Objective: About one-third of all childhood deaths are due to Pneumonia with high respiratory rate/acute respiratory infections. Respiratory rate is used as a preliminary health indicator in the diagnosis and progression of Pneumonia. The current study was conducted to identify factors associated with tachypnea. Material and Methods: Quasi-Poisson modeling using generalized linear mixed-effects (GLM) and multiple logistic regressions models were used to analyze the study variable. The data were extracted from each patient's hospital chart. Parameter estimation was conducted using penalized quasi-likelihood estimation. Results: Four-hundred, fifty-three Pneumonia patients under-five years of age were included in the study. From the main effects, body temperature (adjusted rate ratio (ARR= 1.01, p<0.001), length of hospital stay (ARR=0.92, p<0.001), previous cough history (ARR= 1.03, p=0.0135), and season (summer: ARR= 0.98, p=0.0021; autumn: ARR=0.99952, p=0.0032; spring: ARR= 0.90, p=0.02) had a significant effect on variation of acute respiratory rate in Pneumonia patients. Interaction effects that were significant for the variable of interest included visiting times with family disease history, age with breast feeding history, and length of hospital stay with previous disease history. Conclusion: Certain groups of Pneumonia patients (those with high temperature, previous disease history, and family disease history) need special intervention to reduce the risk of acute respiratory rate in Pneumonia patients. Parents should be educated to follow up their children for health checks whenever breathing rate becomes fast or increases. Special attention should be given to patients with a previous disease history, family disease history, and those hospitalised during the winter season.
Keywords: Acute respiratory rate; generalized linear mixed model; pneumonia; under-five children; Ethiopia
Amaç: Tüm çocukluk ölümlerinin yaklaşık üçte biri yüksek solunum hızlı pnömoni/akut solunum yolu enfeksiyonları nedeniyle meydana gelmektedir. Solunum hızı, pnömoninin tanısı ve ilerlemesi için bir ön sağlık göstergesi olarak kullanılmaktadır. Bu çalışma, Kuzey- Batı Etiyopya'daki Felege Hiwot Başvuru Hastanesinde pnömoni ile hastaneye yatırılan beş yaşın altındaki çocuklarda takipne ile ilişkili faktörleri belirlemek amacıyla yapılmıştır. Gereç ve Yöntemler: Çalışma değişkenini analiz etmek için genelleştirilmiş doğrusal karışık etkiler ve çoklu lojistik regresyon modelleri kullanan Quasi-Poisson modellemesi kullanılmıştır. Veriler, hastaların hastane kayıtlarından elde edilmiştir. Parametre tahmini, penalize yarı-olabilirlik tahmini kullanılarak yapılmıştır. Bulgular: Çalışmaya 5 yaşın altında 453 pnömoni hastası alınmıştır. Ana etkilerden vücut ısısı [ayarlanmış hız oranı (ARR)=1.01, p<0.001], hastanede kalış süresi (ARR=0.92, p<0.001), önceki öksürük öyküsü (ARR=1.03, p=0.0135) ve mevsim (yaz: ARR=0.98, p=0.0021; sonbahar: ARR=0.99952, p=0.0032; ilkbahar: ARR=0.90, p=0.02) pnömoni hastalarında akut solunum hızı varyasyonu üzerinde anlamlı bir etkiye sahipti. İlgilenilen değişken için anlamlı olan etkileşim etkileri arasında aile öyküsü ile ziyaret süreleri, emzirme öyküsü ile yaş ve önceki hastalık nedeniyle hastanede kalış süresi yer almaktadır. Sonuç: Bazı pnömoni hasta grupları (yüksek ateşi, önceki hastalık öyküsü ve ailede hastalık öyküsü olanlar) akut solunum hızı riskini azaltmak için özel müdahaleye ihtiyaç duyarlar. Anne-babalar, solunum hızı hızlandığında veya arttığında çocuklarını sağlık kontrolleri için takip etmeleri konusunda eğitilmelidir. Daha önce hastalık öyküsü olan, ailesinde hastalık öyküsü olan ve kış mevsiminde hastaneye yatırılan hastalara özel dikkat gösterilmelidir.
Anahtar Kelimeler: Akut solunum hızı; genelleştirilmiş doğrusal karma model; pnömoni; beş yaşından küçük çocuklar; Etiyopya
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