title: Adverse drug events in hospitalized children at Ethiopian University Hospital: a prospective observational study.
abstract: BACKGROUND
  The nature and magnitude of adverse drug events (ADEs) among hospitalized children in low-income countries is not well described. The aim of this study was thus, to assess the incidence and nature of ADEs in hospitalized children at a teaching hospital in Ethiopia.
  
  
  METHODS
  We used prospective observational method to study children that were hospitalized to Jimma University Specialized Hospital between 1 February and 1 May 2011. ADEs were identified using review of treatment charts, interview of patient and care-giver, attendance at ward rounds and/or meetings and voluntary staff reports. Two senior pediatric residents evaluated the severity and preventability of ADEs using preset criteria. Logistic regression analysis was employed to determine predictors of ADEs.
  
  
  RESULTS
  There were 634 admissions with 6182 patient-days of hospital stay. There were 2072 written medication orders accounting for 35,117 medication doses. Fifty eight ADEs were identified with an incidence of 9.2 per 100 admissions, 1.7 per 1000 medication doses and 9.4 per 1000 patient-days. One-third of ADEs were preventable; 47% of these were due to errors in the administration stage of medication use process. Regarding the severity of ADEs, 91% caused temporary harms and 9% resulted in permanent harm/death. Anti-infective drugs were the most common medications associated with ADEs. The occurrence of ADEs increased with age, length of hospital stay, and use of CNS, endocrine and antihistamine medicines.
  
  
  CONCLUSIONS
  ADEs are common in hospitalized children in low-income settings; however, one-third deemed preventable. A strategy to prevent the occurrence and consequences of ADEs including education of nurses/physicians is of paramount importance.
authors.affiliation: School of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia. tesfuc@gmail.com.
authors.forename: Tesfahun Chanie
authors.initials: TC
authors.lastname: Eshetie
authors.affiliation: College of Pharmacy, Howard University, 2300 4th Street, N.W, Washington, DC, 20059, USA. bhailemeskel@howard.edu.
authors.forename: Bisrat
authors.initials: B
authors.lastname: Hailemeskel
authors.affiliation: Management Sciences for Health - Ethiopia, P.O Box: 1157, Code 1250, Addis Ababa, Ethiopia. nmekonnen@msh.org.
authors.forename: Negussu
authors.initials: N
authors.lastname: Mekonnen
authors.affiliation: School of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia. getahun.paulos@ju.edu.et.
authors.forename: Getahun
authors.initials: G
authors.lastname: Paulos
authors.affiliation: School of Pharmacy, Clinical Pharmacy Unit, University of Gondar, P.O Box: 196, Gondar, Ethiopia. almayehuber@gmail.com.
authors.forename: Alemayehu Berhane
authors.initials: AB
authors.lastname: Mekonnen
authors.affiliation: Department of Pediatrics and Child Health, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia. tsinuel@yahoo.com.
authors.forename: Tsinuel
authors.initials: T
authors.lastname: Girma
mesh_terms: D000293:Adolescent; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008508:Medication Errors / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors