Treatment outcomes and its associated factors among pneumonia patients admitted to public hospitals in Harar, eastern Ethiopia: a retrospective follow-up study

Abstract

ObjectiveAlthough there is a high risk of drug resistance, empiric treatment is a common approach for pneumonia management. In this respect, it is relevant to know treatment outcomes of patients with pneumonia. This study aimed to assess treatment outcomes and its associated factors among pneumonia patients treated at two public hospitals in Harar, eastern Ethiopia.DesignRetrospective follow-up study.SettingJugal General Hospital and Hiwot Fana Specialised University Hospital in Harar, eastern Ethiopia.ParticipantsPatients admitted and treated for pneumonia in the two public hospitals in eastern Ethiopia between April 2020 and April 2021.Primary outcomeThe primary outcome was unfavourable treatment outcome (died or transferred to intensive care unit) for pneumonia patients.ResultsA total of 693 patients with pneumonia were included in the study. 88 (12.7%) of these patients had an unfavourable treatment outcome, which included 14 (2%) transfers to the intensive care unit and 74 (10.7%) deaths. Patients with comorbidity (adjusted OR, AOR=2.96; 95% CI: 1.47 to 5.97) and with clinical features including abnormal body temperature (AOR=4.03; 95% CI: 2.14 to 7.58), tachycardia (AOR=2.57; 95% CI: 1.45 to 4.55), bradypnoea or tachypnoea (AOR=3.92; 95% CI:1.94 to 7.92), oxygen saturation below 90% (AOR=2.52; 95% CI:1.37 to 4.64) and leucocytosis (AOR=2.78, 95%, CI:1.38 to 5.58) had a significantly increased unfavourable treatment outcome.ConclusionWe found that nearly one out of eight patients with pneumonia had unfavourable treatment outcomes. It was considerably high among patients with comorbidities and apparent abnormal clinical conditions. Therefore, taking into account regionally adaptable intervention and paying close attention to pneumonia patients admitted with comorbidity and other superimposed abnormal conditions might help improve the treatment outcomes of these populations.

Determinants of under‐five pneumonia in randomly selected health facilities at Aleta Wondo Woreda, Sidama Region Ethiopia: Case–control study

“…9 Previous studies indicated comorbid conditions, lack of exclusive breastfeeding, indoor air pollution, parental cigarette smoking, malnutrition, using charcoal for cooking, advanced maternal age, previous upper respiratory tract infections, poor socioeconomic status, keeping domestic animals inside the main house, lack of zinc supplementation, absence of a separate kitchen, father's education, history of diarrhea in child, household history of acute lower respiratory infection, and child born in rural areas as most common determinants for pneumonia in children. 2,5,[10][11][12][13][14][15][16] In Ethiopia, even interventions for under-five pneumonia like immunization, proper nutrition, exclusive breastfeeding, zinc and vitamin A supplementation, appropriate complimentary feeding, safe drinking water, and good sanitation and control of environmental factors are undertaken by using health extension workers. But the available data show still under-five pneumonia is the leading problem of economic, social, and economic burden those developing nations like Ethiopia.…”

“…Previous studies indicated comorbid conditions, lack of exclusive breastfeeding, indoor air pollution, parental cigarette smoking, malnutrition, using charcoal for cooking, advanced maternal age, previous upper respiratory tract infections, poor socioeconomic status, keeping domestic animals inside the main house, lack of zinc supplementation, absence of a separate kitchen, father's education, history of diarrhea in child, household history of acute lower respiratory infection, and child born in rural areas as most common determinants for pneumonia in children 2,5,10–16 …”

“…Ethiopia is one of five countries that accounted for 49% of global pneumonia deaths in 2015 (India, Nigeria, Pakistan, the Democratic Republic of the Congo, and Ethiopia). 6 In Ethiopia, pneumonia contributes to 16.4% of all deaths of children under 5 years of age more than diarrhea, malaria, AIDS, and measles combined. 7,8 The country incorporated the pneumococcal conjugate vaccine into the expanded program on immunization in 2011 to prevent or reduce morbidity and mortality associated with childhood pneumonia.…”