Nursing, College of Health Sciences, Debre Birhan, Ethiopia.
School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda.
BMJ Open. 2024 Mar 21;14(3):e078721. doi: 10.1136/bmjopen-2023-078721.
Severe community-acquired pneumonia (SCAP) is a significant cause of morbidity worldwide and a major cause of morbidity and mortality in developing countries. Ethiopia ranks 6th out of 15 countries with the highest mortality rate due to pneumonia in children under 5 years of age. The aim of this study was to determine the recovery time from SCAP and factors in paediatric patients in selected hospitals in Addis Ababa.
DESIGN, PARTICIPANTS AND SETTING: A retrospective cohort study was conducted among 407 randomly selected paediatric patients admitted with SCAP in Addis Ababa public hospitals from 1 January 2018 to 31 December 2020.
Recovery time and recovery rate from SCAP were estimated using Kaplan-Meier and simple frequency statistics, respectively, and the adjusted HR with a 95% CI was used to identify associated factors for recovery.
91.5% (95% CI: 88.3% to 94.1%) of children recovered from SCAP with an overall recovery rate of 11.5 (95% CI: 10.37 to 12.76) per 100 person-day observation, and the median recovery time was 6 days. In the multivariable analysis, older age and the absence of comorbidities were protective factors for early recovery, while stunting and late utilisation of medical care were risk factors.
The median recovery time after SCAP was very long compared with the optimal recovery time of 3 days given in the British Thoracic Society guidelines. Older age and absence of comorbidities were found to shorten recovery time, whereas stunting and late initiation of treatment delayed recovery. Therefore, measures that increase the recovery rate and shorten the recovery time, such as primary prevention to eliminate malnutrition and increase the utilisation of medical care in the community, should be strengthened, and health workers should focus on the early detection and treatment of comorbid diseases.
严重社区获得性肺炎（SCAP）是全球发病率较高的一个重要病因，也是发展中国家发病率和死亡率较高的一个主要病因。在 5 岁以下儿童肺炎死亡率最高的 15 个国家中，埃塞俄比亚排名第 6。本研究旨在确定在亚的斯亚贝巴选定医院住院的小儿 SCAP 患者的康复时间及相关因素。
设计、参与者和设置：本研究为回顾性队列研究，纳入了 2018 年 1 月 1 日至 2020 年 12 月 31 日期间在亚的斯亚贝巴公立医院住院的 407 名随机选择的 SCAP 患儿。
采用 Kaplan-Meier 法和简单频率统计法分别估计 SCAP 的康复时间和康复率，并采用调整后的 HR（95%CI）来识别与康复相关的因素。
91.5%（95%CI：88.3%至 94.1%）的患儿从 SCAP 中康复，总康复率为 11.5（95%CI：10.37 至 12.76）/100 人日观察，中位康复时间为 6 天。多变量分析显示，年龄较大和无合并症是早期康复的保护因素，而发育迟缓且医疗保健利用较晚是危险因素。
与英国胸科学会指南建议的 3 天最佳康复时间相比，SCAP 后的中位康复时间非常长。年龄较大和无合并症可缩短康复时间，而发育迟缓且治疗开始较晚则会延迟康复。因此，应加强提高康复率和缩短康复时间的措施，例如消除营养不良的一级预防和增加社区医疗保健的利用，卫生工作者应重点关注早期发现和治疗合并症。
