Acute kidney injury (AKI) is characterized by a sudden decline in the kidneys' abilities to remove waste products and maintain water and electrolyte homeostasis. This study aims to determine the incidence and predictors of acute kidney injury among neonates with perinatal asphyxia admitted at the neonatal intensive care unit of West Amhara Comprehensive Specialized Hospital, Northwest Ethiopia, 2023. Multicentred institution-based retrospective follow-up study was conducted from October 1, 2021, to September 30, 2023, among 421 perinatal asphyxia neonates. A simple random sampling technique was used. The data were collected using a data extraction checklist from the medical registry of neonates. The collected data were entered into EPI-DATA V.4.6.0.0. and analyzed using STATA V.14. The Kaplan–Meier failure curve and log-rank test were employed. Bivariable and multivariable Cox regression was carried out to identify predictors of Acute kidney injury. Statistical significance was declared at a p ≤ 0.05. The overall incidence of AKI was 54 (95% CI 47.07–62.51) per 100 neonate days. C/S delivery (AHR = 0.64; (95% CI 0.43–0.94), prolonged labor (AHR = 1.43; 95% CI 1.03–1.99) low-birth weight times (AHR = 1.49; (95% CI 1.01–2.20), stage three HIE(AHR: 1.68; (95% CI (1.02–2.77), No ANC follow up (AHR = 1.43; 95% CI 1.9 (1.07–3.43) and Hyperkalemia (AHR = 1.56; 95% CI 1.56 (1.05–2.29); 95% CI) were significant predictors. The incidence rate of acute kidney injury was higher than in other studies conducted on other groups of neonates. Cesarean section delivery, prolonged low birthweight, no Anc follow-up, stage 3 HIE, and neonatal hyperkalemia were predictors of acute kidney injury. However, it needs further prospective study. Therefore, the concerned stakeholders should give due attention and appropriate intervention to these predictors.

Acute kidney injury is an acute and reversible increment in serum creatinine (SCr) levels with a reduction in urine output oliguria, or anuria. Acute kidney injury is a major cause of neonatal morbidity and mortality worldwide; it is a serious problem in low and middle-income countries, particularly in sub-Saharan Africa such as Ethiopia. Moreover, there are few studies in developing countries. This study aimed to investigate the incidence and predictors of acute kidney injury in neonates admitted to the neonatal intensive care unit of some specialized hospitals in the Amhara region of northwestern Ethiopia. A facility-based retrospective follow-up study was conducted in the Northwest Amhara Region’s comprehensive specialized hospitals with 634 neonates from January 2020 to December 2022. Data were collected by reviewing patient charts using simple random sampling with a pretested checklist, entered using Epi-data 4.6, and analyzed using STATA 14. Median survival time, Kaplan–Meier survival curve, and log-rank test were calculated. Bivariable and multivariable Cox hazard models were used to determine the determinants of acute kidney injury. A hazard ratio with a 95% confidence interval was calculated. Variables with p-values less than 0.05 were considered statistically significant. The incidence of Acute Kidney Injury among Neonates admitted to Neonatal Intensive Care Unit was 14.9 per 1000 (95% CI: 12.5–17.7) with the proportion of acute kidney injury (20.19%) (95% CI: 17.23–23.50) neonates with sepsis (AHR: 2.59; 95%CI: 1.21–5.56), neonates with perinatal asphyxia [(AHR: 2.70; 95%CI: 1.29–5.65) were taking gentamicin drugs [(AHR = 1.74; 95%CI: 1.03–2.94], neonates were preterm [(AHR; 1.77: 95%CI: 1.05 -2.98], and neonatal-hyponatremia [(AHR: 2.14; 95%CI: (1.00 -4.9)] and hyperkalemia [(AHR: 2.64; 95 CI: (1.11- 6.2)] were statistically found to be significant predictors of acute kidney injury. The incidence of acute kidney injury in neonates was high. Premature infants, neonates with sepsis, who suffered perinatal asphyxia, who received gentamicin drugs, whose sodium levels decreased and potassium levels increased were at higher risk of developing acute kidney injury. All concerned agencies should work to prevent acute kidney injury and pay special attention to multifactorial causes. Therefore, strategies need to be developed and/or strengthened to prevent the occurrence of acute kidney injury in infants with sepsis, neonates who suffered perinatal asphyxia, and preterm infants whose sodium levels decreased and potassium levels increased.

