Incidence and predictors of diabetic ketoacidosis among children with diabetes in west and east gojjam zone referral hospitals north west Ethiopia, 2019.

Abstract Background: Recurrent diabetic ketoacidosis in patients with already diagnosed diabetic mellitus remains a relevant problem in pediatric with an incidence of 1–10% per patient. Children may die due to cerebral edema and had significant mortality (24%) and morbidity (35%).Objective: We assess the incidence and predictors of diabetic ketoacidosis among diabetic children at East and West Gojjam zone referral hospitals, North West Ethiopia, 2019.Methods: An institution-based retrospective follow up study was conducted on children who were registered from January 1, 2014, to January 1, 2019. Epi data version 3.1 & Stata 14 were used for data entering and analysis respectively.Result: A total of 354 children were included from this 207(58.5%) had diabetic ketoacidosis. The overall incidence rate of diabetic ketoacidosis was 2.27/100 children/month of observation. Age <5 years (AHR: 3.52, 95% CI (2.25, 5.49), non-adherence (AHR: 1.54, 95% CI (1.11, 2.14), inappropriate insulin storage (AHR: 1.36, 95% CI (1.008, 1.85), presence of upper respiratory tract infections during diabetic ketoacidosis diagnose (AHR: 2.22, 95% CI (1.11, 4.45) and preceding gastroenteritis (AHR: 2.18, 95% CI (1.07, 4.44) were significant predictors. Conclusion: age <5 years old, non-adherence, inappropriate insulin placement at home, Preceding gastroenteritis, and presence of upper respiratory tract infections at the time of diabetic ketoacidosis development were significant predictors. Hence, assessing and close monitoring as well as strengthened diabetic education should be given for the above predictors.