Poor glycemic control and its associated factors among children with type 1 diabetes mellitus in Harar, eastern Ethiopia: A cross-sectional study.

BACKGROUND: Poor glycemic control increases the risk of acute metabolic derangements and long-term consequences, which are the main causes of morbidity and mortality. Maintaining adequate glycemic control is challenging for children with diabetes, particularly in resource-limited settings. There is a paucity of data on the magnitude of poor glycemic control and its predisposing factors in Ethiopian particularly in this study setting. Hence, we aimed to assess the magnitude of poor glycemic control and its associated factors among children and adolescents with type 1 diabetic mellitus in Jugol and Hiwot Fana Compressive Specialized University Hospitals in Harar, eastern Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 231 children and adolescents with type 1 diabetes mellitus in Jugol and Hiwot Fana Compressive Specialized University Hospitals. Participants were included consecutively in the follow-up clinic from November 15, 2022 to January 15, 2023. Data were collected through an interviewer-administered structured questionnaire and a review of medical records. A binary logistic regression model with an adjusted odds ratio (aOR) and a 95% confidence interval (CI) was used to identify the factors associated with poor glycemic control. Statistical significance was set at p < 0.05. RESULT: A total of 231 children and adolescents with type 1 diabetes mellitus were included. The magnitude of poor glycemic control was 166 (71.9%) with 95% CI 66.0-77.7%). In multivariable analysis, the age of the child (aOR = 0.19, 95% CI: 0.05-0.83), education of the caregiver (aOR = 4.13;95% CI: 1.82-9.46), meal frequency less than three (aOR = 3.28; 95% CI: 1.25-8.62), and consumption of forbidden foods (aOR = 3.17; 95% CI: 1.21-8.29) were factors significantly associated with poor glycemic control. CONCLUSION: Two-thirds of participants had poor glycemic control. There was a statistically significant association between the age of the child, education of the caregiver, meal frequency, and forbidden foods with poor glycemic control. To improve glycemic control, diabetes education on meal use and selection should be conducted during follow-up along with parent education.

Hyponatremia and its associated factors in children admitted to the pediatric intensive care unit in eastern Ethiopia: a cross-sectional study.

BACKGROUND: Hyponatremia is a serious problem that leads to substantial increases morbidity and mortality in critically ill children. The identification of risk factors, implementation of preventive measures, and timely diagnosis and management are crucial to reduce adverse events related to hyponatremia. Despite the higher burden of the problem in Ethiopia, evidence related to the risk factors for hyponatremia among children in Ethiopia is limited; in particular, no study has been identified in eastern Ethiopia. Therefore, we aimed to determine the magnitude of hyponatremia and its associated factors in children admitted to the pediatric intensive care unit at the Hiwot Fana Comprehensive Specialized University Hospital. METHODS: A facility-based cross-sectional study was conducted using 422 medical records of pediatric patients admitted to the pediatric intensive care unit at Hiwot Fana Comprehensive Specialized University Hospital from January 2019 to December 2022. Medical records were reviewed to collect data. Data were analyzed using a statistical package for social sciences (SPSS) version 26. A binary logistic regression model with an adjusted odds ratio (aOR) and a 95% confidence interval (CI) was used to identify factors associated with the outcome variable. Statistical significance was set at p < 0.05. RESULTS: The magnitude of hyponatremia was 39.1% (95% CL: 34.4-43.8%). The age of the child (aOR = 2.37;95% CL:1.31-4.31), diagnosis of sepsis (aOR = 2.33; 95% CL:1.41-3.84),   surgical procedures (aOR = 2.39; 95% CL:1.26-4.56), nutritional status (aOR = 2.60; 95% CL:1.51-4.49), and length of hospital stay (aOR = 3.04; 95% CL: 1.73-5.33) were factors significantly associated with hyponatremia. CONCLUSIONS: Four out of ten children admitted to pediatric intensive care units had hyponatremia. Hyponatremia was significantly associated with the age of the child, malnutrition, sepsis, surgical procedures, and length of hospital stay. To reduce the burden of hyponatremia and associated mortality, attention should be focused on improving the care of malnourished children, and those with sepsis, and the quality of postoperative monitoring services. Moreover, intervention strategies aimed at reducing the burden of hyponatremia should target the identified factors.