Time to death and its predictors among neonates admitted with sepsis in neonatal intensive care unit at comprehensive specialized hospitals in Northeast Ethiopia.

Background: In impoverished nations like Ethiopia, neonatal sepsis contributes significantly to neonatal mortality. Despite variations in the specific timing of death and predictors of neonatal mortality associated with sepsis across different settings, there's limited documented information in the Neonatal Intensive Care Units of northeastern Ethiopia. Consequently, the aim of this study was to determine time to death and its predictors among neonates with sepsis admitted to Neonatal Intensive Care Units in comprehensive specialized hospitals in northeastern Ethiopia. Methods: A prospective cohort study conducted at the institution level involved 306 neonates diagnosed with sepsis. Data collection utilized face-to-face interviews and chart reviews. Subsequently, the data were inputted into Epi-data version 4.6 and later analyzed using STATA version 17. The median time to death was determined, and both the Kaplan-Meier curve and log-rank test were applied. Furthermore, a Cox proportional hazard regression model was utilized to identify predictors of neonatal mortality associated with sepsis. Result: The cumulative incidence of mortality among neonates admitted with sepsis was 34% (95% CI: 28.9%-39.5%). The neonatal mortality rate stood at 51 (95% CI: 42.1, 62) per 1,000 neonates admitted to the intensive care units with sepsis over a total of 1,854 person-days of observation. Additionally, the median time to death was 13 days (IQR = 5-23 days). Tachypnea [AHR 6.2 (95% CI: 1.5-9.7)], respiratory distress syndrome [AHR 2.1 (95% CI: 1.3-3.5)], lethargy [AHR 1.8 (95% CI: 1.2-2.6)], preterm birth [AHR 1.8 (95% CI: 1.2-2.7)], continuous positive airway pressure use [AHR 2.1 (95% CI: 1.3-3.4)], home delivery [AHR 2.63 (95% CI: 1.1-6.4)], Subgalea hemorrhage [AHR 1.8 (95% CI: 1.1-3.9)], and low platelet count [AHR 5.9 (95% CI: 2.3-8.6)] were found to be predictors of time to death in neonates with sepsis. Conclusion: The study revealed an alarmingly high neonatal mortality rate among septic neonates, underscoring the urgency for intervention. Enhancing the quality of care in neonatal intensive care units, bolstering infection prevention during procedures such as continuous positive airway pressure, exercising caution with locally made accessories, and reinforcing a culture of institutional delivery are critical in curbing neonatal sepsis-related mortalities.

Incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia comprehensive specialized hospitals, 2022; A multicenter retrospective follow-up study.

Introduction: Around the world, tuberculosis (TB) is the most common cause of mortality and morbidity in both adults and children. The incidence of tuberculosis (TB) is increased worldwide by co-infection with the human immunodeficiency virus (HIV), particularly in Sub-Saharan Africa. As a result, the study aimed to determine the incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia Comprehensive Specialized Hospitals. Methods: An institution-based retrospective follow-up study was carried out in northeast Ethiopia's Comprehensive Specialized Hospitals, among 362 children on antiretroviral therapy from January 1, 2007, to September 30, 2021. The data were entered into Epi Data version 4.6.1 and then exported to STATA version 16 for analysis. Bivariate and multivariable Cox proportional hazards model was used to discover tuberculosis predictors. Variables with a p-value of <0.05 at 95% confidence intervals in the multivariable Cox proportional hazard model were considered statistically significant. Results: Among the 358 Human Immunodeficiency Virus-infected children, two-thirds (69.3%) were over ten years old. The overall tuberculosis incidence rate was 2.0 (95%CI: 1.5-2.6) per 100 person-years with a total of 2452 years of observations. WHO clinical stages III and IV [AHR: 3.2 (95% CI 1.8-5.5)], being severely stunted [AHR = 2.1 (95% CI, 1.5-358)], and "Fair" and "poor" adherence levels to antiretroviral therapy [AHR = 4.0 (95% CI 1.5-10.8)] were independent predictors of tuberculosis. Conclusion: The incidence of tuberculosis in children infected with HIV/AIDS was high in this study. The risk of tuberculosis (TB) in HIV/AIDS-infected children has been linked to WHO stages III and IV, severe stunting, and "Fair" and "Poor" ART adherence. As a result, children with HIV/ADIS should be evaluated on a regular basis in order to improve the quality of ART services and reduce the incidence rate of tuberculosis among children.

Incidence and predictors of common opportunistic infection among HIV -infected children attending antiretroviral treatment clinic at Northeast Ethiopia, public hospitals 2022: A multicenter retrospective follow-up study.

