Pneumonia among under – five children in Ethiopia: a retrospective analysis from an urban hospital

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background:

Pneumonia is the leading cause of death in under-five children in low-income countries. However, the burden of pneumonia in hospital admission is not traced systematically. This study was conducted to determine the proportion of under-five pneumonia admissions among children admitted to a hospital in Addis Ababa, Ethiopia between 2017–2021.

Methods:

A retrospective record of pediatric admissions to the Yekatit 12 referral hospital in Addis Ababa, Ethiopia was assessed for the period 2017– 2021. The date of admission and discharge, length of stay, and outcome at discharge were collected in accordance with the Ethiopian National Classification of Diseases (NCoD). Descriptive statistics were used to assess the proportion of under-five children with pneumonia. Survival analyses using Log rank test and cox regression analysis were done to assess time to recovery (recovering from illness). Multivariable logistic regression was used to assess the influence of selected factors on pneumonia associated hospital admission.

Results:

Between 2017–2021, 2170 children age 1 to 59 months were admitted, 564 (25.99%; 95% confidence interval 24.18% to 27.87%) were diagnosed with pneumonia. Among the sixty children who died during their hospitalization, 15 had been diagnosed with pneumonia. The median time to recover from pneumonia and discharge was 6 days. The odds of pneumonia hospital admission were higher among younger children (4.36 times higher compared to elder children with 95% CI 2.77,6.87)and were increased between the months of September to November.

Conclusions:

Pneumonia accounts for more than a quarter of hospital admissions in under-five children and for a quarter of deaths in this urban cohort. Hospital admission due to pneumonia was higher among older children (36–59 months of age) in the months following the heavy rain months (September to November) as compared to younger children. Our data strongly support increase of vaccination to prevent under 5 pneumonia.

Related collections

Most cited references 36

Record: found
Abstract: found
Article: found

Is Open Access

Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals

Li Liu, Shefali Oza, Dan Hogan … (2016)

Summary Background Despite remarkable progress in the improvement of child survival between 1990 and 2015, the Millennium Development Goal (MDG) 4 target of a two-thirds reduction of under-5 mortality rate (U5MR) was not achieved globally. In this paper, we updated our annual estimates of child mortality by cause to 2000–15 to reflect on progress toward the MDG 4 and consider implications for the Sustainable Development Goals (SDG) target for child survival. Methods We increased the estimation input data for causes of deaths by 43% among neonates and 23% among 1–59-month-olds, respectively. We used adequate vital registration (VR) data where available, and modelled cause-specific mortality fractions applying multinomial logistic regressions using adequate VR for low U5MR countries and verbal autopsy data for high U5MR countries. We updated the estimation to use Plasmodium falciparum parasite rate in place of malaria index in the modelling of malaria deaths; to use adjusted empirical estimates instead of modelled estimates for China; and to consider the effects of pneumococcal conjugate vaccine and rotavirus vaccine in the estimation. Findings In 2015, among the 5·9 million under-5 deaths, 2·7 million occurred in the neonatal period. The leading under-5 causes were preterm birth complications (1·055 million [95% uncertainty range (UR) 0·935–1·179]), pneumonia (0·921 million [0·812 −1·117]), and intrapartum-related events (0·691 million [0·598 −0·778]). In the two MDG regions with the most under-5 deaths, the leading cause was pneumonia in sub-Saharan Africa and preterm birth complications in southern Asia. Reductions in mortality rates for pneumonia, diarrhoea, neonatal intrapartum-related events, malaria, and measles were responsible for 61% of the total reduction of 35 per 1000 livebirths in U5MR in 2000–15. Stratified by U5MR, pneumonia was the leading cause in countries with very high U5MR. Preterm birth complications and pneumonia were both important in high, medium high, and medium child mortality countries; whereas congenital abnormalities was the most important cause in countries with low and very low U5MR. Interpretation In the SDG era, countries are advised to prioritise child survival policy and programmes based on their child cause-of-death composition. Continued and enhanced efforts to scale up proven life-saving interventions are needed to achieve the SDG child survival target. Funding Bill & Melinda Gates Foundation, WHO.

0 comments Cited 979 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study

Katherine L O'Brien, Henry Baggett, W. Brooks … (2019)

