Time To Recovery From Severe Community Acquired Pneumonia And Its Predictors Among Pediatric Patients Admitted To Public Hospitals Of Addis Ababa, Ethiopia, 2024

Abstract

Background: Community-acquired pneumonia is an acute infection of the pulmonary parenchyma acquired outside of the hospital. Severe community acquired pneumonia is characterized in Significant tachypnea, Significant tachycardia, Severe respiratory distress Objective: The aim of this study was to determine the time to recovery from severe community acquired pneumonia and its predictors among pediatric patients in selected public hospitals of Addis Ababa, Ethiopia, 2024. Methods: Institution based retrospective cohort study was used on 387 patient records from 3 consecutive years. Data were collected using kobo toolbox and analyzed with STATA version 14.0. Nutritional status was analyzed using WHO growth curve. Frequencies and median day with interquartile range were used to describe and summarize data set. Kaplan Meier curve and log-rank test was used to estimate recovery time and to compare the probability of survival time among categories of each covariates. Cox Proportional Hazard regression model was used and Adjusted hazard ratio (AHR) with a 95% confidence interval and p-values <0.05 was used to measure the strength of association and to identify statistical significance. Finally test for proportional hazard assumption was tested using cox Snell residual and graphical method. Results: Out of 387 pediatrics enrolled, 325(84%) recovered, with an overall incidence recovery rate of 12.5 (CI: 13.28-16.43) per 100 person days and the overall median recovery time was 5 days with an interquartile range of (IQR = 6). Multivariable Cox proportional hazard results showed that female (AHR =0.64(95% CI:0.49,0.81 ), presence of health insurance (AHR = 0.65; 95% CI: 2.97,5.4), duration before seeking care >=3 days (AHR = 0.58; 95% CI: 044,0.77), previous SCAP history (AHR =1.5; 95% CI: 1.1,2), wasted (AHR = 1.7(95AHR = 0.6; 95% CI: 0.5,0.9) were significant predictors of recovery time of severe community-acquired pneumonia in pediatrics. Conclusion: The median recovery time and the recovery rate is 5 days with IQR=6 and 12.5 per 100 person/day respectively. Similar with United States Centers for Diseases Control and Prevention report in 2024. Recovery time was significantly affected by sex, presence of health insurance, first antibiotics duration, respiratory rate, duration before seeking care, WFH and previous SCAP history. So, special attention should be given at admission and during treatment% CI: 1.3,2.1) and children whose antibiotics changed