Department of Pediatrics and Child Health

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Availability, price, and affordability of anti-cancer medicines in children in Mekelle, Tigray, Ethiopia
(Mekelle University, 2024-09-01) Teklebirhan Hailu
Background: Childhood cancer is a significant public health concern, particularly in low and middle-income countries (LMICs). Access to effective anti-cancer medicines is crucial for improving survival rates and quality of life. There is a lack of data on the availability and pricing of anti-cancer medicines for children in LMICs, including Ethiopia. This study aims to evaluate the availability, price, and affordability of anti-cancer medications for children in Mekelle, Tigray, Ethiopia. Methods: The study was cross-sectional using a modified form of the World Health Organization and Health Action international methodology of measuring medicine price, availability, and affordability of childhood anti-cancer drugs in purposeful Ayder Comprehensive Specialized Hospital, purposefully selected 7 private pharmacies, and a RedCross pharmacy found in Mekelle, Tigray, Ethiopia, from April to September 2024. The study includes 24 cytotoxic medications listed in the WHO essential medication list for children and was collected in the form of lowest-priced generics and originator brands from the health sectors found in Mekelle. The data were entered and analyzed using WHO/HAI data entry in a in a Microsoft Excel (V 15.0)-customized program to enter and analyze the data collected and analysis form. Result: The overall availability of anti-cancer medication in all sectors was found to be low (38.45%). The availability of LPGs was 41.7% and 37.49% in the public and private sectors, respectively. Anti-cancer medications were totally unavailable at Red Cross Pharmacy. The median MPR of LPG for the public sector and private sector was 1.293 and 2.8925, respectively. The prices of cytotoxic medications available in the private sector were higher than in the public. All anti-cancer medicines for the treatment of the most common cancers in Mekelle were unaffordable. Conclusion: Medicines for cancer treatment are unavailable, and the few available medicines are unaffordable in Mekelle. Based on this, we recommend subsidies for essential childhood cancer medicines and importation of cancer medicines by the government. Improvement in price transparency, health insurance schemes for childhood cancers to be affordable
A Study on Electroencephalography (EEG): Its Indications, Findings, and Predictors of Abnormal Results In Pediatrics Age group at Ayder Comprehensive Specialized Hospital, Mekelle, Northern Ethiopia
(Mekelle University, 2024-10-01) Freweini Gebremeskel (MD)
Background: Electroencephalography, often referred to as EEG, is a non-invasive electrophysiological imaging technique used to record the brain’s electrical activity. In Ethiopia, particularly Tigray, there is no study a specific study on EEG study among pediatric age group, its indications, and findings at Ayder Comprehensive Specialized Hospital (ACSH) in Mekelle, Northern Ethiopia. Objective: To study the indications for EEG, the prevalence of abnormal EEG results, and identify predictors of EEG abnormality in pediatrics age group at ACSH. Methods : A cross-sectional study was carried out on 439 pediatric patients who underwent EEG study at ACSH for a range of neurological disorders from October 2019 to September 2024. Data were collected using a checklist, with the data source being electronic EEG records. The ODK collect mobile application was used for simultaneous data collection and entry. After exporting data to SPSS 27, both descriptive and inferential statistics were applied. Binary logistic regression was fitted to identify predictors of EEG abnormality. A p-value less than 0.05 was used to declare statistical significance. Result: The mean age of the study participants is 7.9 years and about two-third (63.6%) were male. More than three-fourths (77.0%) were right-handed and the most common clinical diagnosis wa generalized epilepsy (62%) and 89% of the participants had seizure history. The most prevalent EEG finding was generalized epileptiform (43.1%). Overall, two-thirds (66.5%) of the EEG studies exhibited abnormality. The odds of abnormal EEG findings were almost five times higher in children not on remission (AOR=4.6, 95% CI: 1.9 to 11.2, p=0.001). The odds of abnormal EEG were seven times higher in children with history of seizure (AOR=7.0, 95% CI: 3.4 to 14.3, p<0.001). The odds of abnormal EEG findings were found to increase by 20% as duration of epilepsy rises by one year (AOR=1.2, 95% CI: 1.1 to 1.4, p=0.001). The odds of abnormal EEG results were 12.6 times higher among children who had no febrile seizures than their counterparts (AOR=12.6, 95% CI: 1.4 to 111.3, p=0.022). Conclusion and Recommendations: In the present study, the prevalence of abnormal EEG results was higher compared to other Ethiopian studies due to different reasons. Factors remarkably related to EEG abnormality are duration of seizure/epilepsy, febrile seizure, seizure history, and remission status. Therefore, more emphasis should be given to children with an ongoing seizure (not on remission) and long history of seizure. Further research on the relationship between EEG abnormality and febrile seizure should be conducted and supported by concerned bodies.
