Survival among pneumonic children: A prospective study of western Odisha

Introduction: Pneumonia is still the leading cause of morbidity and mortality of our country, approximately 16% of deaths among children under 5 years of age globally and as per NITI Aayog report 2015; the under-five mortality rate (U5MR) of Odisha is 39 and the most common causes of under-five mortality being pneumonia. Many studies have been done on pneumonic children but currently survival analysis of these children is rare. Methods: The present observational, analytical, hospital based prospective cohort study was conducted over a period of 12 months in a tertiary hospital of western Odisha. Total 152 children were included in the study after satisfying the predefined inclusion and exclusion criteria and ethical committee approval by simple consecutive sampling method. CRF was used to record all relevant data of the study participants and SPSS v25 was used for survival analysis. Results: Median duration of survival in days of children with severe pneumonia (8.0, 6.60 to 9.39) is not significantly higher than the children with very severe pneumonia (7.0, 4.89 to 9.10) as evidenced by Breslow chi-square = 3.93 (1), p = 0.057. There is no overall difference in survival among gender, immunization status, breast feeding status, exposure to smoke, socio economic groups and gestational age as evidenced by p > 0.05. Conclusion: Disease survival (time to event analysis) is not affected by the severity (severe vs very severe pneumonia) of the illness, which may be due to the fact that late diagnosis and late referral from the peripheral centre. So the skill of the health workers and the health technologies should be strengthened at the primary level.