Time to recovery and its predictors among under-five children with severe pneumonia at Jimma town public hospitals, Southwestern Oromia, Ethiopia: a retrospective follow-up study

Abstract

Severe pneumonia is a leading cause of morbidity and mortality in children under-five years of age. In Ethiopia, it is a priority disease under routine surveillance. Several factors have been identified as influencing the length of recovery time in children with severe pneumonia; however, evidence on recovery patterns and their predictors in Jimma, where severe pneumonia remains highly prevalent, is scarce. This study aimed to assess the time to recovery from severe pneumonia and its predictors among children under-five years of age admitted to Jimma town public hospitals. A facility-based retrospective follow-up study was conducted among 272 under-five children admitted with severe pneumonia between July 1, 2021 and July 30, 2024, at public hospitals in Jimma town. A simple random sampling technique was used to select eligible medical records. A structured tool was used to extract data from medical records. The Kaplan–Meier method was used to estimate survival and group differences were assessed via the log-rank test. Variables with P < 0.25 in the bivariate analysis were entered into the multivariable Cox proportional hazards regression to identify independent predictors of recovery time, with significance set at p < 0.05. A total of 272 medical records were reviewed and retained for analysis. The median age was 10 months and 152 (55.9%) patients resided in rural areas. In total, 219 (80.5%) patients achieved clinical recovery, and the total accumulated person-days at risk were 1,913 days. The overall median recovery time from severe pneumonia was 5 days (IQR: 3–9). Children who were malnourished (AHR = 0.57, 95% CI: 0.39–0.84), not exclusively breastfed (AHR = 0.49, 95% CI: 0.31–0.80), or not fully vaccinated (AHR = 0.72, 95% CI: 0.53–0.98) had a lower hazard of recovery than children with no malnutrition, exclusively breastfed and fully vaccinated, respectively. The overall median recovery time was 5 days. Recovery from severe pneumonia was delayed among under-five children who were malnourished, not exclusively breastfed or not fully vaccinated at admission. Future efforts should focus on strengthening child nutrition, promoting exclusive breastfeeding and ensuring full vaccination coverage to reduce recovery time in under-five children with severe pneumonia. Not applicable.