Time to recovery and predictors of severe community-acquired pneumonia among pediatric patients in Debre Markos referral hospital, North West Ethiopia: A retrospective follow-up study

Abstract

Introduction Globally, pneumonia is a major cause of morbidity and mortality among children which leads to over 156 million episodes and 14.9 million hospitalizations each year. Besides this fact, the recovery time and predictors of children's hospitalization related to severe communityacquired pneumonia is not well known. Therefore, the aim of this study was to estimate the median time to recovery and its predictors among severe community-acquired pneumonia patients admitted to the pediatric ward, Debre Markos referral hospital, North West Ethiopia. Methods An institution-based retrospective follow-up study was employed among 352 records of children who were admitted starting from January 2016 to December 2018. Patients' charts were retrieved using a structured data extraction tool. Cox proportional hazard model assumption and model fitness was checked. Stratified Cox regression was fitted as a final model. Hazard ratio with its 95% confidence interval was used and P-value < 0.05 was considered as a statistically significant association. Result The overall median recovery time was 4 days IQR (3-7). Recovery rate from severe community acquired pneumonia was 16.25 (95% CI: 14.54-18.15) per 100 person day observation. Age (AHR; 0.94 95% CI (0.90-0.98)), being stunted (AHR; 0.62 95% CI (0.43-0.91)), presence of danger sign at admission (AHR; 0.61 95% CI (0.40-0.94)), late presentation to seek care(AHR; 0.64 95% CI (0.47-0.88)) and co-morbidity (AHR; 0.45 95% CI (0.35-0.58)) were significant predictors of recovery time.

Time to Recovery from Severe Pneumonia and Its Predictors Among Children 2–59 Months of Age Admitted to Pediatric Ward of Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital, Hossana, Ethiopia: Retrospective Cohort Study

“…32 The CDC's higher estimation of length of hospital stay could be because they estimated for all children under the age of 15 years. Studies conducted in University of Gondar Comprehensive Specialized Hospital, Northern Ethiopia (3 days) 30 Hospital (4 days) 31 found nearly similar median time to recover. But the median time to recovery in this study was higher than the finding in Nepal (2 days), 11 and lower than findings reported by two studies conducted in Tanzania (6 and 10 days).…”

“…This finding is higher than the incidence density of recovery in University of Gondar Comprehensive Specialized Hospital, 30 Debre Markos Referral Hospital. 31 The difference in the quality of services and time when the studies were conducted may explain the discrepancy among studies. The two studies were conducted earlier than this study, over time, there could have been differences in treatment protocol, service quality, and in availability of medical equipment.…”

Time to recovery and its predictors among children age of 2 up to 59 months admitted with severe community acquired pneumonia in Public Hospitals of Central and North Gondar Zones, Ethiopia 2021.

“…Dependent variable. Co-morbidity:-Any disease condition (acute or chronic) present during admission in addition to SCAP (29). .…”

“…Time to seeking care: -Children getting care with in < 5 days after getting sick are considered as early presenters while those children getting care after ≥5 days are considered as late presenters (29).…”

“…Data were collected by using a structured checklist adapted from previous similar studies (21,29,31,32), and developed in the English language to extract relevant information. The tools includes sociodemographic characteristics section, Clinical related variables and Co morbid illness section, nutritional status section and vaccination, breast feeding status section and time to seeking care .…”