Prevalence and predictors of hypoxaemia in respiratory and non-respiratory primary diagnoses among emergently ill children at a tertiary hospital in south western Nigeria.
BACKGROUND
Hypoxaemia is a potentially harmful complication of both acute lower respiratory tract infections (ALRI) and non-ALRI in children but its contribution to burden and outcomes of hospital admissions in Africa is unclear. We investigated prevalence and predictors of hypoxaemia in ALRI and non-ALRI according to age and primary diagnoses in emergently ill children in south western Nigeria.


METHODS
In 1726 emergently ill children admitted to a tertiary hospital in Ibadan, south western Nigeria, oxygen saturation was measured shortly after admission. Hypoxaemia was defined as oxygen saturation <90%. Clinical features and the primary admission diagnoses were recorded. Prevalence of hypoxaemia according to age and diagnoses was calculated. Symptoms and signs associated with hypoxaemia were compared between children with ALRI and those with non-ALRI.


RESULTS
Hypoxaemia was detected in 28.6% (494/1726) of admissions. Prevalence of hypoxaemia varied in different conditions: it was 49.2% (154/313) in ALRI, 41.1% (188/454) in neonates, 27.2% (6/22) in post-neonatal tetanus, 23.3% (14/60) in sickle cell anaemia, 22.6% (38/168) in septicaemia and 14.4% (76/527) of malaria cases. Nasal flaring (OR 3.86; 95% CI 1.70 to 8.74) and chest retraction (OR 4.77; 95% CI 1.91 to 11.92) predicted hypoxaemia in ALRI but not in non-ALRI.


CONCLUSIONS
Hypoxaemia is common among Nigerian children admitted to an emergency unit and is associated with a poor outcome irrespective of primary admission diagnosis. Provision of equipment to measure oxygen saturation and facilities for effective oxygen delivery might substantially reduce mortality.
Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Adebola E
AE
Orimadegun
Babatunde O
BO
Ogunbosi
Shannon S
SS
Carson
D000208:Acute Disease; D000367:Age Factors; D000755:Anemia, Sickle Cell / Q000150:complications / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis* / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000150:complications / Q000453:epidemiology; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000097:blood*; D015995:Prevalence; D040841:Resource Allocation; D012141:Respiratory Tract Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors; D018805:Sepsis / Q000150:complications / Q000453:epidemiology; D012737:Sex Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
D010100:Oxygen
Acute lower respiratory infection; Emergently ill children; Hypoxaemia; Oxygen; Prevalence; Pulse oximetry