Costs incurred by caregivers of under-five inpatients with community-acquired pneumonia at a university hospital in south-western Ethiopia

Background: Pneumonia is one of the commonest diseases among children in Ethiopia resulting in deaths and hospitalisations. The objective of the current study was to determine the cost incurred by caregivers of under-five children with community-acquired pneumonia admitted to the paediatric ward of Jimma University Specialized Hospital, south-western Ethiopia.Methods: An institution-based cross-sectional study was conducted from 01 January to 28 February 2017, through interviews with caregivers. Data on costs incurred before hospital visit, direct medical and non-medical costs, and indirect costs incurred by caregivers of the children were collected. The collected data were analysed using Statistical Package for Social Sciences version 23.Results: Among the 120 caregivers in the study, a median total cost of 304.5 Ethiopian birr (13.22 USD) was reported. This was mostly contributed by indirect costs associated with earnings lost by caregivers related to travel and stay at hospital with the children. Factors, including permanent residence, family size, hospital stay, wealth index, education and major occupation, were found to have statistically significant association with the level of cost incurred by caregivers.Conclusion: This study identified that a significant level of cost is incurred by caregivers of the children in the hospital, a majority of which was contributed by the lost earnings because of the time spent at the hospital with the children

Les pneumonies de l'enfant a Libreville : une etude de 85 cas

INTRODUCTION : Les pneumonies sont l'une des principales causes de deces des enfants de moins de 5 ans. Au Gabon; en 2000; elles etaient la troisieme cause de mortalite des enfants de moins de 5 ans. L'objectif de ce travail etait d'en etudier les caracteristiques epidemiologiques et cliniques a Libreville. PATIENTS ET MeTHODES : Il s'agit d'une enquete descriptive retrospective conduite sur les dossiers d'enfants hospitalises du 1er juillet 2012 au 30 juin 2013; dans le service de pediatrie du Centre Hospitalier Universitaire de Libreville. Les donnees ont ete analysees avec le logiciel epi info 3.5.4. ReSULTATS : Sept cent quatre vingt et un enfants ont ete hospitalises; durant cette periode; 85 cas de pneumonies ont ete enregistres; soit 10;9%. Le sex ratio etait de M/F 2. La moyenne d'age etait de 2 ans et 9 mois. Les enfants de 0 a 2 ans representaient 62;5% de l'effectif. Le delai moyen de consultation apres le debut des symptomes etait de 12;4 jours. Un traitement avait ete administre a domicile avant l'admission dans 52;8% des cas; dont des antibiotiques (47;4%). Le statut vaccinal etait correct pour les vaccinations du Programme elargi de vaccination dans 15;3% des cas. La fievre representait 94;4% des motifs de consultation et la toux 87;5%. La tuberculose etait a l'origine de la pneumonie chez 7 enfants (9;7%). Les opacites parenchymateuses droites representaient 55;8% des anomalies radiographiques et les epanchements pleuraux droits 16;2%. Un deces a ete enregistre suite a la tuberculose. CONCLUSION : Avec une frequence de 10;9% des cas d'hospitalisation; les pneumonies representent un reel probleme de sante publique. Une methode diagnostique fiable de la tuberculose est necessaire en l'absence du test tuberculinique. L'introduction des nouveaux antigenes dans le Programme elargi de Vaccination; tels que le vaccin antipneumococique serait necessaire

Diagnosis and Management of Community-Acquired Pneumonia in Childhood - South African Thoracic Society Guidelines

Background: Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in South African children. The incidence; severity and spectrum of childhood pneumonia have changed owing to the HIV epidemic. Increasing emergence of antimicrobial resistance necessitates a rational approach to the use of antibiotics in pneumonia management. Objective: To develop guidelines for the diagnosis; management and prevention of CAP in South African children. Methods: The Paediatric Assembly of the South African Thoracic Society established five expert subgroups to address: (i) epidemiology and aetiology; (ii) diagnosis; (iii) antibiotic treatment; (iv) supportive therapy; and (v) prevention of CAP. Each subgroup developed a position paper based on the available published evidence; in the absence of evidence; expert opinion was accepted. After peer review and revision; the position papers were synthesised into an overall guideline which was further reviewed and revised. Recommendations: Recommendations based on epidemiological factors include a diagnostic approach; investigations; supportive therapy; appropriate antibiotic treatment and preventive strategies. Specific recommendations for HIV-infected children are provided. Validation: These guidelines are based on the available evidence supplemented by the consensus opinion of South African experts in aediatrics; paediatric pulmonology; radiology; infectious diseases and microbiology. Published international guidelines have also been consulted