Predictors and outcome of first line treatment failure among under-five children with community acquired severe pneumonia at Bugando Medical Centre, Mwanza, Tanzania: A prospective cohort study (Record no. 18885)
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| 000 -LEADER | |
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| fixed length control field | 02853nam a22001577a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION | |
| fixed length control field | 210823b |||||||| |||| 00| 0 eng d |
| 100 ## - MAIN ENTRY--PERSONAL NAME | |
| Personal name | Restituta Phabian Muro |
| 9 (RLIN) | 23219 |
| 245 ## - TITLE STATEMENT | |
| Title | Predictors and outcome of first line treatment failure among under-five children with community acquired severe pneumonia at Bugando Medical Centre, Mwanza, Tanzania: A prospective cohort study |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Place of publication, distribution, etc. | Mwanza, Tanzania |
| Name of publisher, distributor, etc. | Catholic University of Health and Allied Sciences CUHAS - Bugando |
| Date of publication, distribution, etc. | December 11, 2020 |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Abstract<br/>Background<br/><br/>Despite recent advances in management and preventive strategies, high rates of first line antibiotics treatment failure and case fatality for Severe Community Acquired Pneumonia (SCAP) continue to occur in children in low and middle-income countries. This study aimed to identify the predictors and outcome of first line antibiotics treatment failure among children under-five years of age with SCAP admitted at Bugando Medical Centre (BMC) in Mwanza, Tanzania.<br/><br/>Methods<br/><br/>The study involved under-five children admitted with SCAP, treated with first line antibiotics as recommended by WHO. Patients with treatment failure at 48 hours were shifted to second line of antibiotics treatment and followed up for 7 days. Generalized linear model was used to determine predictors of first line antibiotics treatment failure for SCAP.<br/><br/>Results<br/><br/>A total of 250 children with SCAP with a median age of 18 [IQR 9–36] months were enrolled, 8.4% had HIV infection and 28% had acute malnutrition. The percentage of first line antibiotics treatment failure for the children with SCAP was 50.4%. Predictors of first line treatment failure were; presentation with convulsion (RR 1.55; 95% CI [1.11–2.16]; p-value 0.009), central cyanosis (RR 1.55; 95% CI [1.16–2.07]; p-value 0.003), low oxygen saturation (RR 1.28; 95% CI [1.01–1.62]; p-value 0.04), abnormal chest X-ray (RR 1.71; 95% CI [1.28–2.29]; p-value <0.001), HIV infection (RR 1.80; 95% CI [1.42–2.27]; p-value 0.001), moderate acute malnutrition (RR 1.48; 95% CI [1.04–2.12]; p-value = 0.030) and severe acute malnutrition (RR 2.02; 95% CI [1.56–2.61]; p-value<0.001). Mortality in children who failed first line treatment was 4.8%.<br/><br/>Conclusion<br/><br/>Half of the children with SCAP at this tertiary center had first line antibiotics treatment failure. HIV infection, acute malnutrition, low oxygen saturation, convulsions, central cyanosis, and abnormal chest X-ray were independently predictive of first line treatment failure. We recommend consideration of second line treatment and clinical trials for patients with SCAP to reduce associated morbidity and mortality.<br/> |
| 700 ## - ADDED ENTRY--PERSONAL NAME | |
| 9 (RLIN) | 23220 |
| 9 (RLIN) | 22778 |
| 9 (RLIN) | 22515 |
| 9 (RLIN) | 22909 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) | |
| Source of classification or shelving scheme | ddc |
| Koha item type | RESEARCH ARTICLES |
| Withdrawn status | Lost status | Source of classification or shelving scheme | Damaged status | Not for loan | Collection | Home library | Current library | Shelving location | Date acquired | Total checkouts | Barcode | Date last seen | Price effective from | Koha item type |
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| MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | 08/23/2021 | RA0086 | 08/23/2021 | 08/23/2021 | RESEARCH ARTICLES |