Determination of pneumonia case management and outcome in children under-five years of age at arthurdavison children’s hospital (ADCH)

Abstract

Background: Pneumonia is amongst the top 10 causes of hospitalisation and mortality in children below the age of five at Arthur Davison Children’s Hospital, in Ndola, Zambia. Despite having protocols of management such as the WHO standard case management or the hospital protocols, there are no studies concerning case management of inpatients and their associated outcomes. The study aims to describe pneumonia case management and its associated outcomes in children under the age of five. Methods: Deploying a retrospective study, 289 in-patient records for the year 2015, Staffing levels, hospital registers and equipment were used to determine pneumonia case management and outcomes. Results: Of the 289 in-patient pneumonia case-files files reviewed, they showed that more males (56.7%) than females (43.3%) were admitted for pneumonia and that there was inadequate assessment of pneumonia signs and symptoms in 62.3% of the total number, and this seemed to be the cause of lack of uniformity and standard in treatment received by patients. These findings reflected the clinician’s failures and weaknesses in management of pneumonia. Children’s monitoring was inadequate. Only oxygen therapy (17.3%) had charts for recording signs of respiratory distress, and that routinely monitored signs temperature, pulse and respiratory rate count predominated (41.5%).These inadequacies in assessment and treatment led to prolonged hospitalization in some children(16.3%). Conclusion: Findings indicate that much needs to be done by the clinicians in the area of assessment of under-five children for improved and better outcomes, and this can be through training, algorithmic charts of case management and standardized hospital protocols.