Time to recovery and its predictors among under-five children admitted with severe pneumonia in East Wallaga Zone public hospitals, western Ethiopia, 2023; a retrospective cohort study

Abstract

BackgroundGlobally, pneumonia is one of the leading causes of morbidity and mortality as well as hospitalization burden for under-five children. Despite significant initiatives implemented to reduce morbidity and mortality from pneumonia in under-five children, little is known regarding the time to recovery and its predictors among under-five children admitted with severe pneumonia in Ethiopia. Hence, this study intended to estimate the median time to recovery and its predictors among under-five children admitted with severe pneumonia in East Wallaga zone public hospitals, western Ethiopia; 2023.MethodsAn institution-based retrospective cohort study was conducted among 383 under-five children who were admitted with severe pneumonia in East Wallaga zone public hospitals from January 2017 to December 2022. A systematic sampling method was used to select eligible medical records. EpiData Version 4.6 was used to enter the data and analyzed using STATA Version 17.0. Cox-proportional hazard assumption test and model fitness were checked. Variables with P-value ˂ 0.25 at bivariable Cox regression analysis were selected for the multivariable Cox proportional model. A multivariable Cox regression model with 95% CI and Adjusted Hazard Ratio (AHR) was used to identify a significant predictor of time to recovery from severe pneumonia at a P-value < 0.05.ResultsAt the end of the follow-up, 356 observations were developed an event (recovered) with the median time to recovery of 4 days with IQR of 3–5 days. The overall incidence rate of recovery was 22.26 per 100 (95% CI: 20.07–24.70) person-days observations. Being rural residency (AHR: 0.75, 95% CI: 0.60–0.93), late presenters for seeking care (AHR = 0.70, 95% CI: 0.53–0.93), presence of danger sign at admission (AHR = 1.46, 95% CI: 1.15–1.83), and presence of comorbidity (AHR = 1.63, 95% CI, 1.31–2.04) were found to have a statistically significant association with prolonged recovery time.ConclusionThe median time to recovery from severe pneumonia was long, and factors such as Residence, co-morbidity, presence of danger signs, and duration prior to seeking care were statistically significant predictors of recovery time from severe pneumonia. Hence, due attention has to be given to increasing the community’s health-seeking behavior to visit health facility early and especial attention should be given for children with danger signs and comorbidity.