Prevalence and Clinical Predictors of Hypoxaemia in Hospitalized Children with Pneumonia in Northern Nigeria

Abstract

Background: Early detection of hypoxaemia and commencement of oxygen therapy improves the management outcome of children with pneumonia.

Objective: To find the prevalence of hypoxaemia and its clinical predictors amongst children presenting with pneumonia at a hospital in northeastern Nigeria.

Methods: Two hundred and ninety (290) children aged 2-59 months who presented to the Emergency Paediatric Unit of the hospital were studied from February 2016 to January 2017. They were selected based on the WHO-defined cases of pneumonia. General and systemic examination was carried out with particular emphasis on the respiratory system. Thereafter, arterial oxygen saturation was measured using a Nellcore Oximax® pulse oximeter.

Results: Hypoxaemia occurred in 169 (58.3%) children. The clinical features of pneumonia which were found to be significantly associated with hypoxaemia were cyanosis (p<0.001), inability to feed (p<0.001), head nodding (p<0.001) and impaired consciousness (p<0.001). The clinical features found most likely to independently predict hypoxaemia were head nodding (p = 0.009, OR = 6.834) and inability to feed (p = 0.000, OR = 16.33).

Conclusion: The prevalence of hypoxaemia in childhood pneumonia was high. The presence of a combination of cyanosis, head nodding, and inability to feed may be used to identify hypoxaemia and serve as a criterion for oxygen administration in children with pneumonia.