Kusse Koirita Toitole, doctoral student in the East Tennessee State University College of Public Health Department of Health Services Management and Policy, is co-author of an article in Frontiers in Public Health. The article is titled, “Adherence to WHO guidelines on severe pneumonia management in children and its impact on outcome: an observational study at Jinka General Hospital in Ethiopia.”
Jinka General Hospital is the only referral hospital in South Omo Zone of Ethiopia and is located about 466 miles to the southwest of the Ethiopian capital, Addis Ababa. South Omo zone is one of the most culturally diverse, but also among the least developed zones in Ethiopia and because of its location at the international border with Kenya and South Sudan, it is prone to cross-border disease epidemics.
“I worked in South Omo zone as a project manager for an international health NGO called Doctors with Africa from November 2021 until end of December 2022 (just 3 days before I came to US for my DrPH study),” said Toitole. “The main project I oversaw was focused on maternal and child health, the other projects included hepatitis B prevention and control, small-scale solar projects aimed at enhancing institutional delivery, among others.”
This study sought to determine the adherence to World Health Organization guidelines on severe pneumonia first-line treatment in children and to assess the impact of non-adherence on patient outcomes. An observational study was conducted on all children (2–59 months) clinically diagnosed with severe pneumonia and admitted to the Pediatric Ward of Jinka Hospital from June 2021 through the end May 2022.
During the observational period, 266 patients aged between 2 and 59 months were registered as having severe pneumonia. After excluding 114 patients due to missing charts or other exclusion criteria, a total of 152 patients were included in the analysis. Overall, 75 (49%) patients received therapy according to the WHO guidelines. Compared to patients treated adherently to the guidelines, patients not treated adherently had similar outcomes.
The study found adherence to the revised WHO guidelines was limited and not associated with outcomes. Less than half of children received a treatment adherent to the WHO guidelines. Alternative antibiotic schemes did not prove superior to guideline-recommended schemes. Efforts should focus on understanding the causes and filling the gap between theory and practice. The fight against antimicrobial resistance should include a step up in quality monitoring systems in low-income countries where data are missing.