Clinical Outcomes and Its Associated Factors of Community Acquired Acute Respiratory Infections Among Admitted Pediatric Patients in Jimma Medical Center: Concurrent Observational Study

Abstract

Background: acute respiratory infections are infections of the air ways and are classified as upper respiratory tract infections and lower respiratory tract infections. They are the most common illnesses in childhood, comprising as many as 50% of all illnesses in children less than 5 years old and 30% in children aged 5 – 12 years. Despite the availability of antibiotics, acute respiratory infections bear high morbidity and mortality burden worldwide, just the largest share taken by developing nations including Ethiopia. Objective: to assess clinical outcome (s) and its predictors of community acquired acute respiratory infections in pediatric patients admitted to Jimma medical center. Method and Participants: prospective observational study was conducted starting from April – September 2019 on patients admitted to pediatric wards of Jimma medical center with a diagnosis of any of the acute respiratory infections to determine in-patient clinical outcomes. These outcomes were designed as good or poor for this study. Multivariate logistic regression was conducted to identify independent predictors of poor outcome. Results: overall, 212 pediatric population was enrolled in this study with a male: female ratio of 1.12:1 and the average age of the participants was 38.66±17.36 months. Almost all (99.5%) of the participants had been provided with at least one antibiotic. Seventy eight (36.8%) of the cases had “poor outcome” and the outcome was fatal in 1.4% of the participants. Independent predictors of poor outcome were cyanosis [AOR=11.911(95% CI, 4.354-32.587)], wasted body weight [AOR = 5.492(95% CI, 1.729- 17.445)], initial ceftriaxone plus gentamicine administration [AOR = 3.166 ( 95% CI, 1.114-8.996)], antibiotic use within 3 months prior to admission [AOR = 2.961(95% CI, 1.087-8.069)], co morbidity [AOR = 2.116( 95% CI, 1.468-3.654)] and duration of symptoms [AOR = 1.046(95% CI, 1.001-1.092)] in order of their relative importance. Conclusion and Recommendation: both the burden of acute respiratory infections and its poor outcome were high in our setting. Factors including cyanosis, wasted body weight, initial ceftriaxone plus gentamicine administration, antibiotic use of 3 months prior to admission, co morbidity and duration of symptoms were independent predictors of poor outcome and hence practitioners should never contempt these factors to give priority for those cases coming with them.