Speciality in Pediatrics and Child Health

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    TRAUMATIC BRAIN INJURY OUTCOME AND ASSOCIATED FACTORS AMONG PEDIATRIC PATIENTS TREATED AT ASELLA REFERRAL AND TEACHING HOSPITAL: A 4-YEAR RETROSPECTIVE STUDY
    (2025-05-01) ADUGNA DEBELO
    ABSTRACT Background: Traumatic brain injury is a brain injury that occurs following a blow to the head, a fall, a bullet, a high-speed crash, or an explosion that disrupt physiologic and anatomic function of the brain. Despite the significant burden of Traumatic Brain Injury, there is a lack of comprehensive, data-based studies in this area, particularly in low-resource settings, limiting the development of effective prevention and management strategies. Objective: To assess treatment outcome and associated factors of traumatic brain injury among pediatric patients treated at Asella Referral and Teaching Hospital, Asella, Southeast Ethiopia. Methods: An institution-based retrospective cross-sectional study was conducted on 282 pediatric patients with traumatic head injury treated at Asella Referral Hospital from 2021 to 2024. Data were analyzed using SPSS version 27. Bivariate and Multivariable logistic regression were performed to identify factors independently associated with unfavorable outcomes. Adjusted odds ratios with 95% CI were used to measure the strength of associations, and statistical significance was declared at p <0.05. Results: In this study of 282 patients, 49 (17.4%) of pediatric traumatic brain injury patients had an unfavorable outcome. Lower Glasgow Coma Scale(AOR = 2.96 (95 % CI 1.36 - 8.91)), the presence of increased intracranial pressure(AOR=3.61(95%CI 1.71-7.62)), and the need for Intensive Care Unit(AOR= 6.04(95%CI, 2.02-17.58)) were found to be significantly associated with unfavorable outcomes. Conclusion: A significant proportion of pediatric patients with traumatic brain injury experienced unfavorable outcomes. Severe brain injury, increased intracranial pressure, and intensive critical care requirements were independently associated with adverse outcomes. Early identification of high-risk patients and prompt management may improve pediatric TBI outcomes. Key words: Traumatic brain injury, Associated Factors, Pediatrics, ARTH, Treatment Outcome
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    MORTALITY AND ITS PREDICTORS AMONG PRETERM NEONATES ADMITTED AT ASELLA TEACHING AND REFERRAL HOSPITAL
    (2025-05-01) TEMESGEN REGASSA
    Abstract Background: Preterm birth, defined as the birth of a baby before 37 completed weeks of gestation, remains a major public health concern worldwide, particularly in low- and middle-income countries. It is a leading cause of neonatal morbidity and mortality, contributing significantly to under-five deaths. In Ethiopia, preterm birth is a major contributor to neonatal mortality, despite ongoing efforts to improve maternal and neonatal health services. Understanding the outcome and underlying predictors of mortality in this vulnerable population is critical for developing targeted interventions and improving survival rates. Objectives: To Assess Mortality and its predictors among preterm neonates at Asella teaching and referral hospital from April 2022 to March 2025. Methods: A Hospital based retrospective cohort study was conducted on preterm neonates admitted to neonatal intensive care unit of Asella teaching and referral hospital. A sample of 304 preterm neonatal records was included in the study. Data was collected from the medical records of neonates using a customized KOBO Toolbox based data collection form. Data was exported,coded and analyzed using SPSS version 26. Descriptive analysis was carried out to describe patient’s baseline characteristics and was summarized as frequencies, proportions, means, and SD. A descriptive survival time analysis using the duration of illness from birth until the event was carried out and Kaplan-Meier survival estimates was computed. Results: In this study, out of 304 recorded cases, 302 neonates were included, resulting in a response rate of 99.3%. Of the 302 preterm neonates that were included, 22.8% died (95% CI: 18.0–28.1) or 22.5 deaths per 1,000 neonate-day. Among those who died, the mean survival time was 19.78 days (95% CI: 18.26–21.31). Significant predictors of mortality were gestational age <32 weeks (AHR = 6.56; 95% CI: 3.66–11.77), delivery at other health facilities (AHR = 2.46; 95% CI: 1.45–4.18), lack of Kangaroo Mother Care (AHR = 4.04; 95% CI: 2.22–7.34), and thrombocytopenia (AHR = 2.13; 95% CI: 1.22–3.71). Conclusion and recommendation: Preterm neonatal mortality remains high in the study area, with an incidence of 22.8% or 22.5 deaths per 1,000 neonate-day and a mean survival time of 19.78 days. Key predictors include extreme prematurity, delivery at other facilities, lack of Kangaroo Mother Care, and thrombocytopenia. It is recommended that the concerned bodies strengthen neonatal care units, implement standardized Kangaroo Mother Care, and ensure early detection and management of thrombocytopenia. Strengthening referral systems and improving perinatal care quality has also paramount importance. Key words: preterm, mortality, predictors.
