MORTALITY AND ASSOCIATED FACTORS AMONG UNDER-FIVE CHILDREN WITH SEVERE PNEUMONIA ADMITTED TO HIWOT FANA COMPREHENSIVE SPECIALIZED UNIVERSITY HOSPITAL, HARAR CITY, EASTERN ETHIOPIA

Abstract

Globally pneumonia and diarrhea cause1.36 million deaths in children under five, from this pneumonia cause 878,829 deaths in 2016. Over two-third of the global burden of pneumonia mortality occurs in just 15 countries. Ethiopia is the fifth among 15 countries having the highest death rate of under five years of clinical pneumonia in the world. Despite in Ethiopia, there are limited studies assessed the mortality of severe pneumonia among under five children admitted to Hiwot Fana Specialized Hospital. Objective: To estimate the mortality and associated factors among under-five children with severe pneumonia admitted to Hiwot Fana Comprehensive Specialized University Hospital in Harar, Ethiopia, data extracted fromAug 29 to September 15, 2022. Methods: A cross-sectional study was conducted among 472 Systematic Randomly selected under-five children with severe pneumonia admitted in Hiwot Fana Comprehensive Specialized University Hospital from Jan 15, 2016-December, 2020. Check list used retrieved data from medical records. Data was entered into Epi Data version 3.1 and exported to SPSS version 22 for analysis. A Bivariate and Multivariate logistic regression analysis was used to investigate the associated between the independent variable and outcome. Candidate variable with p-value <0.25 during Bivariate analysis were included to Multivariate logistic regression with AOR at 95% significant association was declared at p-value<0.05. Results: Mortality of severe pneumonia was 16.95% (95% CI: 13.7, 20.6) and trend of mortality decreased from 29.4% in 2016-2018 to 20 % in 2019-2020. Male [AOR=0.254, 95% CI: 0.113 - 0.571], Un-vaccination [AOR=3.6, 95% CI: 1.2 - 10.2],have previous history of pneumonia [AOR= 2.9, 95% CI: 1.3 - 6.5], not heart failure [AOR=0.145, 95% CI: 0.070 - 0.29], stunting [AOR=3.1, 95% CI: 1.5 - 6.5] and abnormal chest x-ray [AOR=7.8, 95% CI: 3.4 – 17.8] had statistical significant Association with mortality of severe pneumonia. Conclusion and Recommendation: This study revealed that about one in five children admitted with severe pneumonia had died and the overall trend of mortality has decreased from 2016 to 2020. Male, Un-vaccination status, having previous history of pneumonia, not heart failure, stunting and abnormal chest x-ray were factors associated with mortality of severe pneumonia among under five children. Strengthening under five children vaccination at the community and institutional levels, Hence close attention should be given to children with stunting, having previous history of pneumonia and having abnormal chest x-ray in the management of severe pneumonia during at institutional levels care were recommended in order to decrease the mortality of severe pneumonia under five children.