ABSTRACT
BACKGROUND: Pneumonia, which is an infection and inflammation of an air-space in the lungs due to an impurity. Child mortality due to pheumonia is estimated at 921,000 children under 5 years (U5) in 2015. OBJECTIVE: To determine the TTR and factors of severe pneumonia among U5 children admitted at UOGCSH, Northwest Ethiopia.with. METHODS: A facility-based retrospective follow-up study was conducted on children U5 severe pneumonia from 2015 to 2020. The data were collected using pre-test and structured questionnaires. Statistical analysis was performed using Stata version 14.1. RESULT: The average TTR was 3 days IQR (3-6). TTR from severe pneumonia was 13.5 (95% CI: 13.54-17.15) per 100-persons. The cumulative time for children at risk was 1112 days, with a TTR of 29.7 per 100 children per day. Severity, signs and symptoms of pneumonia (AHR, 3.88 (95% CI =3.12-5.57)); mode of infancy feeding (cows milk feeding) (AHR, 2.4, (95% CI: 2.22-6.6)), and formula feeding (AHR, 0.68, (95% CI 0.58-1.25)) as compared to breastfeeding; nutritional status (underweight) (AHR, 2.2, (95% CI: (2.1-3.76)) as compared to normal, age (2-3-years) (AHR, 1.4, (95% CI: 1.31-2.22)), and ≥4-years (AHR, 1.32, (95% CI: 1.3-2.32)) as compared to age of ≤1 year were important factors of TTR. CONCLUSION: The overall TTR was 3 days IQR (2-6). This study identifies severity, signs, and symptoms of pneumonia, Mode of infancy feeding (cows milk feeding, formula feeding), nutritional status, and age were main determinants of TTR.
ABSTRACT
INTRODUCTION: There are few studies on the hematologic parameters of HIV-infected individuals in Ethiopia; of these, almost all studies researched adults. Our current study is unique in that it mainly focused on the pediatric population and compared both pre- and post-antiretroviral therapy (ART) children. Inference from this study can be used for other developing countries where the burden of HIV disease is high. OBJECTIVE: The aim of this study was to identify hematologic abnormalities in HIV-infected children before and after initiation of ART. METHODOLOGY: A cross-sectional study was conducted on HIV-infected children from June 1 to August 30, 2015. Data were collected using a pretested and structured questionnaire. Statistical analysis was performed using SPSS 20 version. RESULTS: The median age of study subjects was 10 years with an interquartile range (IQR) of (6, 12). Two-thirds (74.3%) of study subjects received ART for >1 year. The median of CD4 count before ART was 490 cells/mm3 with an IQR of (286, 765); this increased to 663 cells mm3 with an IQR of (499, 908) after ART. Likewise, the median of hemoglobin before ART was 11.5 mg/dL with an IQR of (9.9, 13), which increased after ART to 13 mg/dL with an IQR of (11.8, 14). The prevalence of anemia was 42.8% before and 18.9% after ART initiation. The median of absolute neutrophil count before ART was 3×103 with an IQR of (2.1, 4.6) and after ART, it became 3×103 with IQR of (1.9, 4.2). Age <5 years (adjusted odds ratio [AOR]: 2.76; 95% CI: 1.5, 5.0), an advanced stage of AIDS (AOR: 2.8; 95% CI: 1.4, 5.6) and CD4% <25% (AOR: 2.4; 95% CI: 1.2, 4.9) were significantly associated with anemia before ART initiation, while opportunistic infections were associated with anemia after initiation of ART (AOR: 2.3; 95% CI: 1.08, 4.8). CONCLUSION: ART positively or negatively affects the hematologic profile of HIV-infected children. The current study demonstrated a significant reduction of anemia after initiation of ART.
