Abstract:
Background: Severe pneumonia is a leading cause of morbidity and mortality in under-five
children, accounting for 14% of global under-five deaths in 2019. In Ethiopia, it is a priority
disease under routine surveillance. While recovery times have been studied in various
regions, most studies were limited to specific settings. Evidence on recovery patterns and
predictors in Jimma, where severe pneumonia remains highly prevalent, is scarce.
Objective: To assess the time to recovery from severe pneumonia and its predictors among
under-five children admitted to Jimma University Medical Center and Shenen Gibe General
Hospital.
Methods: 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.
Data were double-entered in EpiData 3.1 and exported to Stata 15 for analysis. The Kaplan
Meier was used to estimate the survival function, and group differences were assessed using
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.
Results: A total of 272 medical records reviewed and were retained for analysis. The median
age was 10 months and 152 (55.9%) resided in rural areas. Of the total, 219 (80.5%) achieved
clinical recovery and the total accumulated person-days at risk was 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 compared to children with no malnutrition, exclusively breastfed and fully
vaccinated respectively.
Conclusion: 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. Strengthening child nutrition, promoting exclusive
breastfeeding, and ensuring full vaccination coverage are essential to improve recovery time
in under-five children with severe pneumonia.
