Search

Introduction: Perinatal asphyxia is failure to maintain normal breathing at birth. World Health Organization indicates that perinatal asphyxia is the third major cause of neonatal mortality in developing countries accounting for 23% of neonatal deaths every year. At global and national level efforts have done to reduce neonatal mortality, however fatalities from asphyxia remains high in Ethiopia (24%). And there are no sufficient studies to show incidence and prediction of mortality among asphyxiated neonates. Developing validated risk prediction model is one of the crucial strategies to improve neonatal outcomes with asphyxia. Therefore, this study will help to screen asphyxiated neonate at high-risk for mortality during admission by easily accessible predictors. This study aimed to determine the incidence and develop validated Mortality Prediction model among asphyxiated neonates admitted to the Neonatal Intensive Care Unit at Felege-Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia. Method: Retrospective follow-up study was conducted at Felege-Hiwot Comprehensive Specialized Hospital from September 1, 2017, to March 31, 2021. Simple random sampling was used to select 774 neonates, and 738 were reviewed. Since was data Secondary, it was collected by checklist. After the description of the data by table and graph, Univariable with p-value < 0.25, and stepwise multivariable analysis with p-value < 0.05 were done to develop final reduced prediction model by likelihood ratio test. To improve clinical utility, we developed a simplified risk score to classify asphyxiated neonates at high or low-risk of mortality. The accuracy of the model was evaluated using area under curve, and calibration plot. To measures all accuracy internal validation using bootstrapping technique were assessed. We evaluated the clinical impact of the model using a decision curve analysis across various threshold probabilities. Result: Incidence of neonatal mortality with asphyxia was 27.2% (95% CI: 24.1, 30.6). Rural residence, bad obstetric history, amniotic fluid status, multiple pregnancy, birth weight (< 2500 g), hypoxic-ischemic encephalopathy (stage II and III), and failure to suck were identified in the final risk prediction score. The area under the curve for mortality using 7 predictors was 0.78 (95% CI 0.74 to 0.82). With ≥ 7 cutoffs the sensitivity and specificity of risk prediction score were 0.64 and 0.82 respectively. Conclusion and recommendation: Incidence of neonatal mortality with asphyxia was high. The risk prediction score had good discrimination power built by rural residence, bad obstetric history, stained amniotic fluid, multiple pregnancy, birth weight (< 2500 g), hypoxic-ischemic encephalopathy (stage II and III), and failure to suck. Thus, using this score chart and improve neonatal and maternal service reduce mortality among asphyxiated neonates. [ABSTRACT FROM AUTHOR]

Introduction: Visual impairment is a major public health problem in developing countries where there is no enough health-care service. It has a significant impact on the affected child's psychological, educational and socioeconomic experiences, during childhood and beyond. Therefore, the aim of this review was to estimate the pooled prevalence of visual impairment and its associated factors among children in Ethiopia. Method: This systematic review and meta-analysis was designed based on the PRISMA guidelines. Relevant published articles in Ethiopia from 2011–2021 were searched in PubMed/Medline, HINARI, Google scholar, and conference paper and thesis or research final reports were accessed from Ethiopian Universities' repositories. Data was extracted in Microsoft excel by using JBI data extraction checklist. The pooled prevalence and odds ratio of associated factors with their 95% CI was computed by using STATA 14/SE software. A fixed effect meta-analysis model was employed for a Cochrane Q test statistic and I2 test showed there was no heterogeneity in the included studies. Result: A total of 7,647 children from nine studies were included in this study. The overall prevalence of visual impairment among children in Ethiopia was 7% (95% CI: 6, 7%). The pooled prevalence of visual impairment by region was almost similar in Ethiopia. However, there was no significant association between the identified factors and visual impairment among children. But the result showed that being males (AOR 0.642, 95% CI: 0.357–1.156), Children in the age of 10–13 years (AOR 0.224, 95% CI: 0.046–1.102) and 14–18 years (AOR 0.508, 95% CI: 0.102–2.534) were found to be less likely to have visual impairment. On the other hand, children of parents with visual impairment (AOR 1.820, 95% CI: 0.381–8.698) more likely to have visual impairment. Conclusion: Visual impairment among children in Ethiopia is still a public health problem one year later to VISION 2020, a global initiative aimed to eliminate avoidable blindness. All most one out of fourteen children in Ethiopia had visual impairment. Therefore, the government of Ethiopia should focus on effective, efficient, comprehensive eye health care services by integrating with the national health system to prevent avoidable visual impairment among children. [ABSTRACT FROM AUTHOR]