ADHERENCE TO ART AND ASSOCIATED FACTORS AMONG HIV INFECTED CHILDREN ON FOLLOW-UP AT MEKELLE GENERAL HOSPITA
(Mekelle University, 2025-02-01) Selam Gebreslassie Weldetatyos
Introduction: Adherence to antiretroviral therapy (ART) is a significant factor for the success of HIV treatment. The challenges are particularly serious in Sub-Saharan countries as the high rates of HIV/AIDS lead to greater numbers of affected individuals. The magnitude of this challenge remained large in developing countries like Ethiopia. In Tigray, though high rates of patient’s poor adherence are expected which is resulted from the war and associated siege there is limited evidence on adherence to ART particularly among children. Objective: to assess the level of adherence to ART and the factors associated among HIV infected children in Mekelle General hospital. Method: Using hospital based cross-sectional study design a total of 136 children age under 18 who was on ART. Census method of data collection was used. Then, the collected data was analyzed using SPSS27. Dependent variable was dictomized, then a descriptive, bi-variate and multivariate logistic regression analysis was performed to see the frequency, measure the level of adherence and identify the determinate factor of good / poor adherence. The research was done on April 2024 by September 2024. Result and discussion: A total of 136 study participants were included. The level of ART adherence among children was 115 (84.6%). Majority of children are in the age of 10-18 years 98[72%] of all female are dominant number than male 80[58.8%] majority resides in Mekelle 122[87.9%]. No variable is found significant factor affecting adherence. Care givers of lower economic status [AOR=5.711(0.532-61.350)], self-care-giver type [AOR=3.332(0.356-31.227)], and those who were aware of their HIV serio status [AOR=1.202(0.433-3.334)] were more likely to adhere to ART treatment. On the other hand, the study showed the Sex of the child [AOR=0.922(0.360-2.361)], sex of the caregiver [AOR=0.493(0.181-1.341)] and caregivers with other occupation [AOR=0.450(0.050-4.036)], were less related to Adherence of ART medication. Caregiver’s forgetfulness (28.7%) and stigma of children (25%) were more likely the main reasons for missed doses. Conclusion and recommendation: The level of adherence to antiretroviral therapy was poor. This study indicated the level of adherence (84.6%) showed a difference with WHO requirements, 95%
DETERMINANTS OF INCOMPLETE VACCINATION AMONG CHILDREN AGED 12-23 MONTHS IN NAEDIER WOREDA, CENTRAL ZONE, TIGRAY, ETHIOPIA, 2024/2025 COMMUNITY BASED UNMATCHED CASE CONTROL STUDY
(Mekelle University, 2025-02-21) GEBERZIHER GEBERSLASSIE
Background: Vaccination is among the most cost-effective health interventions and has been responsible for substantial reductions in mortality and morbidity, especially for those under five. Globally, around 67 million children are only partially immunized. Neglecting to protect children from vaccination can lead to severe outcomes such as permanent disability, child mortality, and vaccine-preventable disease outbreaks. In Africa, an estimated 12.7 million children, 1.4 million children in Ethiopia and 41% of children in Tigray are partially immunized. The reasons behind these incomplete vaccinations haven't been extensively studied. Therefore, this study aimed to identify the determinants of incomplete vaccination among children aged 12-23 months in Naedier Woreda, Central Zone, Tigray, Ethiopia, 2024 /2025 Methods: A community-based unmatched case-control study design was implemented with a total sample size of 294 among children aged 12 to 23 months in Naedier Woreda, Central Zone of Tigray, Ethiopia, from August to October 2024. A participant was selected from 12 Kebeles by a simple random sampling technique. Data was collected from mothers/caregivers using a pretested, structured questionnaire. Data were entered into Epi Info 7 and analyzed using the Statistical Package for Social Sciences version 27. Multicollinearity was checked using the variance inflation factor, and the model of fitness was checked by Hosmer Lemeshow. Multivariable logistic regression analysis was used to control confounding variables at the p-value < 0.05, and the strength of the statistical association was measured by using adjusted odds ratios and ` 95% confidence intervals. Result: This study revealed that children born to mothers/caregivers who did not receive antenatal care follow-up (AOR = 4.58, 95% CI: 1.23-17.1), households not visited by health workers (AOR = 2.53, 95% CI: 1.23-5.17), mothers/caregivers who were not informed about the types of vaccines received (AOR = 3.209, 95% CI: 1.29-8.0), were not informed about potential side effects of vaccines (AOR = 2.92, 95% CI: 1.36-6.31), and were not given information about the next vaccination date (AOR = 3.76, 95% CI: 1.8-7.42) were the determinants to default on completing their vaccination. Conclusions and Recommendations: From this study, suggested several determinants contributing to children aged 12-23 months failing to complete their full vaccination schedule are no antenatal care follow-up, absence of home visits by healthcare workers, and no information on vaccinations, including potential side effects and subsequent vaccination schedules. To address those factors, health offices and healthcare workers should prioritize providing detailed information about the specific vaccines administered, including expected side effects and the timing of future vaccinations, and reinforce the importance of consistent antenatal care for both maternal and child health.