Background Globally, pneumonia is the leading cause of children under age five morbidity and mortality with 98% of deaths in developing countries. Objective This study aimed to identify the determinants of longitudinal measures of pneumonia and time to convalescence or recovery of under five admitted pneumonia patients at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. Methods A prospective cohort study was conducted among a randomly selected sample of 101 pneumonia patients using simple random sampling who were on follow up from December 2019 to February 2020. A Linear mixed effect model were used for the longitudinal outcomes and joint model for modeling both longitudinal and time to event outcomes jointly respectively. Results The significant values of shared parameters in the survival sub model shows that the use of joint modeling of multivariate longitudinal outcomes with the time to event outcome is the best model compared to separate models. The estimated values of the association parameters: − 0.297(p-value = 0.0021), − 0.121) (p-value = < 0.001) and 0.5452 (p-value = 0.006) indicates association of respiratory rate, pulse rate and oxygen saturation respectively with time to recovery. The significant values show that there is an evidence to say that there is a negative relationship between longitudinal measures of respiratory rate and pulse rate with time to recovery and there is positive relationship between longitudinal measures of oxygen saturation with time to recovery. Variables age, birth order, dangerous signs, severity and visit time were significant factors on the longitudinal measure of pulse rate. The significant factors related to longitudinal measures of oxygen saturation were birth order, severity and visit. From this we can conclude that birth order, severity and visit were significant variables that simultaneously affect the longitudinal measures of respiratory rate, pulse rate and oxygen saturation of patients at 5% level of significance. Conclusion Results of multivariate joint analysis shows that severity was significant variable that jointly affects the three longitudinal measures and time to recovery of pneumonia patients and we can conclude that patients with severe pneumonia have high values of respiratory rate and pulse rate as well as less amount of oxygen saturation and they need longer time to recover from the disease.
Background: Globally, pneumonia is the first infectious disease which is the leading cause of children under age five morbidity and mortality with 98% of deaths in developing countries.Objective: The study aimed to identify the determinant factors that jointly affect the longitudinal measures of pneumonia (respiratory rate, pulse rate and oxygen saturation) and time to convalescence or recovery of under five admitted pneumonia patients at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia.Methods:A prospective cohort study design was used on 101 sampled under five admitted pneumonia patients from December 2019 to February 2020. The study was conducted using joint model of longitudinal outcomes and survival outcomes.Results: The significant values of shared parameters in the survival sub model shows that the use of joint modeling of multivariate longitudinal outcomes with the time to event outcome is the best model compared to separate models. The estimated values of the association parameters for \({\gamma }\_1,\) \({\gamma }\_2 \text{a}\text{n}\text{d} {\gamma }\)_3 were -0.297, -0.121 and 0.5452 respectively and indicates that; respiratory rate and pulse rate were negatively related with recovery time, whereas oxygen saturation was positively associated with recovery time. As age of patients increased by one month, the average respiratory rate and pulse rate were significantly decreased by 0.3759 bpm and 1.1012 bpm respectively keeping other variables constant, but age has no information about oxygen saturation.Conclusion: Residence, birth order, severity and visit were found as determinants of the longitudinal measures of pneumonia and time to recovery of under-five admitted pneumonia patients jointly. To improve child survival, the community should be responsible for post ponding child birth and marriage.
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