Background: Opportunistic infections (OIs) are illnesses that attack people with weakened immune systems, such as HIV patients, more frequently and severely. The majority of opportunistic infections (OIs) are the leading causes of morbidity and mortality in HIV/AIDS patients, emerging at the end of the illness. The objective of this study was to assess the incidence and risk factors of opportunistic infections (OIs) in HIV-infected children receiving antiretroviral therapy in public hospitals in Northeast Ethiopia. Methods: A multicenter retrospective follow-up study was undertaken at public hospitals in northeast Ethiopia from September 1, 2010, to January 30, 2022. A total of 341 HIV-infected children on antiretroviral therapy were included in the study. Data was entered using Epi-Data Manager version 4.6.1, and it was analyzed using STATA version 16.1. The opportunistic infection free-survival time was estimated using the Kaplan-Meier survival curve. Bivariable and multivariable Cox proportional hazard models were used to investigate the determinants of opportunistic infections. Results: The overall incidence rate of opportunistic infections (OIs) was 6.0 (95% CI: 5.0-7.1) per 100 child-years of observation. This study's participants were observed for a minimum of 9 months and a maximum of 122 months, for a total of 21,629 months, or 1802.4 years. Children with WHO clinical stages III and IV (AHR: 1.77; 95% CI: 1.13, 2.77), non-users of Cotrimoxazole Preventive Therapy (CPT) (AHR: 2.10; 95% CI: 1.40, 3.08), and low hemoglobin levels (10 mg/dl) (AHR: 1.88; 95% CI: 1.25, 2.82) were identified as significant predictors of opportunistic infection. Conclusion: In this study, the incidence rate of opportunistic infections among HIV-infected children was found to be high when compared to other studies. Low hemoglobin levels (10 mg/dl), low CD4 counts or percentages, clinical stages III and IV, and non-users of CPT were all associated with higher rates of opportunistic infection.

Predictors of first-line antiretroviral treatment failure among children on antiretroviral therapy at the University of Gondar comprehensive specialised hospital, North-west, Ethiopia: a 14-year long-term follow-up study.

OBJECTIVE: To determine the incidence and predictors of first-line human immune deficiency virus treatment failure among human immune deficiency virus-infected children at the University of Gondar comprehensive specialised hospital in Ethiopia. DESIGN: A retrospective follow-up study. SETTING: University of Gondar comprehensive specialised hospital, North-west, Ethiopia. PARTICIPANTS: Children were among the HIV infected from January 2005 to December 2018. There were 336 children included in the study. The data were entered into EPi Info V.7.2 and then exported to STATA V.14.0 Software for analysis. Both bivariable and multivariable analyses with Cox proportional hazards models were used to identify the predictors of treatment failure. PRIMARY OUTCOME MEASURES: Predictors of first-line antiretroviral treatment failure among children on antiretroviral therapy (ART) during 14 years long-term follow-up study. RESULT: A total of 336 human immunodeficiency virus-infected children participated in this study with 27 058 child years of observation. The overall incidence rate was 2.1 (95% CI 1.57 to 2.78) per 100 child years. Poor adherence (adjusted HR (AHR); 6.5 (95% CI 2.03 to 21.39)), fair adherence (AHR; 6.55 (95% CI 2.64 to 16.53), the presence of opportunistic infection (AHR; 4.22 (95% CI 1.44 to 12.30), clinical staging of III/IV (AHR; 3.08 (95% CI 1.17 to 8.08) and a baseline CD4 count less than 200 cells/mm3 (AHR; 3.61 (95% CI 1.12 to 11.54)). CONCLUSION: The incidence of first-line ART failure was found to be high. Baseline opportunistic infection, poor and fair adherence, advanced WHO clinical staging III/IV and a CD4 count less than 200 cells/mm3 were all predictors of first-line treatment failure. Early identification of associated factors and monitoring treatment failure has to be important for the optimal management of HIV-infected children who are receiving ART and to prevent further complications.

The effect of timely initiation of complementary feeding and vitamin A supplementation on acute malnutrition among children aged 6-59 months attending Hamusit Health Centre, Northwest Ethiopia, 2021: A cross-sectional study.

INTRODUCTION: Acute malnutrition is a nutritional deficiency that results either from inadequate energy or protein intake. It is more prevalent in low- and middle-income countries. Even though efforts have been carried out at the global and national level, the burden is still intolerable and it attracts the attention of the government and researchers. Hence, this study aims to assess the magnitude of acute malnutrition and its associated factors among under-five children who attended Hamusit Health Centre from 1st September to 30th January 2021. MATERIALS AND METHODS: This institution-based cross-sectional study was conducted from 1st September to 30th January on 404 randomly selected under-five children who visited the health centre. Samples were selected using a simple random sampling technique, and the data were obtained using a pre-tested standardized questionnaire. For data entry and analysis, Epi-info 7 and SPSS 21 applications were used, respectively. Bivariable and multivariable binary logistic regression were used to identify associated factors at a 95% confidence interval. Significance was considered at p-value<0.05. RESULTS: The present research involved a total of 404 children aged 6-59 months. The magnitude of acute malnutrition in this study was 14.4%. Children aged 6-23 months [AOR: 2.92; 95%CI (1.46, 5.85)], vitamin A supplementation [AOR: 0.49; 95%CI (0.25, 0.95)], not timely initiation of complementary feeding [AOR: 2.02; 95%CI (1.06, 3.82)] and children with diarrhea prior to two weeks of the survey [AOR: 2.47; 95% CI (1.28, 4.87)] were significantly associated with acute malnutrition. CONCLUSION: A significant number of children aged 6-59 months were affected by acute malnutrition. Younger children, vitamin A supplementation, not timely initiation of complementary feeding, and children with diarrhoea were other factors associated with acute malnutrition.