Child health services and armed conflict in Tigray, North Ethiopia: a community-based study

BACKGROUND

Access to basic health services, notably child health services, is severely hampered by the armed conflict in Tigray, North Ethiopia. Little is known regarding the impacts of the armed conflict during the war in Tigray on access to child health services. The current study investigates the impact of the armed conflict on the utilization of child health services in Tigray.

METHODS

4,381 caregivers from randomly recruited households (HHs) with at least one child younger than 1 year old participated in a community-based cross-sectional survey. We collected data on childhood immunizations and illness-related treatment seeking from August 4 to 20, 2021. We describe data using frequency and percentage and carry out an internal comparison among the study participants using chi-square tests.

RESULTS

4,381 children under the age of one included in the study. In total, 39% of infants received no basic vaccines, 61.3% of the children under the age of one received at least one vaccine, and 20% received all the vaccinations recommended for their age. About 61% of children were affected by at least one childhood ailments where majority of them were from rural areas. Mothers who did not seek postnatal care (PNC) were responsible for more than 75% of reported childhood illnesses.

CONCLUSIONS

A sizable portion of children were unvaccinated and had at least one childhood sickness while the war was in progress. Particularly, people who live in rural areas reported a higher percentage of children's illnesses but a lower use of child health services. To lower childhood morbidity and mortality in the besieged area, such as Tigray, local to global actors need to get coordinated and warrying parties should stop weaponization of vaccination healthcare services.

Neonatal Seizure Pattern, Outcome, and its Predictors Among Neonates Admitted to NICU of Ayder Comprehensive Specialized Hospital, Mekelle, Tigray, Ethiopia

Background

Seizure is the most frequently observed symptom of neurological disorders and an important determinant of outcome during neonatal period. In clinical practice, it is prevalent and observed in neonates admitted to hospital in low-resources countries, but due to the paucity of studies in these regions, little is known about its pattern, clinical outcomes of hospitalization, and its predictors. Therefore, aims to evaluate seizure patterns, clinical outcomes, and its predictors among neonates admitted to the NICU of ACSH, Mekelle, and Tigray.

Methods

A hospital-based cross-sectional study design was conducted among neonates with neonatal seizures admitted to NICU of Ayder Comprehensive Specialized Hospital. Data collection was done from record reviews. SPSS Version 25 was used. Descriptive statistics and bivariate logistic regressions where a p-value of <0.05 is considered statistically significant.

Results

Out of 1622 NICU admissions, 155 (9.6%) were cases of neonatal seizure. The most frequently observed types of seizure in this study were subtle 70 (45.1%) and tonic 49 (31.6%) respectively. At the end of hospitalization 70.3% of neonates were discharged improved, 21.3% of neonates died and 8.4% of neonates had severe neurologic deficits. Poorly controlled seizures (AOR 4.8, 95% CI 2.6-9.2), prolonged duration of labor (AOR 4.3, 95% CI 2.2-8.8) and seizure onset <72 hours (AOR 3.7, 95% CI 1.6-8.5), respectively, were found to be independent predictors of poor neonatal outcome.

Conclusion

Of all neonatal admissions, neonatal seizure was observed in close to 9.6%. The most frequently observed type of seizure was subtle. Of those admitted neonates, 30% had poor outcomes following the end of their hospitalization or when they leave against medical advice for lack of improvement). Poorly controlled seizures, prolonged duration of labor, and seizure onset <72 hours were independent predictors of poor neonatal outcomes.