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    PATIENT PROFILE, TREATMENT OUTCOME, AND ASSOCIATED FACTORS OF PEDIATRIC EMERGENCY DEPARTMENT VISITS AT ASSELA REFERRAL AND TEACHING HOSPITAL: A 3-YEAR RETROSPECTIVE STUDY
    (2025-05-01) TUFA NUGUSU KEBE
    ABSTRACT Background: Pediatric emergency patients require special attention because of their vulnerability. Over recent decades, utilization of pediatric emergency departments has increased globally. However, data on patient profiles, associated factors, and outcomes of pediatric emergency care remain limited in low- and middle-income countries. Objective: To characterize the epidemiologic profile, associated factors, and outcomes of pediatric patients attending the pediatric emergency department (PED) of Assela referral and teaching hospital Methods: A retrospective chart review was conducted among pediatric patients presenting to the PED of Assela referral and teaching hospital, Arsi University, from September 10, 2022, to September 10, 2025. A total of 407 patient records were reviewed. Data were analyzed using SPSS version 27. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with escalated care. Statistical significance was determined at a p-value < 0.05. Results: Male children accounted for 63.9% of visits, 55.3% were from rural areas, and 75.9% were under five years of age. Factors independently associated with escalated care include altered mental status(AOR = 5.75; 95% CI: 1.67–19.83), comorbidity(AOR = 7.30; 95% CI: 1.30–40.94), danger signs(AOR = 2.06; 95% CI: 1.09–3.86), malnutrition (AOR = 13.25; 95% CI: 3.40–51.61),referral case (AOR = 1.91; 95% CI: 1.05–3.46),true emergency (AOR = 7.59; 95% CI: 2.59–22.20), delayed presentation of illness (1–3 days(AOR = 2.23,>3 days: AOR = 5.66) and diarrhea case have six fold odds of escalated care. Conclusion: Pediatric emergency utilization at ARTH reflects a high burden of acute illnesses, particularly among under-five children from rural settings. Clinical severity indicators were the strongest predictors of escalated care. Strengthening pediatric emergency triage systems and early risk identification is strongly recommended. Keywords: Pediatric emergency department, Patient profile, Clinical outcomes, associated factors, Assela referral and teaching hospital, Ethiopia
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    CLINICAL PROFILE, SHORT-TERM OUTCOMES AND ASSOICITED FACTORS OF NON-SURGICALLY MANAGED CONGENITAL HEART DISEASES IN PEDIATRICS PATIENTS AT ASELLA TEACHING AND REFERRAL HOSPITAL, ETHIOPIA
    (2025-05-01) Kasim Benka
    Abstract Background: Congenital heart disease (CHD) is a leading cause of morbidity in children, particularly in low-resource settings where surgical intervention is limited. Understanding the clinical profile and short-term outcomes of non-surgically managed CHD is essential to guide care. Methods: A retrospective cohort study was conducted at Asella Teaching and Referral Hospital, Ethiopia, from March 2020 to February 2025 among 156 pediatric patients with CHD. Data on demographs, clinical presentation, CHD types, comorbidities, anthropometric status, hospital admissions, medical management, and six-month clinical outcomes , further reclassified poor outcome(Death and / or DAMA) and good outcome (improved discharged and / or referred after stabilization) were collected from medical records. Descriptive statistics summarized the findings, and multivariable logistic regression identified factors associated with poor outcomes. Results: The majority of patients were infants (<1 year, 46.8%) and from rural areas (69.2%), with slight male predominance (54.5%). Most were symptomatic (91.7%), presenting with fast breathing (75.2%) and feeding difficulties (55.9%). Acyanotic CHD predominated (82.1%), with ventricular septal defect most common (41.7%); cyanotic CHD accounted for 17.9%, predominantly Tetralogy of Fallot (15.4%). Moderate or severe malnutrition affected 