Treatment failure among children under 5 years hospitalized with pneumonia at the pediatric ward of Mbarara Regional Referral Hospital in Southwestern Uganda: a prospective observational study.

Background: Pneumonia remains a significant global health concern, particularly for children in low- and middle-income countries. Despite advancements in medical care and the availability of effective medication, treatment failure still occurs. Objective: This study evaluated the incidence, associated factors, and outcomes of treatment failure among children under 5 years with pneumonia. Design: A prospective observational study. Method: We conducted this study among children under 5 years hospitalized with pneumonia at the pediatric ward of Mbarara Regional Referral Hospital over a period of 3 months. We enrolled the participants in the study consecutively. Data was analyzed using SPSS software Version 27. Logistic regression was used to determine factors associated with treatment failure. Results: A total of 216 children aged between 0 and 59 months were included in the study. The incidence of treatment failure after 48 h was 53 (24.5%). A total of 32 (60.4%) cases of treatment failure occurred early (between 48 and 72 h), while 21 (39.6%) occurred late (after 72 h). Distance of >5 km from the nearest health facility (adjusted odds ratio (AOR) = 2.2, 95% CI: 1.1-4.4, Conclusion: Our study identified a high incidence of treatment failure among children under 5 years in this setting. There is a need for early and accurate diagnosis, which includes culture and sensitivity tests, timely initiation of effective antibiotic therapy, active pharmacovigilance, and close monitoring of patients with acute malnutrition to reduce the likelihood of treatment failure.