Length of stay in the emergency department and its associated factors among pediatric patients attending Wolaita Sodo University Teaching and Referral Hospital, Southern, Ethiopia.

BACKGROUND: Globally, there is an increase in the need for emergency department visits, which is exceptionally high in pediatric patients, resulting in longer lengths of stay, which is a global challenge and a hospital bottleneck that increases the risk of patient morbidity and mortality while also lowering satisfaction. OBJECTIVE: This study aimed to assess the length of stay and associated factors in the pediatric emergency department at Wolaita Sodo University Hospital in 2021. METHODS: An institution-based cross-sectional investigation was undertaken from March 15 to May 15, 2021. The 422 study participants were chosen using a systematic sampling procedure. The data were collected using semi-structured interviewer-administered questionnaires and chart reviews. Epi Data version 4.6 was used to enter the data, while SPSS version 26 was used to analyze it. With a 95% confidence interval, descriptive statistics were used to describe the prevalence, pediatrics, and emergency department duration of stay. The factors related to the length of stay were identified using bivariable and multivariable logistic regression analysis. On the AOR, a significant level was proclaimed when the p-value was less than 0.05, and the confidence interval was less than 95%. RESULTS: The proportion of prolonged pediatric emergency department length of stay was 79.70% (95% CI; 75.7, 83.6). Nighttime arrival [AOR = 3.19, 95% CI (1.14, 8.98)], weekend arrival [AOR = 4.25, 95% CI (1.49, 5.35)], not receiving ordered medication in the hospital [AOR = 2.05, 95% CI (1.04, 4.03)], orange triage category [AOR = 4.01, 95% CI (1.60, 10.05)], and duration of pain 13-24 h [AOR = 0.29, 95% CI (0.89,0.98)], were significantly associated with length of stay. CONCLUSION: The percentage of children who stayed in the pediatric emergency department for an extended period was high. Policymakers should implement evidence-based care, maximize existing resources, provide equal access to care and high-quality care, and make pediatric emergency departments more accessible and operationally efficient.

Spatiotemporal distributions of immunization coverage in Ethiopia from 2000 to 2019.

BACKGROUND: Vaccination is the most important mechanism to improve childhood survival. However, immunization coverage is very low and unevenly distributed throughout the country. Therefore, this study was aimed to investigate the spatiotemporal distribution of immunization coverage in Ethiopia. METHOD: Immunization coverage data and geospatial covariates data were obtained from EDHS 2000 to 2019 and different publicly available sources. A Bayesian geostatistic model was used to estimate the national immunization coverage at a pixel level and to identify factors associated with the spatial clustering of immunization coverages. RESULT: The overall immunization coverage in Ethiopia was 38.7%, 36.55%, 51.8%, 67.1% and 66.9% for 2000, 2005, 2011, 2016 and 2019 respectively. Spatial clustering of low immunization coverage was observed in Eastern, Southern, Southwestern, Southeastern and Northeastern parts of Ethiopia in EDHSs. The altitude of the area was positively associated with immunization coverage in 2000, 2005 and 2019 EDHS. The population density was positively associated with immunization coverage in 2000, 2005, 2011 and 2016. Precipitation is also positively associated with immunization coverage in 2016. Moreover, mean annual temperature was positively associated with immunization coverage in 2000, 2005 and 2019 EDHSs. Travel time to the nearest city is negatively associated with immunization coverage in 2000, 2005, 2011 and 2016. Likewise, distance to health facilities was negatively associated with immunization coverage in all the five EDHSs. CONCLUSION: This study found that immunization coverage in Ethiopia substantially varied across the subnational and local levels. Spatial clustering of low immunization coverage was observed in Southern, Southeastern, Southwestern, Northeastern, and Eastern parts of the country. Altitude, population density, precipitation, temperature, travel time to the nearest city in minutes, and distance to the health facilities were factors that affect the spatial clustering of immunizations coverage. These findings can guide policymakers in Ethiopia to design geographically targeted interventions to increase programs to achieve maximum immunization coverage.