50% of patients. Hospital admission occurred in 82.7%, mainly for heart failure (79.8%) and pneumonia (53.5%). Medical management, primarily furosemide (73%) and spironolactone (69.5%), was provided in 76.9% of cases. At six months, 76.9% had good outcomes, while 23.1% had poor outcomes. Down syndrome (AOR = 4.63, 95% CI: 1.15–18.61, p = 0.031, short (≤3 days) (AOR = 6.01, 95% CI: 1.02–35.54, p =0.049) or prolonged (>14 days) hospital stay (AOR = 7.41, 95% CI: 1.08–50.93, p = 0.042), and loss to follow-up (AOR = 0.13, 95% CI: 0.04–0.41, p = 0.001)were independent predictors of poor outcomes. Conclusion: Pediatric CHD patients managed non-surgically are mostly infants with high rates of malnutrition. Continuous follow-up, nutritional support, and attention to comorbidities such as Down syndrome are essential to improve survival and functional outcomes.
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    Isolated Pathogens, Antimicrobial Resistance Patterns and Associated Risk Factors Among Pediatric ICU Patients Beyond the Neonatal Age Group at Asella Teaching and Referral Hospital
    (2025-05-01) Abdi Hayato
    ABSTRACT Background: Antimicrobial resistance (AMR) is a global public health crisis. Pediatric intensive care units (PICUs) provide care for critically ill children who are at high risk for infections caused by multidrug-resistant (MDR) pathogens. Patients with infections caused by drug-resistant bacteria are at increased risk of worse clinical outcomes including death and increased health care cost. Objectives: To assess the isolated microbial pathogens, antimicrobial resistance patterns, and associated risk factors among PICU patients beyond the neonatal age group at Asella Teaching and Referral Hospital (ATRH). Method: A hospital-based cross-sectional study was conducted using medical records of children aged 29 days to 14 years admitted to the PICU of ATRH. Medical records of 217 patients meeting inclusion criteria were included. Data wase coded and entered in to EPI-INFO version 7.2.7.0 and analyzed by Statistical Package for Social Science (SPSS) version 27. In the binary logistic regression analysis odds ratios (OR), 95 % confidence intervals (CI) and P-values was used to determine factors associated with AMR. Variables with P <0.25 in the bivariate analysis was analyzed for multivariate logistic regression. A P-value of less than 0.05 will be considered statistically significant. Results: Among 217 pediatric ICU admissions, 114 (52.5%) had positive cultures, and 66 isolates underwent antimicrobial susceptibility testing. Coagulase-negative staphylococci were the most frequent isolated organisms, followed by Klebsiella and Enterobacter species. High-risk Antimicrobial resistance (AMR) was identified in 45 (68.2%) isolates. Prolonged PICU stay (>7 days) was independently associated with high-risk AMR (AOR = 7.59; 95% CI: 1.10–52.60). Mortality during PICU admission was also significantly associated with high-risk AMR (AOR = 8.22; 95% CI: 1.39–48.63). Conclusion: A high prevalence of high-risk antimicrobial resistance was observed among pediatric patients admitted to the PICU. The findings are consistent with Ethiopian hospital-based studies and WHO global surveillance reports. Prolonged length of stay in the PICU and death during PICU admission were significantly associated with high-risk antimicrobial resistance. These findings highlight the close relationship between hospitalization duration, disease severity, and high-risk antimicrobial resistance, and emphasize the need for targeted interventions in pediatric intensive care settings. Key words: Antimicrobial resistance, Pediatric ICU, Hospital-acquired infections, Asella, Ethiopia
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    Determinants of delay in timely treatment seeking for diarrheal diseases among mothers with under-five children in public health facilities of Asella town, Oromia, central Ethiopia: a case - control study
