Assessment of clinical profiles, and treatment outcomes for children with diabetic ketoacidosis, in two hospitals selected from Addis Ababa, Ethiopia, 2020

Type 1 diabetes mellitus(T1DM)is a common autoimmune disorder that often presents in children. In these patients, diabetic ketoacidosis(DKA)is one of the most common and serious acute complications, which isassociated with significant morbidity and mortality. The study aimed to assess the clinical profilesand outcomesof children admitted with DKA.Objective:To assess the clinical manifestationsand treatment outcomesof DKA patients in two tertiary hospitals in Addis Ababa. Methods: A hospital-based retrospective analysis was conductedon175 pediatric diabetic ketoacidosis children, who wereadmitted to the emergency units of two hospitalsin Addis Ababafrom September 2015 to February 2020andwhose medical records contained complete pertinent data. Patients were between theages of0 to 12 years.Proportional samples were taken from each hospitaland data wascollected retrospectively using a formatted checklist. The data waschecked for its inclusiveness and enteredEpi Info. version4.6 andthen transferred into SPSS version 25 software for further analysis. Result:DKA was the presenting manifestation of Diabetes in 78.3% of patients and 21.7% were already known cases of Diabetes. Half (50.9%) of the study participants were diagnosed with DKA in the age range of 5 to 10 years and almost one-third (30.9%) were abovethe age of 10. A high-incomelevel of the caretakers wasfound to be protective against DKA during thediagnosis of T1DM. Out of the 175 children admitted, 12 passed on, resulting ina mortality rate of 6.9%.Conclusion: The majority of the known DM patients presented with DKA after the omission of insulin and a newly diagnosed T1DMat first presentation.The age of presentation and clinical symptoms of the studied participantswere likeother international studies. Community education regardingthe signs and symptoms of childhood DM can further prevent the development of DKA.[Ethiop. J. Health Dev. 2022; 36(2):000-000]Keywords: Diabetic ketoacidosis, Treatment outcome, and precipitating factors

Knowledge, attitude, and practice of pain assessment and management in children among pediatric and pediatric surgical residents in Tikur Anbessa Specialized Hospital

Background:Pain is widely prevalent regardless settingsand is thought to be one of themainreasons why patients seek medical care. Pain is consideredas the "fifth vital sign" and there is a need forit to be assessedand recordedregularly,as with other vital signs. Barriers to appropriate pain management includehealth worker's insufficient knowledge on pain assessment toolsandthe general attitude towards patient's pain management. Objective: To assess knowledge, attitude, and practice of childhood pain assessment and the management among pediatrics and pediatric surgical residents in Tikur Anbessa Specialized Hospital.Methodology: A descriptive cross-sectional study was conductedto assess the knowledge, attitude, and practice of pediatric and pediatric surgical residents in TASHbasedon pediatric pain assessment and management. The data was collected by a standardized pretested questionnaire. Data were analyzed using SPSS computer software version 25.Results:The mean total score of the residents was 14.56 (SD=3.16) from a total of 27 questions consisting of 15 T/F and 12 MCQ questions. The maximum and minimum scores were 25 and 7 respectively. Most of the study groups (86.2%) were not using pain assessment tools. Final-year residents had 5.5(95% CI=1.38-21.85) more than "average and above" scores than the other year residents. Conclusion and recommendation :Knowledge deficit, poor attitude, and poor practice on pediatric pain assessment and management werediscovered from this study.The findings of the present study emphasize the need to improve the Knowledge, attitude, and practices of residents on assessment and management of pain in children.

Clinical and socio-demographic profile of the first 33 COVID-19 cases treated at dedicated treatment center in Ethiopia

BACKGROUND:Severe respiratory tract infection caused by family of Corona viruses has become world pandemic. The purpose of this study was to describe the first few COVID 19 cases in Ethiopia. METHOD: Descriptive study was conducted on the first 33 consecutive RT-PCR confirmed COVID 19 cases diagnosed and managed at Ekka-Kotebe COVID Treatment Center in Addis Ababa, Ethiopia. RESULT: The median age of the cases was 36 years. Cough, headache and fever were the most frequent symptoms. Diarrhea, sore throats, loss of taste and/or smell sensation were among the rare symptoms. Most (84.8%) had mild to moderate disease, and 15.2%(n=5) were critical at the time of admission. Among the five ICU admissions, four patients required invasive mechanical ventilation. Thirty cases were discharged after two pairs of nasopharyngeal and oropharyngeal samples turned negative for SARS CoV2. Three cases from the ICU died while on mechanical ventilator. The age of the two deaths was 65 years, and one was 60 years. With the exception of three, all cases were either imported from abroad or had contact with confirmed cases. CONCLUSION: Most of our patients were in the younger age group with male predominance and few with comorbidities. Cough was the commonest symptom followed by headache and fever. As it was in the early stage of the pandemic, observation of more cases in the future will reveal further clinical and demographic profiles of COVID-19 cases in Ethiopia

The magnitude of sexual abuse and its physical effects among female children seen at Gandhi Memorial Hospital in Addis Ababa, Ethiopia

Background: Child sexual abuse is a form of abuse that involves sexual activity with a minor. A child does not possess the ability to consent to any form of sexual activity. Therefore, perpetrators who engage in sexual activity with a minor are committing the crime of sexual abuse. The definition of child sexual abuse does not need to include physical contact between a perpetrator and a child. The objective of this study was to assess the magnitude and associated physical consequences of sexual abuse among female children seen at Gandhi Memorial Hospital in Addis Ababa, Ethiopia. Method and Materials: This cross-sectional study identified and reviewed 1,500 reported cases of sexual abuse through hospital records at Gandhi Memorial Hospital (Addis Ababa, Ethiopia) between March 2016 and February 2017. These cases were all perpetrated against females and included both adults and children. From a total of 1,500 cases reviewed, 1,100 involved victims in the pediatric age group (under 18 years) who first presented to the hospital following sexual abuse. Of these 1,100 cases, 292 female children were selected. One study participant was selected for every three victims of child sexual abuse, until the required sample size was met. Data were collected from these 292 cases, and descriptive analysis was used to describe study findings. This analysis included frequencies, percentages, and standard deviations. The socio-demographic and educational status of study participants, as well as the physical findings of the victims on presentation, were analyzed, and presented numerically and as percentages of the total study population. Results: The majority of the victims were referred from Addis Ababa. Among the 292 selected cases, 221 (75.7%) were from Addis Ababa and the rest were from the surrounding areas. The majority of respondents (64.7%) were between 12 and 18 years of age, with a small percentage of respondents (5.8%) between 2 and 3 years of age. Most respondents (242 cases, 82.9%) had no previous history of sexual abuse, but the remaining 50 cases (17.1%) had a previous history of sexual abuse by the same or a different perpetuator. Conclusions: This study provides data, and thus evidence for policymakers and other stakeholders, to strive for an improvement in the security and protection of children, as well as education on the matter of child sexual abuse for parents and guardians. Those who could be involved in the implementation of intervention strategies may include parents, health professionals and pertinent personnel from the Ministry of Health and Ministry of Education. Above all, the data suggest a need for the victims to receive training on how to protect themselves from victimization