Incidence and Outcome of Severe Acute Respiratory Infections Among Children Under Five at University of Uyo Teaching Hospital, South South Nigeria

Severe acute respiratory infections (SARI) remain a leading cause of paediatric hospital admission and mortality in sub-Saharan Africa. This retrospective descriptive study determines the incidence, clinical profile, and outcomes of SARI among children under five years admitted to the paediatric unit of the University of Uyo Teaching Hospital (UUTH), Akwa Ibom State, South South Nigeria, over a three-year period from 2021 to 2023. Medical records of 396 children meeting WHO criteria for SARI were reviewed. Key variables included age, sex, nutritional status, oxygen saturation on admission, diagnosis, treatment received, and clinical outcome. Pneumonia was the primary diagnosis in 71.2% of SARI cases. Among pneumonia cases, 34.6% were classified as very severe. Malnutrition coexisted with SARI in 43.4% of cases and was a significant predictor of mortality (OR 4.2, 95% CI 2.4-7.3). Oxygen supplementation was required in 61.9% of cases, yet oxygen availability was interrupted in 28.6% of facilities. Case fatality rate was 12.6%, highest in children under 12 months (18.3%). Delayed presentation was documented in 54.5% of fatal cases. Seasonal clustering of SARI was observed, peaking during the harmattan season from November to February. The study recommends strengthening oxygen therapy infrastructure, improving caregiver recognition of respiratory danger signs, and expanding pneumococcal and influenza vaccination coverage. Keywords: SARI, pneumonia, under-five mortality, UUTH, South South Nigeria.