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Free Content The spectrum of hypoxaemia in children admitted to hospital in The Gambia, West Africa

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Abstract:

Summary Objective 

Hypoxia predicts mortality in children with acute lower respiratory infections (ALRIs). We investigated the prevalence and predictive value of hypoxia in ALRI and other acute infectious diseases. Methods 

We studied the spectrum of hypoxaemia in 4047 children admitted to a tertiary hospital in The Gambia. Oxygen saturation was measured shortly after admission. Severe hypoxaemia was defined as an oxygen saturation below 90%. Results 

5.8% of all admissions had severe hypoxaemia. Prevalence of hypoxaemia varied between disease groups: it was 11.7% in ALRI cases, 16.5% in neonates; 2.9% in malaria cases overall but 6.5% in cerebral malaria patients; and 2.7% in children with meningitis. Hypoxaemia predicted a poor outcome; the odds ratio for death among paediatric admissions overall was 7.45 [95% confidence intervals (CI) 5.40–10.29]. Surprisingly, it was lowest for children with ALRI [OR 3.53 (95% CI 1.13–10.59)], and higher for those with malaria 9.90 [95% CI 4.39–22.35]. Conclusion 

Hypoxaemia is common among Gambian children admitted to hospital and it is often associated with a poor outcome. A similar situation is likely in many other developing countries. Thus, equipment for measuring oxygen saturation, and facilities and equipment for effective oxygen delivery need to be made available in developing countries.

Keywords: The Gambia; acute lower respiratory infection; hypoxaemia; malaria; outcome predictor

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-3156.2006.01570.x

Affiliations: 1: University Children's Hospital, Zurich, Switzerland 2: Royal Victoria Hospital, Banjul, The Gambia 3: Medical Research Council Laboratories, Fajara, The Gambia

Publication date: March 1, 2006

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