Abstract:
Pneumonia is the one of infectious cause of morbidity and mortality among children under age
five years in low and middle-income countries including Ethiopia. The main objective of this
study was to analysis survival time to death under-age five children with pneumonia in the
presence of computing risk in East Hararge Zone General Hospitals. To meet the study objective
the retrospective study design was used secondary data on 436 sampled under-age five children
with pneumonia patients from January 1st, 2022 up to January 1st, 2023. Out of 436 patients, 35
(8.03%) died from pneumonia, 29 (6.65%) died from other causes, 292 (66.97%) recovered
from pneumonia, and 80 (18.35%) were censored. The maximum relative difference observed
for the covariate between the cause-specific hazard ratios and sub-distribution hazard ratios
was 89%. The model comparison was done using the sub-bayesian information criteria to select
the best model to fit the data. The cause-specific hazard frailty model was appropriate as
compared to candidate models to fit the pneumonia patient’s dataset. There was an unobserved
heterogeneity due to clustering (Hospitals) in the survival experience of patients in Eastern
Hararghe of General Hospitals. The final results of the cause-specific hazard frailty model
showed that sex, age group 12-23, age group 24-35, health insurance, season of diagnosis in
summer, acute respiratory tract infection, patient referral status, micro-nutrient deficiency, and
weight were significant risk factors associated with death due to pneumonia in thepresence of
competing risk. The male patients, patients whose age categories were 12-23, 24-35 months,
the season of diagnosis summer, and patients with ARTI had a significantly increased risk of
death due to pneumonia patients. While, patients who use health insurance, patients referred
from other health centers and weight had significantly decreased risk of death due to pneumonia
patients. It is recommended that the hospital variation should be taken into account during
intervention and awareness creation should give to the local community to increase the health
insurance status which reduces the child mortality risk of pneumonia.
