Severe pneumonia and risk factors among hospitalized children under five in Adama, Ethiopia

Abstract

Abstract Background Ethiopia stands fifth in pneumonia death rate among children under five worldwide but the severity and determinants of the disease are inconsistently reported, hindering policy and practice. This study aimed to assess the magnitude and determinants of severe pneumonia among hospitalized children under five in Adama town, Ethiopia. Method A facility-based cross-sectional study was conducted among under five children admitted at Adama Hospital and Medical College (AHMC), Adama Town, East Shoa Zone of Oromia in Ethiopia. Using adapted, structured questionnaire and systematic random sampling, the patients’ parents or caregivers were interviewed to determine the magnitude of the disease and underlying determinants including sociodemographic, environmental, comorbidity, nutrition, and immunization characteristics. The bivariate logistic regression model was used to test the association between variables on SPSS version 21. Result The study enrolled 465 hospitalized children under five, with a mean (standard deviation) age of 22.4 (15.5) months, 236 (50.8%) males, and 285 (61.3%) living in urban areas. The magnitude of severe pneumonia among the children was 41.9%. Factors significantly associated with severity of the pneumonia episode were: persistent diarrhea lasting two or more weeks [adjusted odds ratio (AOR) 4.31, 95% CI 2.14–8.66], non-exclusive breastfeeding [AOR 3.23, 95% CI 1.23–8.49], undernutrition [AOR 1.73, 95% CI 1.04–2.90], and smoking of a family member [AOR 8.33, 95% CI 4.10–17.00]. Conclusion Severe pneumonia among hospitalized children under five was higher in Adama town, and more common among those with persistent diarrhea, non-inclusive breastfeeding, undernutrition, and living closely with smokers that require a coordinated intervention.