    (2025-05-01) Abdisa Gonfa
    Abstract Background: Early treatment of diarrheal disease reduces morbidity and mortality among under-five children. However, in many low-income countries, mothers and caregivers often fail to seek care promptly or do not seek care at all. Delayed treatment may result in chronic diarrhea, malabsorption, malnutrition, growth retardation, and long-term impairment. Factors such as maternal knowledge, type of diarrhea, and distance to health facilities influence treatment-seeking behavior. This study aimed to identify determinants of delayed treatment seeking for diarrheal disease among under-five children attending public and private health facilities in Asella town, Oromia region, central Ethiopia. Methods: An institutional-based unmatched case–control study was conducted from October 1 to November 30, 2025, among 324 under-five children (162 cases and 162 controls). Three government and two private health facilities were selected, and the sample size was proportionally allocated to each facility. Data were collected using a pretested questionnaire and analyzed using SPSS version 27. Variables with a p-value ≤0.25 in bivariate analysis were entered into multivariable logistic regression. Statistical significance was declared at p-value <0.05 with 95% confidence intervals. Results: A total 324 participants were included, giving a 100% response rate. Children under 24 months were more likely to experience delayed treatment seeking than those aged ≥24 months (AOR = 2.19; 95% CI: 1.23–3.99). Living more than 10 km from the nearest health facility increased the likelihood of delayed treatment (AOR = 2.67; 95% CI: 1.67–4.27). Children of mothers or caregivers with poor knowledge were also more likely to delay seeking treatment (AOR = 2.60; 95% CI: 1.50–4.43). Conclusion and recommendation: Delayed treatment seeking was significantly associated with younger child age, long distance to health facilities, and poor mothers/caregivers knowledge. Strengthening community-based health education and improving access to health services are essential. Targeted interventions for high-risk families are necessary to reduce diarrhea-related morbidity and mortality among under-five children. Keywords: Diarrhea, Ethiopia, treatment delay, under-five
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    Magnitude and Associated Factors of Meconium Aspiration Syndrome among Neonates Admitted to Asella Referral and Teaching Hospital, Southeast Ethiopia
    (2025-05-01) Tsegaye Zebenu
    Abstract Background: Meconium Aspiration Syndrome (MAS) remains a major cause of neonatal morbidity and mortality, particularly in low- and middle-income countries such as Ethiopia. Despite global efforts to reduce perinatal complications, MAS continues to pose significant clinical challenges, especially in resource-constrained healthcare settings. Understanding its magnitude and associated risk factors is critical for developing effective prevention and management strategies. There is a notable lack of data regarding the burden and contributing factors of MAS among neonates admitted to Asella Referral and Teaching Hospital, a key referral center in Southeast Ethiopia. This study aims to address this knowledge gap by assessing the magnitude and associated factors of MAS in this setting. Objective: To assess the magnitude and associated factors of meconium aspiration syndrome among neonates admitted to Asella Referral and Teaching Hospital, Southeast Ethiopia, from September 2024 to November 2025. Method: A cross-sectional study was conducted among neonates admitted to the Neonatal Intensive Care Unit of Asella Referral and Teaching Hospital. A systematic random sampling technique was employed and a total of 295 neonates were included in the analysis. The diagnosis of meconium aspiration syndrome was made based on clinical criteria. Descriptive statistics were used to determine the magnitude of MAS. