Tegenu Kenenisa, Geleto Gelane, Tilahun Desalew, Bayana Ebissa, Bereke Bayisa
School of Nursing, Faculty of Health Science, Institute of Health Jimma University, Jimma, Ethiopia.
Jimma University Medical Center, Jimma University, Jimma, Ethiopia.
SAGE Open Med. 2022 Feb 21;10:20503121221078445. doi: 10.1177/20503121221078445. eCollection 2022.
Over 2 million children die from pneumonia each year accounting for almost one in five children's deaths worldwide which is estimated to be 18% of mortality cases. Therefore, this study is aimed to assess treatment outcome and its determinant factors among under-five patients, Jimma, Ethiopia.
Study design was conducted on 522 under-five children with severe pneumonia from 1 January 2017 to 30 December 2020. Pretested chart review format was used to collect data. Data were entered into EpiData, version 3.1, and exported to Statistical Package for the Social Sciences, version 23, for analysis. Logistic regression analysis with 95% confidence interval was used to declare statistical significance at value <0.05.
Among 522 under-five children with severe pneumonia, majority (83.91%) of them were improved, whereas 1 over 6 (16.09%) of them were died. This finding showed that children who have malnutrition (adjusted odds ratio = 7.23 (3.17-14.51), = 0.000), positive serostatus for HIV (adjusted odds ratio = 5.01 (1.91-12.13), = 0.001), history of upper respiratory tract infections (adjusted odds ratio = 3.27 (1.55-6.91), = 0.002), unvaccinated (adjusted odds ratio = 4.35 (1.60-11.79), = 0.004), having complicated types of pneumonia (adjusted odds ratio = 8.48 (4.22-16.65), < 0.001), and comorbidity disease (adjusted odds ratio = 5.21 (2.03-13.3), < 0.001) were statistically significant with mortality.
This study showed that mortality secondary to severe pneumonia was high. Being malnourished, positive serostatus for HIV infection, history of upper respiratory tract infections, unvaccinated, having complicated type of pneumonia, and other comorbidity disease were identified as determinant factors of mortality. Committed, harmonized, and integrated intervention needs to be taken to reduce mortality from severe pneumonia by enhancing child's nutrition status, early detection and treatment, effectively vaccinating children, and preventing other comorbidity diseases.
每年有超过200万儿童死于肺炎，占全球儿童死亡人数的近五分之一，估计占死亡病例的18%。因此，本研究旨在评估埃塞俄比亚吉马地区五岁以下重症肺炎患者的治疗结果及其决定因素。
对2017年1月1日至2020年12月31日期间522名五岁以下重症肺炎儿童进行了研究设计。采用预先测试的图表回顾形式收集数据。数据录入EpiData 3.1版本，并导出到社会科学统计软件包23版本进行分析。采用95%置信区间的逻辑回归分析，在P值<0.05时判定具有统计学意义。
在522名五岁以下重症肺炎儿童中，大多数（83.91%）病情好转，而六分之一（16.09%）死亡。这一发现表明，患有营养不良（调整比值比=7.23（3.17 - 14.51），P = 0.000）、HIV血清学阳性（调整比值比=5.01（1.91 - 12.13），P = 0.001）、有上呼吸道感染史（调整比值比=3.27（1.55 - 6.91），P = 0.002）、未接种疫苗（调整比值比=4.35（1.60 - 11.79），P = 0.004）、患有复杂类型肺炎（调整比值比=8.48（4.22 - 16.65），P < 0.001）以及患有合并症（调整比值比=5.21（2.03 - 13.3），P < 0.001）的儿童与死亡率具有统计学显著相关性。
本研究表明，重症肺炎继发的死亡率很高。营养不良、HIV感染血清学阳性、上呼吸道感染史、未接种疫苗、患有复杂类型肺炎以及其他合并症被确定为死亡率的决定因素。需要采取坚定、协调和综合的干预措施，通过改善儿童营养状况、早期发现和治疗、有效为儿童接种疫苗以及预防其他合并症来降低重症肺炎的死亡率。
