Background Human immunodeficiency virus and acquired immunodeficiency syndrome had created enormous challenges worldwide, and continues to be the world’s serious health and development challenges. Globally, at the end 2017, there were 1.8 million children (< 15 years) living with HIV. The survival of HIV-positive children treated with ART depends on a variety of factors, which might vary greatly with economic, socio-demographic, behavioral risk, and health factors. This study aimed to assess survival status and predictors of mortality among HIV-positive children on antiretroviral therapy at East Gojjam Zone Public hospitals, Northwest Ethiopia. Methods An institution-based retrospective cohort study was conducted in selected hospitals of the East Gojjam zone, Northwest Ethiopia, among < 15-year-old children who were newly enrolled in HIV care clinic from January 1st, 2014 to December 31, 2018. Data were collected from patient charts from March 1 to 22, 2019 using a standardized checklist. Data were analyzed by SPSS version 24. A Kaplan–Meier curve and log-rank test were used to estimate the survival time and compare survival curves between variables. Multivariable Cox proportional-hazards model was fitted to identify predictors of survival status taking p-value < 0.05 as statistically significant. Result In this study, a total of 251 HIV-positive children on ART were followed up for a total of 60 months, with a mean survival time of 55.54 (± 0.83) (95% CI: 53.90–57.17) months. The overall mortality incidence rate in the cohort during the 626 Child-Year-Observation (CYO) was 2.56/100 CYO. The overall estimated survival probability after starting ART was 0.90 at 60 months of follow-up. In this study age < 5 years, Hgb < 10 gm/dl, CD4 count below threshold, cotrimoxazole preventive therapy, and subnormal weight for height were statistically significant predictors of survival status (P < 0.05). Conclusion and recommendation Age, hemoglobin level, CD4 count, weight for height, and not taking cotrimoxazole preventive therapy were independent predictors of mortality. Therefore, concerned stakeholders should focus on the above-mentioned predictors of mortality and nutritional interventions to enhance the survival of HIV-infected children on antiretroviral therapy.

Background Recurrent diabetic ketoacidosis in patients with known diabetes mellitus remains a relevant problem in pediatrics with an incidence of 1–10% per patient. Children may die because of cerebral edema and had a significant mortality (24%) and morbidity (35%). Objective We assessed the incidence and predictors of diabetic ketoacidosis among diabetes children at East and West Gojjam zone referral hospitals, North West Ethiopia, 2019. Methods An institution-based retrospective follow up study was conducted on children who were registered from January 1, 2014, to January 1, 2019. Epi data version 3.1 & Stata 14 were used for data entering and analysis respectively. Result Out of 354 children included in the study, 207 (58.5%) developed diabetic ketoacidosis. The overall incidence rate of diabetic ketoacidosis was 2.27/100 children/month of observation. Age < 5 years (AHR: 3.52, 95% CI (2.25, 5.49), non-adherence (AHR: 1.54, 95% CI (1.11, 2.14), inappropriate insulin storage (AHR: 1.36, 95% CI (1.008, 1.85), presence of upper respiratory tract infections during diabetic ketoacidosis diagnose (AHR: 2.22, 95% CI (1.11, 4.45) and preceding gastroenteritis (AHR: 2.18, 95% CI (1.07, 4.44) were significant predictors. Conclusion Age < 5 years old, non-adherence, inappropriate insulin placement at home, preceding gastroenteritis, and presence of upper respiratory tract infections at the time of diabetic ketoacidosis development were significant predictors. Hence, assessing and close monitoring as well as strengthened diabetic education should be given for the above predictors.

