Impact of preventive and early treatment of childhood pneumonia and diarrhea in Ethiopia, analysis from Health Management Information System (HMIS) report 2010 -2016

Efrem Teferi, Daniel Gemechu, Ismael Ali
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Abstract

Background: In Ethiopia mortality in children younger than five years it has dropped from 202 in 1990 to 55 in 2019 (EDHS 2019). Pneumonia and diarrhea are the two leading causes of under-five mortality. They have overlapping risk factors, such as poverty, undernutrition, and poor hygiene. Ethiopia introduced Integrated Community Case management (ICCM) is strategy to treat sick children in communities. Pneumococcal Conjugate vaccine was introduced in 2010, and Rotavirus vaccine was in 2013.This research was conducted to assess the changes in morbidity and mortality in children due to pneumonia and diarrhea based on HMIS data. Methodology: Diarrhea and pneumonia morbidity, admission, and mortality data of under five children were extracted from 2002/09 EFY to 2008/16 GC, annual Federal Ministry of Health and Health related indicators bulletin. Proportion of morbidity, admission, mortality, and change in percentage analyzed and compared using significant test. Results: Morbidity due to pneumonia to total under five morbidity increased from 2.6% to 8.7%, and that of diarrhea from 2.3% to 11.8% in six years (2010 to 2016) p-0.000. Admission due to pneumonia decreased from 5% to 4.5%, (10% reduction), p-0.009 and that of diarrhea 3.4%, to 1.3%, (63% reduction), p-0.000. Mortality due pneumonia decreased from 2.7%, to 1.4 %, (48% reduction), p-0.113, that of diarrhea decreased from 1.9% to 0.9%, (53% reduction), p-0.42. The change in morbidity and admission were significant, but that of mortality was not significant. Conclusion: The increase in morbidity of pneumonia and diarrhea might be due to increase in health service utilization. The decline in admission and mortality of both diseases showed that introduction of new vaccines of, Rota, and early treatment in health posts using ICCM algorisms, have significant contribution. Standard quality treatment, prevention by improving immunization quality and coverage, maximum utilization of health service, is necessary to further decrease, admission and mortality.
埃塞俄比亚儿童肺炎和腹泻预防和早期治疗的影响,2010 -2016年卫生管理信息系统(HMIS)报告分析
背景:在埃塞俄比亚,5岁以下儿童的死亡率已从1990年的202降至2019年的55 (EDHS 2019)。肺炎和腹泻是五岁以下儿童死亡的两个主要原因。他们有重叠的风险因素,如贫穷、营养不良和卫生条件差。埃塞俄比亚采用了社区病例综合管理(ICCM)战略,在社区治疗患病儿童。肺炎球菌结合疫苗于2010年推出,轮状病毒疫苗于2013年推出。本研究旨在评估基于HMIS数据的儿童肺炎和腹泻的发病率和死亡率的变化。方法:5岁以下儿童腹泻和肺炎发病率、入院率和死亡率数据提取自2002/09 EFY至2008/16 GC年度联邦卫生部和卫生相关指标公报。采用显著性检验对发病率、入院率、死亡率和变化百分比进行分析比较。结果:6年间(2010 - 2016年)肺炎占5岁以下儿童总发病率从2.6%上升到8.7%,腹泻占比从2.3%上升到11.8%,p < 0.000。肺炎住院率从5%降至4.5%(减少10%),p-0.009;腹泻住院率从3.4%降至1.3%(减少63%),p-0.000。肺炎死亡率从2.7%下降到1.4%(降低48%),p = 0.113;腹泻死亡率从1.9%下降到0.9%(降低53%),p = 0.42。发病率和住院率变化显著,但死亡率变化不显著。结论:肺炎和腹泻发病率的增加可能与卫生服务利用率的增加有关。两种疾病的入院率和死亡率下降表明,引入新疫苗和在卫生站使用ICCM算法进行早期治疗是重要的贡献。标准的高质量治疗、通过提高免疫质量和覆盖率进行预防、最大限度地利用保健服务,是进一步降低住院率和死亡率的必要条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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