 149 children who meet the i nclusion criteria were analyzed using Statistical Package for Social Sciences (SPSS) version 25. We conducted both descriptive and anal ytical statistics. We run Chi square test, Log Rank test and Cox regression to assess association among the variables of interest. Kaplan Meier esti mates were used for five-year overall survival analysis. P-values of <0.05 were considered statistically significant differences or association. Result: Most (44.3%) childhood cases of NHL occurred between five to ten years of age, more commonl y affecti ng males than females (2.38:1 ratio). More than half of the patients presented with advanced stage and commonest presentation is abdominal swelling. Burkitts lymphoma is the commonest histologic type. Advanced disease stage is signi ficantl y associated with low hemoglobin level, high LDH and older age.. In this study we did not find signi ficant differences in the EFS rate by different prognostically relevant variables. The five year OS was 66.5% and EFS was 63.1%. Conclusion Five year over all and event free survival for childhood NHL at TASH is lower than what has been reported elsewhere including the average i n developing countries.
Magnitude and Associated Risk Factors Of Possible Fungal Infection Among HematoOncology Patients With Neutropenia at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
(Addis Abeba University, 2021-10) Teshome, Beza; Dr.Abebe, Workeabeba(MD, MPH); Dr.Hailu, Daniel (MD)
Background A fungal infection represents a growing problem i n children with hematologic mali gnancies duri ng chemotherapy-induced neutropenia. Objectives: This study ai med to evaluate the magnitude of possible fungal infection among hemato-oncologic children admitted to the hospital between 2017 and 2021 in TASH, Ethiopia. Methods: Institution-based retrospective cross-sectional study reviewed the charts of 256 neutropenic patients at Ti kurAnbessa specialized hospital. Required data were collected using a questionnaire. The data were entered i nto a computer usi ng Excel and exported to Statistical Package for Social Sciences Version 25 for analysis. Binary logistic regression analysis assessed predicting factors associated with a fungal infection, and p-value <0.05 was considered statistically signi ficant. Results: Among 256, 152 were males, and most of the patients were in the age range of 5-10 years. In this study, the magnitude of fungal infection among haemato-oncology neutropenic patients was 31%. Among those patients diagnosed with a possible fungal infection, 56 (72%) ALL patients, 6 (7.7%) AML patients and 15 (19%) of NHL patients. Age, duration, and severity of neutropenia and prolonged use of steroids are significantl y associated factors. Conclusion: Our fi nding suggests a high rate of fungal infections in neutropenic ALL and AML patients. These results help i mprove the management of these patients. However, fur ther studies are needed.
Parental Knowledge, attitude and practice about their children attending medical care at TASH regarding COVID-19 infection, Addis Ababa, Ethiopia
(Addis Abeba University, 2021-11) Damtie, Bethelhem; Shimelis, Damte(Professor of Pediatrics and Child Health, Pediatric nephrologist)
Background: Covid-19 is one of the global public health crises. Resource limited countries like Ethiopia are at risk of being severely affected by the pandemic. Children of all ages can be affected by the virus and are one of the burdens of Covid-19 pandemic. As children accounts for majority of the population in Ethiopia, early diagnosis and management of the disease is crucial to curb the spread of the disease. Parents have a significant role in children’s health. Hence the aim of this study is to assess parents’ knowledge, attitude and practice towards Covid-19 in children. Methodology: A cross-sectional study was conducted at TASH located in Addis Ababa, the capital city of Ethiopia from June to August 2021 G.C. Parents whose children were admitted at TASH and parents who came to pediatric regular OPD and referral clinics were used as a study population. An interview based questionnaire was used to gather information from study participants. Data was entered using SPSS version 25 to be analyzed based on the objectives of the study. A descriptive analysis was performed. Inferential statistics were investigated using a chi-square test. P value less than 0.05 was considered as statistically significant. Result: A total of 385 parents who fulfilled the inclusion criteria were enrolled. The finding of this study reveal that majority of the participants (68.6%) have moderate knowledge whereas 17.7% of participants have poor knowledge. Regarding attitude and practice of parents, 68.3% of participants have good attitude and 51.7% of participants have moderate practice. There was a moderate positive correlation between knowledge score and attitude score (r=0.56, p<0.001), between knowledge score and practice score (r=0.44, p<0.001) and between attitude score and practice score (r=0.43, p<0.001). Conclusion: The finding of this study suggests that knowledge and practice of parents of children attending medical care at TASH towards COVID-19 in children was moderate. Majority of the parents had good attitude. A considerable number of sociodemographic characteristics of participants affect the knowledge, attitude and practice of parents towards COVID-19 in children.

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