Magnitude and Associated Factors of Ventilator-Associated Pneumonia In Pediatric Intensive Care Unit, Tash Addis Ababa, Ethiopia
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Date
2025-02-19
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Addis Ababa University
Abstract
Background: Ventilator-associated pneumonia (VAP) is a lung infection that occurs in patients who have been receiving mechanical ventilation through an endotracheal or tracheostomy tube for more than 48 hours. [1]. In critically ill children, VAP is a severe complication which can lead to an increased length of stay in the hospital along with increased costs of healthcare services due to increased morbidity and mortality rates [2, 3, 4, 5]. However, it seems that concerning VAP, there is not much research done in Ethiopia concerning this critical problem.
Objective: This study aimed to describe Magnitude and Associated Factors of VentilatorAssociated Pneumonia in Pediatric Intensive Care Unit, TASH Addis Ababa, Ethiopia
Methods: A retrospective Hospital-based cross-sectional study design was used. A total of 250 patient records kept in TASH from September 11, 2019 to January 8, 2025. Data were collected by using a checklist through Google form and analyzed using SPSS version 27 software package. Mean and standard deviation were used to describe Continuous data and frequency and percentage were used to describe categorical data to identify factors associated with the VAP, bi-variable analysis with P value <0.25 and multivariable analysis with P value <0.05 binary logistic regression analyses were performed. Statistical significance was set at a 5% level, and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated to present the strength of the associated factors.
Result: A total of 250 patients were included (56.4% male), with a median age category of 1–5 years. 16.8% of patients had ventilator-associated pneumonia (VAP) (95% CI: 12.4%–22%). VAP was more common among males (78.6%) and in patients older than 5 years (47.6%). Patients with VAP had a significantly longer mean duration of mechanical ventilation (18.0 ± 9.9 vs. 6.1 ± 6.1 days) than patients without the condition. The most common admission sources were Emergency OPD (49.6%) and pediatric ward (27.6%). Acute respiratory failure (52.8%) and impaired consciousness (41.2%) were the leading indications for ventilation. Frequent comorbidities included malignancy (7.6%) and severe acute malnutrition (5.6%). VIII The most prevalent risk factors were nasogastric tube (NGT) feeding (20.1%), continuous intravenous sedation (15.8%), and steroid use (15.3%), followed by PPI use (12%), aspiration (7.7%), and re-intubation (5.3%).
Conclusion: Ventilator-associated pneumonia (VAP) was identified in 16.8% of mechanically ventilated children in the PICU at TASH. VAP was associated with prolonged ventilation and was more frequent in older children and males. Common risk factors included NGT feeding, continuous IV sedation, and steroid use. To lessen the burden of VAP, prevention measures must be strengthened and modifiable risk factors must be addressed.
Key words: Magnitude, Ventilator associated Pneumonia, pediatrics, ICU, Factors TASH, Ethiopia
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Magnitude Ventilator associated Pneumonia pediatrics ICU Factors TASH Ethiopia