Time to recovery from severe pneumonia and its predictors among pediatric patients admitted in South West Region governmental hospitals, South West Ethiopia: Prospective follow-up study

Abstract

Background

The Ethiopian Federal Ministry of Health has been working by introducing vaccines, and integrating the management of newborn and child illnesses to prevent pneumonia, pneumonia-related hospitalization, and mortality. Despite these attempts, the prevalence of pneumonia and the proportion of hospitalizations have increased. Little is known about recovery time from severe pneumonia and its predictors in pediatric patients in the study area. Therefore, this study aimed to determine the time to recovery from severe pneumonia and its predictors in pediatric patients admitted to government hospitals in the southwest Region.

Methods and Materials

A hospital-based prospective follow-up study was conducted among 791 pediatric patients admitted with severe pneumonia at a governmental hospital in the South West Region, of Ethiopia. A systematic sampling technique was used to recruit participants. Data were entered into Epi-data 4.4.2.1 and exported to STATA 14 for analysis. The assumptions of Cox proportional hazard models and goodness of fit were assessed using the Shoenfield residual and Cox-Snell, respectively. Bivariate and multivariable Cox regression models were used to identify the predictors of time to recovery. Variables with a p-value of <0.05 at a 95 % confidence level in multivariable Cox regression model analysis were declared statistically significant predictors of time to recovery.

Results

This study revealed that 641 (81.04 %) participants recovered with an incidence rate of 12.48 per 100 person-day observations. The median time to recovery was 5 days. Rural residence [AHR=0.82; 95 % CI 0.69–0.97], hypoxemia [AHR=1.25; 95 % CI 1.01- 1.55], danger sign, [AHR=1.77; 95 % CI 1.28- 2.45], comorbidity [AHR=0.60; 95 % CI 0.50- 0.7] and history of previous respiratory infections [AHR=0.76; 95 % CI 0.64- 0.90] were found significant predictors of time to recovery from severe pneumonia.

Conclusion

In this study, the recovery rate from severe pneumonia among pediatric patients was low and the time to recovery was slightly prolonged with a median time to recovery of five days. Rural residence, hypoxemia, danger signs, comorbidity, and history of previous respiratory infections were independent predictors of time to recovery among pediatric patients. Therefore, the Ethiopian Federal Ministry of Health, family, community leaders, healthcare providers, and other stakeholders should provide timely initiation of advanced diagnosis, appropriate therapeutic interventions, and proper follow-up for pediatric patients with severe pneumonia to reduce mortality.