Background: Diabetic ketoacidosis (DKA) is one of the most common public health problems and is still a major child killer in sub-Saharan African countries, particularly Ethiopia. There are limited and inconclusive data in Amhara regional state; moreover, predictors for the incidence of DKA were not investigated before. Therefore, this study aimed to assess the frequency of DKA and its determinants among pediatric diabetes mellitus patients in public hospitals in northwest Ethiopia. Methods: An institutional-based retrospective follow-up study was conducted from September 2015 to February 2018 at selected public hospitals in northwest Ethiopia. A simple random sampling method was used to select 389 study subjects. Statistical analysis was done by R-studio version 1.1.4. Akakia's information criteria was used for model comparison and the negative binomial regression model was fitted to identify determinants for the frequency of DKA. An adjusted incidence rate ratio with 95% confidence interval was used to declare statistical significance. Results: The average frequency of DKA was 1.01 per individual. The incidence rate of DKA was increased among diabetes mellitus patients with an infection (adjusted incidence rate ratio (AIRR) = 1.41, 95% CI = 1.05-2.14), heart diseases (AIRR = 4.1, 95% CI = 1.17-14.68), treatment discontinuation (AIRR = 2.91, 95% CI = 2.02-4.22), low level of sodium (AIRR = 1.88, 95% CI = 1.22-2.89) and low dose of treatment at baseline (AIRR = 0.96, 95% CI = 0.94-0.97). Conclusion:Having an infection, heart diseases, taking a low dose of treatment, a low sodium level, and treatment discontinuation were the factors that increase the frequency of DKA.
Introduction The magnitude of childhood anemia has increased from 44% in 2011 to 56% in 2016. Thus, even if the Ethiopian government tried remarkable solutions, anemia among under-five children still continues as a serious health issue. So, exploring spatial distribution and identifying factors associated with childhood anemia helps to design appropriate strategies for control and prevention.Methods For this study data from the recent 2016 Ethiopian Demographic Health Survey were employed. The sample size was 8602 children aged 6–59 months. They were selected by stratified two-stage cluster sampling techniques. Sat Scan version 9.4 was also used to identify childhood anemia by geographic clusters and ArcGIS version10.1 was used to show anemia cases through Regions of Ethiopia. Thus to declare factors that are statistically related with anemia among under-five children a Mixed effect logistic regression model was utilized.Result This study showed there is spatial clustering of childhood anemia throughout Ethiopia (Moran’s I: 0.65, p<0.001). Statistically significant clusters were detected in Somali, Afar, Harari and southern part of Oromia regions (P<0.001). Age of child, wealth index, mother’s current working status, maternal anemic status, number of living children in the family, history of fever, and stunting were significant factors associated with anemia among under-five children.Conclusion In the country childhood anemia showed spatial clustering. Regions high risk of childhood anemia should be emphasized by allocating additional resources and providing appropriate interventions which have public health implications.
Diabetes mellitus is a global public health problem. Glycemic control is a major public health problem. Diabetes results from elevated levels of glycaemia such as increased glucose and glycated hemoglobin, and controlling glycaemia is an integral component of the management of diabetes. Glycemic control in children is particularly difficult to achieve. Identifying determinants of poor glycemic control is important for early modification of diabetic related end organ damages. This study was aimed to assess the status of glycemic control and associated factors among pediatric diabetes mellitus patients in northwest Ethiopia. Facility-based cross sectional retrospective cohort study design was used and this study was conducted from September, 2015 to February, 2018. Simple random sampling was used to select 389 samples. Data were collected using an extraction checklist. Data were entered into Epi-data − 4.6, and analyzed using Stata-16. Finally, multivariable binary logistic regression was done. Poor glycemic control was more common among pediatric patients 39.3% (95% CI 34.6, 44.3). Treatment discontinuation (AOR 2.42, 95% CI 1.25, 4.69), age (AOR 1.15, 95% CI 1.03, 1.28) and treatment dose (AOR 0.96, 95 CI 0.92, 0.99) were significantly associated with poor glycemic control. Prevalence of poor glycemic control was high. Patient’s age, history of treatment discontinuation and dose of treatment were the significant contributing factors to poor glycemic control. These need to be addressed to attain the objective of adequate glycemic control.
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