Objective This study aimed to assess the coutilisation of oral rehydration solution (ORS) and zinc for treating diarrhoea and its associated factors among under-5 children in East Africa. Design Cross-sectional study design. Multilevel Poisson regression analysis with robust variance was fitted to identify predictors of zinc and ORS coutilisation. An adjusted prevalence ratio (aPR) with a 95% CI was reported to declare the statistical significance. Setting Twelve East African countries. Participants 16 850 under-5 children who had diarrhoea were included in the study. Result In East African nations, the coutilisation of ORS and zinc for the treatment of diarrhoea in children under 5 was 53.27% with a 95% CI (52.54% to 54.01%). Children of mothers with primary education (aPR 1.15, 95% CI 1.09 to 1.20), secondary education (aPR 1.08, 95% CI 1.02 to 1.14), higer education (aPR 1.19, 95% CI 1.10 to 1.29), those from maternal age category of 20–24 (aPR 1.14, 95% CI 1.07 to 1.21), age category of 25–29 (aPR 1.13, 95% CI 1.06 to 1.21), age category of 30–34 (aPR 1.09, 95% CI 1.02 to 1.16), those from wealthy households (aPR 1.04, 95% CI 1.01 to 1.09) and those who have a media exposure (aPR 1.04, 95% CI 1.01 to 1.08) were more likely to receive combination. Conclusion Only half of the under-5 children with diarrhoea in East Africa were treated with a combination of ORS and zinc. To increase the use of the suggested combination therapy of ORS with zinc, it is important to empower women through education and prevent teen pregnancy.

Objective To assess the incidence of delirium and its predictors among adult patients admitted to the intensive care units of comprehensive specialised hospitals in the Amhara region of northwest Ethiopia from 18 October 2024 to 20 February 2025. Design A multicentre prospective observational study was conducted. Setting Four comprehensive specialised hospitals in the Amhara region of northwest Ethiopia, from 18 October 2024 to 20 February 2025. Participants A total of 351 patients were included in the final analysis during the study period. Outcome measures The primary outcome measure of this study was the incidence of delirium. Additionally, the study investigated the factors associated with delirium incidence among adult patients admitted to intensive care units. Results The incidence of delirium among adult patients in intensive care units was 42.17% (95% CI: 37.08 to 47.42). Pain (adjusted HR (AHR) = 4.74; 95% CI: 2.38 to 9.44), mechanical ventilation (AHR = 2.96; 95% CI: 1.56 to 5.63), age 65 years or older (AHR = 2.18; 95% CI: 1.48 to 3.21) and agitation (Richmond Agitation-Sedation Scale (RASS) ≥1) (AHR = 3.26; 95% CI: 2.09 to 5.09) were statistically significant factors associated with delirium. Conclusion and recommendation In the present study, more than one-third of patients developed delirium. Pain, mechanical ventilation, age 65 or older and agitation (RASS≥1) were significantly associated with delirium occurrence. To reduce the incidence of delirium, the current study recommends treating or preventing pain and agitation. Additionally, special attention should be given to patients receiving mechanical ventilation and those aged 65 or older during care.

Objective: To determine the length of hospital stay and related factors in newborns with perinatal asphyxia in comprehensive specialised hospitals in Northwest Ethiopia. Design: A multicentre institutional-based cross-sectional study. Setting: Tertiary hospitals in Northwest Amhara Regional State, Northwest Ethiopia, from 1 to 30 December 2023. Participants: A total of 609 neonates with perinatal asphyxia were admitted to the neonatal intensive care unit of selected public hospitals in Northwest Amhara from September 2018 to October 2023. Outcome measures: Length of hospital stay and associated factors in newborns with perinatal asphyxia were noted. Results: A total of 609 newborns with perinatal asphyxia were included in this study. The mean hospital stay for the newborns was 13.9 days (coef=13.9, 95% CI 13.43 to 14.38), with minimum and maximum hospital stays of 4–28 days, respectively. Neonatal sepsis, AKI, hypoxic ischaemic encephalopathy, fetal macrosomia and prolonged labour were significantly associated with a longer hospital stay in neonates with perinatal asphyxia. Conclusions: The current study indicated that the mean length of hospital stay in newborns with perinatal asphyxia was 13.9 days. Contributing factors to prolonged hospital stays include neonates with neonatal sepsis, prolonged second-stage labour, acute neonatal kidney injury stages 2 and 3 hypoxic ischaemic encephalopathy and fetal macrosomia. The length of hospital stay for neonates with perinatal asphyxia can be reduced by implementing appropriate standards of care.

Background Many primary articles in Ethiopia approach the prevalence and factors associated with respiratory distress syndrome, but discrepancies were seen among those articles. This study aimed to assess the pooled prevalence and factors associated with neonatal respiratory distress syndrome in Ethiopia. Methods Primary studies were searched using different data sources. Thirteen primary studies were included. The data were extracted using a Microsoft Excel spreadsheet and exported to Stata version 14 for analysis. Publication bias was confirmed using Egger’s regression test. Results This study included thirteen primary articles that met the inclusion criteria. The pooled prevalence of respiratory distress syndrome in Ethiopia was 30.28%. Neonates with birth weights less than 1500gm and preterm neonates had a significant factor for respiratory distress syndrome. Conclusion We found a high pooled prevalence of respiratory distress syndrome. Thus, to reduce this problem, the relevant body should put special emphasis on the variables mentioned above.