Prevalence and Factors Associated With Persisting Respiratory Symptoms and Signs Four Weeks After Discharge From Hospital Following Treatment for Severe Acute Pneumonia in Children Aged 2 – 59 Months

Abstract

Background: Pneumonia is the single largest infectious cause of death in children worldwide. With advances in treatment, many children survive severe pneumonia with risk of residual disease. Our study sought to describe the prevalence and factors associated with persisting respiratory symptoms and signs after discharge from the hospital following treatment for severe acute pneumonia in children aged 2 – 59 months. Method: Observational prospective cohort study conducted in KNH general paediatric wards between December 2022- March 2023. Ninety-four children aged between 2-59 months were involved in the study. The eligibility for inclusion was patients with severe acute pneumonia at admission with subsequent persisting respiratory symptoms and signs for four weeks after discharge from the hospital. Data Analysis Plan: Data was entered into pre-coded questionnaires, reviewed, cleaned, entered into a customized Microsoft Excel database, then analysed. Results were summarized using medians and interquartile ranges, and frequencies and proportions. Risk factors were analysed using logistic regression and results were presented as risk ratios and p-values. Results: Out of 94 children, 35 had persisting symptoms and signs of pneumonia, a prevalence of 37% (95% CI 28%, 48%). The residual symptoms and signs at 4 weeks post discharge included 15 (16%) children with cough, 10 (10.6%) with difficulty breathing and 9 (9.6%) with congested chests, 19 (20.2%) had hypoxia, 7 (7.4%) had tachypnoea and 18 (19.1%) used accessory muscles of respiration. Abnormal chest X-ray findings were significantly associated with the persistence of symptoms and signs of pneumonia with a p value <0.05. Conclusion: Persistence of respiratory symptoms and signs after treatment of severe pneumonia among children at KNH was common. It is important recognise those at risk and follow up and manage these patients appropriately after discharge