Time to recovery and predictors of severe pneumonia in children under five years of age at referral and general hospitals in sidama region. southern Ethiopia, prospective cohort study

BackgroundA longer period of hospitalization is known to raise the risk of local and systemic infection, which can lead to complicated pneumonia. These negative impacts of inpatient management of severe pneumonia become more pronounced if the length of recovery time is prolonged. Therefore, the aim of this study was to assess the time to recovery from severe pneumonia and its predictors among under-five children. MethodologyA multicenter prospective cohort study was conducted on 286 children under five years of age with severe pneumonia from March to July 2024 at referral and general hospitals in the Sidama Region, South Ethiopia. Data collectors received two-days training. Systematic sampling was employed to select participants. Data analysis was performed using STATA version 16, with Cox proportional regression. The Cox proportional hazard model assumption was validated using the Schoenfeld residual global test, which yielded a P-value of 0.505. ResultsAmong 286 under-five children with severe pneumonia, the median time to recovery was 5 days (interquartile range = 4-7). The incidence of recovery rate was 17.27 (95% CI, 15.3- 19.4) per 100 person-days. Severe acute malnutrition (adjusted hazard ratio; 0.567, 95% CI (0.357- 0.90)), presence of danger signs (adjusted hazard ratio; 0.497, 95% CI (0.314-0.787)) and presence of co-morbidities (adjusted hazard ratio; 0.618, 95% CI (0.477- 0.800)) were associated with time to recovery from severe pneumonia in children younger than five years. Conclusions and recommendationsThe median recovery time of pediatric patients admitted with severe pneumonia was relatively high. Malnutrition, presence of danger signs, and comorbidities were significant associated factors; therefore, to reduce time to recovery from severe pneumonia by enhancing nutritional status, early detection and treatment of the danger signs, and comorbidity diseases.