Trends and Referral Patterns of Ethiopian Pediatric Patients Seeking Treatment Abroad at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Retrospective Cross-Sectional Study
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Date
2025-06-15
Authors
Arif Abdujebar
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Addis Ababa University
Abstract
Background: Referral is the process by which a health worker transfers care responsibility to another professional due to limitations in providing necessary treatment. In developing countries like Ethiopia, pediatric referral patterns for treatment abroad have received insufficient attention. Understanding these patterns can help address treatment-related health issues and improve patient quality of life. This study aims to provide valuable data that informs policy and practice regarding demographic characteristics, primary diagnoses, referral trends, and patient outcomes.
Objective: To assess the trends and referral patterns of Ethiopian pediatric patients seeking treatment abroad at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Methods: A facility-based, retrospective, cross-sectional study was conducted from 2022 to 2024 G.C, at Tikur Anbessa Specialized Hospital. Data were collected on demographics, diagnoses, medical and surgical interventions provided abroad, and patient outcomes using medical board-approved referral papers and phone interviews with attendants. The study included all children with referral papers during the study period. Data were analyzed using SPSS version 26, employing descriptive analysis, with results presented in tables & figures.
Result: The study surveyed 298 children with referrals for treatment abroad. Most participants were aged 1-5 years, with 52.5% male (male-to-female ratio of 1.1:1). Notably, 94% underwent imaging, primarily chest X-rays (73.1%) and echocardiograms (68.5%). Most referrals (63.8%) came from the Cardiac Unit, followed by the Hemato-Oncology Unit (21.8%). Congenital Heart Disease (CHD) was the most common diagnosis, with Acute Lymphoblastic Leukemia (ALL) prevalent among oncologic conditions. The main reason for referral was surgical management (63.4%), followed by Hematopoietic Stem Cell Transplantation (HSCT) (12.1%). Referral rates significantly increased over the study period, with 161 participants seeking treatment abroad, primarily in India (70.2%) and Israel (13%). While 95% of treated patients returned alive, the study revealed a concerning 15.1% mortality rate during treatment and a 20.8% rate of unknown outcomes, indicating critical gaps in follow-up care.
Conclusion- The steady increase in pediatric referrals abroad, particularly for CHD and childhood cancers, underscores an urgent need for enhanced local healthcare infrastructure to provide specialized interventions often unavailable in Ethiopia. Ideally, as hospital care improves, the need for referrals should decrease; however, the data suggests otherwise. Policymakers must prioritize pediatric health in national agendas, ensuring funding for local healthcare infrastructure to enhance access to essential treatments and reduce reliance on international referrals. The 20.8% of cases with unknown outcomes represents a significant data gap that limits our understanding of referral effectiveness. Improved follow-up care and robust patient tracking systems are essential for addressing these gaps, for monitoring the long-term impacts of these interventions on health outcomes. Furthermore, ongoing research for overall healthcare accessibility and enhancing pediatric patient management
Keywords: Pediatric referrals, congenital heart disease, childhood cancer, healthcare infrastructure, treatment abroad, Ethiopia, patient outcomes, referral patterns.
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Keywords
Pediatric referrals congenital heart disease childhood cancer healthcare infrastructure treatment abroad Ethiopia patient outcomes referral patterns