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with MAS. Statistical significance was declared at a p-value < 0.05 with a 95% confidence interval. Result: The magnitude of meconium aspiration syndrome among admitted neonates was 19% at 95% CI. Gestational age of ≥37 weeks was significantly associated with MAS (AOR = 2.46; 95% CI: 1.05–5.81; p = 0.039). Exposure to meconium-stained amniotic fluid (MSAF) showed a strong association with MAS (AOR = 33.36; 95% CI: 8.61–129.16; p < 0.001). In addition, the requirement for oxygen therapy immediately after birth was also associated with MAS (AOR = 29.41; 95% CI: 5.02–172.37; p < 0.001). Conclusion: Overall, the magnitude of meconium aspiration syndrome was high among admitted neonates. Exposure to meconium-stained amniotic fluid, requirement for oxygen therapy at birth and gestational age were significantly associated with MAS. Understanding these associations is crucial for improving risk assessment, strengthening preventive strategies and optimizing the management of MAS in neonates. Keywords: Neonates, Meconium Aspiration Syndrome, Asella Referral and Teaching Hospital,Ethiopia
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    PREDICTORS OF PROLONGED HOSPITAL STAY AMONG CHILDREN AGED 3 MONTHS TO 14 YEARS ADMITTED WITH SEVERE PNEUMONIA AT ASELLA REFERRAL AND TEACHING HOSPITAL, SOUTHEAST ETHIOPIA, 2024/2025
    (2025-05-01) MUBAREK REDWAN
    Abstract Background: Severe pneumonia is a leading cause of hospitalization and death among children under five, especially in low-income countries like Ethiopia.Various factors such as malnutrition, Anemia, Comorbidities, and delayed treatment are associated with prolonged hospital stay in children with severe pneumonia. Prolonged hospital stay increases health care costs, risks of hospital acquired infections, and resource burden on health systems. Objective: This study aimed to determine the magnitude of prolonged hospital stay and identify its predictors among pediatric patients admitted with severe pneumonia at Asella referral and teaching hospital, Arsi zone, southeast, Ethiopia from 2024 to 2025. Methods: A hospital based retrospective cross-sectional study was conducted using secondary data analysis on pediatric patients with severe pneumonia. Data was entered into Microsoft Excel for data cleaning, coding, and preliminary processing, then exported to Statistical Package for Social Sciences (SPSS) version 27.0.1 for analysis. Bivariate logistic regression analysis at a significance level of 0.25 and multivariate logistic regression analyses with a significance level of 0.05 were conducted to determine the factors associated with prolonged hospital stay among pediatric patients. Results: In this study 42% (95% CI: 37.21%- 46.81%) of patients with severe Pneumonia had prolonged hospital stays. The presence of underlying comorbidity (adjusted odds ratio [AOR]: 3.16, 95% CI: [1.832-5.336]), unvaccinated status (AOR: 2.01, 95% CI [1.694-3.815]), Malnutrition (AOR: 2.94,95% CI [1.383-6.290]),having history of previous pneumonia (AOR: 3.277, 95% CI [1.798-5.971]) and delayed in seeking health care provider( AOR: 3.773; CI [2.037-6.989] were independent predictors of prolonged hospital stay among pediatric patients with severe pneumonia. Conclusion: In this study, more than one-third of pediatric patients with severe pneumonia had a length of stay of more than 5 days, and not vaccination status, malnutrition, previous history of pneumonia, delayed health care seeking, and underlying comorbidities were independent predictors of prolonged hospital stay. Therefore, healthcare providers, parents, and other stakeholders should work to improve vaccination rate, improve community early health care seeking behavior through education, and inpatient management of malnutrition and other comorbid diseases to reduce hospital stays for pediatric patients with severe pneumonia. Key words: pediatric patients, prolonged hospital stay, severe pneumonia, southeast Ethiopia