Predictors of Mortality in Children Admitted With Pneumonia in the Kumasi Metropolis: A Prospective Cross-Sectional Study.

INTRODUCTION

Pneumonia is a major contributor to childhood morbidity and mortality. This study aimed to describe the clinical profile and predictors of death among Ghanaian children admitted with pneumonia to hospitals within the Kumasi Metropolis.

METHODS

A prospective, cross-sectional, multi-center design was employed across six facilities, including four government district hospitals, one private pediatric hospital, and a teaching hospital. Following informed consent, socio-demographic data, clinical history and birth history were obtained, alongside anthropometric and clinical assessments.

RESULTS

Of 3086 admissions during the study period, 506 children were screened for pneumonia, and 266 were admitted for severe pneumonia. Most of the children were under 24 months (79.7%, n = 212), males (57%, n = 153), and (9%, n = 24) died. Immunization coverage was up to date in 57.5% (n = 153), while 68.7% (n = 189) had been exclusively breastfed for 6 months. Common presenting symptoms included cough (95%), fast breathing (91%), difficulty in breathing (90%), and fever (89%). Hypoxemia was present in 21% (n = 56), and 56% (n = 148) had a respiratory rate above 50 breaths per minute. Poor feeding was associated with a threefold increased risk of mortality (aHR 3.23, 95% CI 1.13-9.23), while oxygen saturation above 90% resulted in improved survival (aHR 0.34, 95% CI 0.13-0.86). Fifteen children died within 24 h of admission.

CONCLUSION

Pneumonia in children under 2 years carries a substantial burden, with hypoxemia, poor feeding, prior hospitalization, and malnutrition identified as key predictors of mortality.