Summary Background Pneumonia is the leading cause of death among children younger than 5 years. In this study, we estimated causes of pneumonia in young African and Asian children, using novel analytical methods applied to clinical and microbiological findings. Methods We did a multi-site, international case-control study in nine study sites in seven countries: Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. All sites enrolled in the study for 24 months. Cases were children aged 1–59 months admitted to hospital with severe pneumonia. Controls were age-group-matched children randomly selected from communities surrounding study sites. Nasopharyngeal and oropharyngeal (NP-OP), urine, blood, induced sputum, lung aspirate, pleural fluid, and gastric aspirates were tested with cultures, multiplex PCR, or both. Primary analyses were restricted to cases without HIV infection and with abnormal chest x-rays and to controls without HIV infection. We applied a Bayesian, partial latent class analysis to estimate probabilities of aetiological agents at the individual and population level, incorporating case and control data. Findings Between Aug 15, 2011, and Jan 30, 2014, we enrolled 4232 cases and 5119 community controls. The primary analysis group was comprised of 1769 (41·8% of 4232) cases without HIV infection and with positive chest x-rays and 5102 (99·7% of 5119) community controls without HIV infection. Wheezing was present in 555 (31·7%) of 1752 cases (range by site 10·6–97·3%). 30-day case-fatality ratio was 6·4% (114 of 1769 cases). Blood cultures were positive in 56 (3·2%) of 1749 cases, and Streptococcus pneumoniae was the most common bacteria isolated (19 [33·9%] of 56). Almost all cases (98·9%) and controls (98·0%) had at least one pathogen detected by PCR in the NP-OP specimen. The detection of respiratory syncytial virus (RSV), parainfluenza virus, human metapneumovirus, influenza virus, S pneumoniae, Haemophilus influenzae type b (Hib), H influenzae non-type b, and Pneumocystis jirovecii in NP-OP specimens was associated with case status. The aetiology analysis estimated that viruses accounted for 61·4% (95% credible interval [CrI] 57·3–65·6) of causes, whereas bacteria accounted for 27·3% (23·3–31·6) and Mycobacterium tuberculosis for 5·9% (3·9–8·3). Viruses were less common (54·5%, 95% CrI 47·4–61·5 vs 68·0%, 62·7–72·7) and bacteria more common (33·7%, 27·2–40·8 vs 22·8%, 18·3–27·6) in very severe pneumonia cases than in severe cases. RSV had the greatest aetiological fraction (31·1%, 95% CrI 28·4–34·2) of all pathogens. Human rhinovirus, human metapneumovirus A or B, human parainfluenza virus, S pneumoniae, M tuberculosis, and H influenzae each accounted for 5% or more of the aetiological distribution. We observed differences in aetiological fraction by age for Bordetella pertussis, parainfluenza types 1 and 3, parechovirus–enterovirus, P jirovecii, RSV, rhinovirus, Staphylococcus aureus, and S pneumoniae, and differences by severity for RSV, S aureus, S pneumoniae, and parainfluenza type 3. The leading ten pathogens of each site accounted for 79% or more of the site's aetiological fraction. Interpretation In our study, a small set of pathogens accounted for most cases of pneumonia requiring hospital admission. Preventing and treating a subset of pathogens could substantially affect childhood pneumonia outcomes. Funding Bill & Melinda Gates Foundation.

0 comments Cited 353 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

How dangerous is a day in hospital? A model of adverse events and length of stay for medical inpatients.

Xueyan Zhao, Katharina Hauck (2011)

Despite extensive research into adverse events, there is no quantitative estimate for the risk of experiencing adverse events per day spent in hospital. This is important information for hospital managers, because they may consider discharging patients earlier to alternative care providers if this is associated with lower risk, but other costs and benefits are similar. We model adverse events as a function of patient risk factors, hospital fixed effects, and length of stay. Potential endogeneity of length of stay is addressed with instrumental variable methods, using days and months of discharge as instruments. We use administrative hospital episode data for 206,489 medical inpatients in all public hospitals in the state of Victoria, Australia, for the year 2005/2006. A hospital stay carries a 5.5% risk of an adverse drug reaction, 17.6% risk of infection, and 3.1% risk of ulcer for an average episode, and each additional night in hospital increases the risk by 0.5% for adverse drug reactions, 1.6% for infections, and 0.5% for ulcers. Length of stay is endogenous in models of adverse events, and risks would be underestimated if length of stay was treated as exogenous. The results of our research contribute to assessing the benefits and costs of hospital stays-and their alternatives-in a quantitative manner. Instead of discharging patients early to alternative care, it would be more desirable to address underlying causes of adverse events. However, this may prove costly, difficult, or impossible, at least in the short run. In such situations, our research supports hospital managers in making informed treatment and discharge decisions.

0 comments Cited 67 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Walelegn Worku Yallew: Role: involved proposal writingRole: Data cleaningRole: Data AnalysisRole: manuscript writing

Selamawit Assefa: Role: involved proposal writingRole: Data collectionRole: Data AnalysisRole: manuscript writingRole: editing

Berhane Yemane: Role: involved proposal writingRole: Data AnalysisRole: manuscript writingRole: editing

Journal

Journal ID (nlm-ta): Res Sq

Journal ID (publisher-id): ResearchSquare

Title: Research Square

Publisher: American Journal Experts

Publication date (Electronic): 12 April 2023

Electronic Location Identifier: rs.3.rs-2790057

Affiliations

Addis Continental Institute of Public Health

Department of Pediatrics, Yekatit 12 Hospital Medical College

Addis Continental Institute of Public Health

Author notes

[✉ ] walelegnwaciph@ 123456gmail.com

Article

Other ID: 10.21203/rs.3.rs-2790057

DOI: 10.21203/rs.3.rs-2790057/v1

PMC ID: 10120775

PubMed ID: 37090625

SO-VID: a9a99e54-931c-4076-9260-0642e834570a

License:

This work is licensed under a Creative Commons Attribution 4.0 International License, which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use.

This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License

History

Funding

Research reported in this publication was supported by the Fogarty International Center of the National Institutes of Health under Award Number D43TW011386. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Pneumonia among under – five children in Ethiopia: a retrospective analysis from an urban hospital

Read this article at

Abstract

Background:

Methods:

Results:

Conclusions:

Related collections

Pneumonia, sex, and the environment

Most cited references 36

Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals

Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study

How dangerous is a day in hospital? A model of adverse events and length of stay for medical inpatients.

Author and article information

Contributors

Journal

Affiliations

Author notes

Article

History

Funding

Categories

Comments

Comment on this article

Similar content 454

Most referenced authors 410