Conjoined twins sharing major organs and with discordant congenital anomaly.

Thoraco-omphalopagus conjoined twins born to a 25-year-old para one Ethiopian lady are presented. Prenatal diagnosis was not made until elective cesarean section delivery was done for severe preeclampsia and twin pregnancy with breech presentation. Detailed autopsy results and relevant literature reviews are described. To the best of our knowledge, these are the second-documented cases of conjoined twins in this country.

Kangaroo mother care: a randomized controlled trial on effectiveness of early kangaroo mother care for the low birthweight infants in Addis Ababa, Ethiopia.

A randomized controlled trial was conducted over a 1-year period (November 2001-November 2002) in Addis Ababa to study the effectiveness of early Kangaroo mother care before stabilization of low birthweight infants as compared with the conventional method of care. There were 259 babies weighing less than 2000 g during the study period and a total of 123 (47.5 per cent) low birthweight infants were included in to the study. Sixty-two infants were enrolled as Kangaroo Mother Care (KMC) and the remaining 61 were Conventional Method of Care (CMC) cases. The demographic and socioeconomic characteristics for both groups were comparable. The mean age at the time of enrollment was 10 and 9.8 h for KMC and CMC, respectively (p>0.05 with 95 per cent confidence interval). The mean birthweight was 1514.8 g (range 1000-1900 g) for KMC and 1471.8 g (range 930-1900 g) for CMC (p>0.05 with 95 per cent CI) and the mean gestational age was 32.42 and 31.59 weeks for KMC and CMC cases, respectively. Fifty-eight per cent of KMC and 52 per cent of CMC cases were on i.v. fluid. Twenty-one of 62 (34 per cent) of KMC and 23/61 (37 per cent) of CMC babies were on oxygen through nasopharyngeal catheter. The mean age at exit from the study was 4.6 days for KMC and 5.4 days for CMC. Ninety-one per cent and 88 per cent of babies in KMC and CMC were discharged from the study in the first 7 days of life, respectively. The study showed that 14/62 (22.5 per cent) of KMC vs. 24/63 (38 per cent) CMC babies died during the study (p<0.05 and CI of 95 per cent.) The majority of deaths occurred during the first 12 h of life. Survival for the preterm low birthweight infants was remarkably better for the early kangaroo mother care group than the babies in the conventional method of care in the first 12 h and there after. More than 95 per cent of mothers reported that they were happy to care for their low birthweight babies using the early Kangaroo mother method. It was recommended to study the feasibility and effectiveness of Kangaroo mother care at the community level.

Child abuse in urban setting: a one-year analysis of hospital information on abused children at Yekatit 12 hospital, Addis Ababa.

BACKGROUND: In recent years, there has been growing concern over the rapidly mounting situation of child abuse in Ethiopia. This tragic situation is generally thought to be rare in Sub-Saharan Africa. The government of Ethiopian has ratified and endorsed the Convention of Right of Children in spite of which the situation is considerable. It is important to consider the subject as a momentous issue and review the situation in the capital. OBJECTIVE: To know the extent, magnitude, seriousness and the existing trend of child abuse in the capital city of Ethiopia. METHODS: This study is a prospective cross-sectional analysis undertaken in pediatrics department of Yekatit 12 hospital. Two hundred and fifty six allegedly abused children were seen from July 2001 to June 2002 of which 214 were enrolled in this study that fulfilled the criteria of inclusion RESULTS: Among two hundred and fourteen children less than the age of 15 years 93% were female. Most common mode of abuse was sexual with vaginal penetration N=160 (75%). Forty one percent of abused children had laboratory investigations of which 9% were pathological results. The highest percent of victims reside in Woreda 11. The monthly distribution of abused children shows increasing trend. Only 18% had Psychological follow-up visit. Thirty percent of perpetrators were close neighbors followed by teachers. The age between 35 to 45 years were found to be the commonest age of perpetrators (29%). Among the offenders' occupation disclosed N= 17, 6 (35%) were priests. CONCLUSIONS: This study has tried to prove that child abuse is increasing in magnitude and seriousness & the growing trend of threat is to cross the threshold of public health alarm. Female children are at higher risk and need special protection. The low number of follow-up visits and few laboratory results show that there is lack of awareness on the future prospective of the child and/or lack of financial resources. It is necessary to improve and curb this catastrophic situation through comprehensive measures.

AMBAR as a public health index for assessment of malnutrition in children.

This is a prospective case control study conducted in Gondar College of Medical Sciences Hospital and Gondar Health Center from March 1998 to March 2000 to determine the value of different size "AMBAR" to assess malnutrition in children age 12 months - 59 months. A total of 191 cases and 191 controls were enrolled in this study. In the process, we have developed a modified form of measuring the arm circumference by using a locally made bracellet called "AMBAR" of three different sizes. Among the three different size "AMBARs", the one with an internal diameter of 4 cm was found to be the most appropriate size to diagnose Protein Energy Malnutrition (PEM) as compared to the Harvard standard with a positive predictive value of 87.6% and negative predictive value of 95%. However "AMBAR" with an internal diameter of 3.5 cm has shown a sensitivity of 29% and specificity of 100%. The positive predictive value was 100% and Negative predictive value was 58%. Since the sensitivity was very low for this size, we felt that, it would not be rational to continue computing for "AMBAR" with an internal diameter of 3.0 cm. Finally we have concluded that, assessment of malnutrition using "AMBAR" 4 cm is a fairly useful method which can be used by mothers/caretakers who do not know how to read and write. It is also technically simpler to apply and requires inexpensive and easily available apparatus.