Incidence and predictors of diabetic ketoacidosis among children with diabetes in West and East Gojjam zone referral hospitals Northern Ethiopia, 2019

Abstract

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.

Treatment outcomes of diabetic ketoacidosis among diabetes patients in Ethiopia. Hospital-based study

“…However, these strategies have not been appropriately implemented in Ethiopia. In addition, the cost and lack of medication supplies, presence of comorbid conditions, inappropriate insulin storage, medication non-adherence, electrolyte disturbance and smoking habits complicated the prevention and treatment of DKA in Ethiopia [ 21 , 23 , 24 ]. There was limited data on treatment outcomes including hospital stay, glycemic control during hospitalization and in-hospital mortality related to DKA in north Ethiopia.…”

Time to Recovery from Diabetic Ketoacidosis and its Predictors among Adult Diabetic Ketoacidosis Patients in DEBRE MARKOS Referral Hospital, North West Ethiopia, 2021: Retrospective Cohort Study

“…This study was conducted at Debre Markos referral hospital which is located in the city of Debre Markos 265 Km from Bahir-Dar and 300 kilometers from Addis Ababa. The hospital is the only referral hospital in the East Gojjam zone and serves around 3.5 million people and 100 health centers and 9 district hospitals are available in the catchment area of the referral hospital (44).…”