Objective The purpose of this study was to determine the level of adherence to diabetes self-management and associated factors among adolescents living with type 1 diabetes at Public Hospitals in Addis Ababa, Ethiopia. Methods An institutional-based cross-sectional study was carried out among 422 adolescents with type 1 diabetes attending outpatient diabetic clinics at public hospitals in Addis Ababa. The adolescents were interviewed using pretested questionnaires to give information on adherence to diabetes self-management. A variable that has a P-value of <0.2 in bi-variable logistic regression analysis was subjected to multivariable logistic regression analysis to control the confounding factors. The level of significance was pronounced at P-value <0.05. Results In this study, a total of 414 adolescents living with type 1 diabetes were interviewed making a 98.1% response rate. About 218 participants (52.7%) had poor adherence to overall diabetes self-management. Self-efficacy (AOR=8.7, 95% CI:1.9–14.1, P=0.005), social support (AOR=4.6, 95% CI:1.5–13.5, P=0.006), age (AOR=0.2, 95% CI:0.1–0.4, P=0.001), good knowledge of the disease (AOR=9.046, 95% CI:3.83–13.5, P=0.000), moderate knowledge (AOR=6.763, 95% CI:2.18–12.921, P=0.001), and time since diagnosis of type 1 diabetes (AOR=0.1, 95% CI:0.02–0.2, P=0.005) were significantly associated with adherence to diabetes self-management. Conclusions and Recommendations More than half of this population had poor adherence to diabetes self-management. The finding suggested that implementing a comprehensive guideline of adherence and expanding the recurrence of follow-up visits could be important for this population.

Background: Recurrent diabetic ketoacidosis in patients with known diabetes mellitus remains a relevant problem in pediatrics with an incidence of 1–10% per patient. Children may die because of cerebral edema and had a significant mortality (24%) and morbidity (35%).Objective: We assessed the incidence and predictors of diabetic ketoacidosis among diabetes children at East and West Gojjam zone referral hospitals, North West Ethiopia, 2019. Methods: An institution-based retrospective follow up study was conducted on children who were registered from January 1, 2014, to January 1, 2019. Epi data version 3.1 & Stata 14 were used for data entering and analysis respectively.Result: Out of 354 children included in the study, 207 (58.5%) developed diabetic ketoacidosis. The overall incidence rate of diabetic ketoacidosis was 2.27/100 children/month of observation. Age <5 years (AHR: 3.52, 95% CI (2.25, 5.49), non-adherence (AHR: 1.54, 95% CI (1.11, 2.14), inappropriate insulin storage (AHR: 1.36, 95% CI (1.008, 1.85), presence of upper respiratory tract infections during diabetic ketoacidosis diagnose (AHR: 2.22, 95% CI (1.11, 4.45) and preceding gastroenteritis (AHR: 2.18, 95% CI (1.07, 4.44) were significant predictors. Conclusion: Age < 5 years old, non-adherence, inappropriate insulin placement at home, preceding gastroenteritis, and presence of upper respiratory tract infections at the time of diabetic ketoacidosis development were significant predictors. Hence, assessing and close monitoring as well as strengthened diabetic education should be given for the above predictors.

Objectives The purpose of this study was to determine the level of adherence to diabetes self-management and associated factors among type 1 diabetic adolescents attending outpatient diabetic clinics at Public Hospitals in Addis Ababa, Ethiopia. Methods An institutional-based cross-sectional study was carried out among 422 adolescents with type 1 diabetes attending outpatient diabetic clinics at four randomly selected public hospitals in Addis Ababa. The adolescents were interviewed using pretested questionnaires to give information on socio-demographic characteristics, medical factors, knowledge about type 1 diabetes, adherence to diabetes self-management, self-efficacy, and social support related to type 1 diabetes. A variable that has a P-value of <0.2 in bi-variable logistic regression analysis was subjected to multivariable logistic regression analysis to control the confounding factors. The level of significance was pronounced at P-value <0.05. Results In this study, a total of 414 diabetic adolescents were interviewed making a 98.1% response rate. About 218 participants (52.7%) had poor adherence to overall diabetes self-management. Self-efficacy (AOR=8.7, 95% CI:1.9-14.1, P=0.005), social support (AOR=4.6, 95%CI:1.5-13.5, P=0.006), age (AOR=0.2, 95%CI:0.1-0.4, P=0.001), good knowledge of the disease (AOR=9.046, 95%CI:3.83-13.5, P=0.000), moderate knowledge (AOR=6.763, 95%CI:2.18-12.921, P=0.001), and time since diagnosis of type 1 diabetes (AOR=0.1, 95%CI:0.02-0.2, P=0.005) were significantly associated with adherence to diabetes self-management. Conclusions and Recommendations: More than half of this population had poor adherence. The finding suggested that implementing a comprehensive guideline of adherence and expanding the recurrence of follow-up visits could be important for this population.