Nutritional assessment and associated factors in children with congenital heart disease-Ethiopia.

INTRODUCTION: Worldwide, congenital heart disease is the principal heart disease in children and constitutes one of the major causes of infant mortality, particularly in developing countries. Infants and children with congenital heart disease exhibit a range of delays in weight gain and growth. In some instances, the delay can be relatively mild, whereas in other cases, cause the failure to thrive. OBJECTIVES: To determine the nutritional status and associated factors of pediatric patients with congenital heart disease. MATERIAL AND METHOD: A cross sectional analytical study conducted over a period of 6 months (Feb to Jul 2020). A total of 228 subjects with congenital heart disease who visited the cardiac center during the study period where included until the calculated sample size attained. Data is collected from patient's card and their care giver. Data was then analyzed using Statistical Package for Social Sciences (SPSS) for windows version 25.0. Odds Ratio with 95% Confidence Interval (CI) was used to determine the effect of the independent variables on the outcome variable and P-value less than 0.05 was considered statistically significant. RESULTS: A total of 228 children ranging from 3month to 17yrs of age with mean age of 4.7 years (SD = 3.8 years) were included in the study. Most of the subjects had acyanotic heart disease accounting for 87.7%. The overall prevalence of wasting, underweight and stunting were 41.3%, 49.1% and 43% respectively. Children with congenital heart disease and having pulmonary hypertension, were found more likely to develop wasting compared to those without pulmonary hypertension with an odds of 1.9 (95% CI: 1.0-3.4) and also have greater chance of stunting with an odds of 1.9 (95% CI: 1.0-3.4). Children 5 to 10 years of age were 2.3 times more likely to be underweight. CONCLUSION: Malnutrition is a major problem in pediatric patients with congenital heart disease. Pulmonary hypertension and older age are associated with increased risk of undernutrition.

Magnitude and Associated Factors of Undernutrition Among Children Aged 6-59 Months in Ethiopian Orphanage Centres.

BACKGROUND: Children without parental care are at high risk for under-nutrition. Ethiopia counts as one of the largest populations of orphans in the world. However, there is no information about the nutritional status of children in Ethiopian orphanage centers. Thus, we aimed to assess magnitude and associated factors of undernutrition among children aged 6-59 months in Ethiopian orphanage centres. METHODS: Institution-based descriptive and analytical cross-sectional study was conducted on 227 children aged 6-59 months in selected orphanage centers of Addis Ababa, Ethiopia from July to August 2019. A simple random sampling technique was used to select the study participants. Interviewer administered structured pretested questionnaire, document review and anthropometric measurements were used to collect the data. Epi info version 7.2.1.0 and SPSS version 23.0 were used for data entry and analysis respectively. Anthropometric indices were generated using the WHO Anthro software version 3.2.2. A cut-off point below -2 standard deviation used to determine under-nutrition (stunting, underweight, and wasting). All variables with p-value < 0.25 in the bivariable analysis were considered for further multivariable binary logistic regression analysis. The level of statistical significance was declared at a p-value <0.05. RESULTS: The prevalence of wasting, underweight, and stunting were 4.4%, 12.3%, and 34.8%, respectively. Being a double orphaned child [AOR= 2.9 (1.201, 7.167)] and lack of vitamin A supplement in the last six months (AOR=1.9 (1.049, 3.799) were significant predictors of stunting and illness in the last two weeks before the survey [AOR= 4.9 (1.345, 1.865)] was a significant predictor of wasting. CONCLUSION: The prevalence of stunting was high when compared with WHO's classification. Being a double orphaned, lack of vitamin A supplement, and illness in the last two weeks were associated with undernutrition. Therefore, intensified efforts to increase rates of vitamin A supplementation and as well as other disease prevention measures should be strengthened by the orphanage administrators and the health authorities.

Perinatal outcome of meconium stained amniotic fluid among labouring mothers at teaching referral hospital in urban Ethiopia.

OBJECTIVE: To determine the perinatal outcome of labouring mothers with meconium-stained amniotic fluid (MSAF) compared with clear amniotic fluid at teaching referral hospital in urban Ethiopia. METHODS: A prospective cohort study was conducted among labouring mothers with meconium-stained amniotic fluid from July 1 to December 30, 2019. Data was collected with pretested structured questionnaires. A Chi-square test used to check statistical associations between variables. Those variables with a p-value of less than 0.05 were selected for cross-tabulation and binary logistic regression. P-value set at 0.05, and 95% CI was used to determine the significance of the association. Relative risk was used to determine the strength and direction of the association. RESULT: Among 438 participants, there where 75(52.1%) primigravida in a stained fluid group compared to112 (38.5%) of the non-stained fluid group. Labour was induced in 25 (17.4%) of the stained fluid group compared to 25(8.6%) of a non-stained fluid group and has a statistically significant association with meconium staining. The stained fluid group was twice more likely to undergo operative delivery compared with a non-stained fluid group. There were more low Apgar scores at birth (36.8% versus 13.2%), birth asphyxias (9% versus 2.4%), neonatal sepsis (1% versus 5.6%), neonatal death (1% versus 9%), and increased admissions to neonatal intensive care unit (6.2% versus 21.5%) among the meconium-stained group as compared to the non-stained group. Meconium aspiration syndrome was seen in 9(6.3%) of the stained fluid group. CONCLUSION: Meconium-stained amniotic fluid is associated with increased frequency of operative delivery, birth asphyxia, neonatal sepsis, and neonatal intensive care unit admissions compared to clear amniotic fluid.