BACKGROUND: Acute lower respiratory tract diseases are an important cause of mortality in children in resource-limited settings. In the absence of pulse oximetry, clinicians rely on clinical signs to detect hypoxaemia. OBJECTIVE: To assess the diagnostic value of clinical signs of hypoxaemia in children aged 2 months to 5 years with acute lower respiratory tract disease. METHODS: Seventy children with a history of cough and signs of respiratory distress were enrolled. Three experienced physicians recorded clinical signs and oxygen saturation by pulse oximetry. Hypoxaemia was defined as oxygen saturation <90%. Clinical predictors of hypoxaemia were evaluated using adjusted diagnostic odds ratios (aDOR). RESULTS: There was a 43% prevalence of hypoxaemia. An initial visual impression of poor general status [aDOR 20.0, 95% CI 3.8-106], severe chest-indrawing (aDOR 9.8, 95% CI 1.5-65), audible grunting (aDOR 6.9, 95% CI 1.4-25) and cyanosis (aDOR 26.5, 95% CI 1.1-677) were significant predictors of hypoxaemia. CONCLUSION: In children under 5 years of age, several simple clinical signs are reliable predictors of hypoxaemia. These should be included in diagnostic guidelines.
BACKGROUND: Acute lower respiratory tract diseases are an important cause of mortality in children in resource-limited settings. In the absence of pulse oximetry, clinicians rely on clinical signs to detect hypoxaemia. OBJECTIVE: To assess the diagnostic value of clinical signs of hypoxaemia in children aged 2 months to 5 years with acute lower respiratory tract disease. METHODS: Seventy children with a history of cough and signs of respiratory distress were enrolled. Three experienced physicians recorded clinical signs and oxygen saturation by pulse oximetry. Hypoxaemia was defined as oxygen saturation <90%. Clinical predictors of hypoxaemia were evaluated using adjusted diagnostic odds ratios (aDOR). RESULTS: There was a 43% prevalence of hypoxaemia. An initial visual impression of poor general status [aDOR 20.0, 95% CI 3.8-106], severe chest-indrawing (aDOR 9.8, 95% CI 1.5-65), audible grunting (aDOR 6.9, 95% CI 1.4-25) and cyanosis (aDOR 26.5, 95% CI 1.1-677) were significant predictors of hypoxaemia. CONCLUSION: In children under 5 years of age, several simple clinical signs are reliable predictors of hypoxaemia. These should be included in diagnostic guidelines.
Authors: Ahmed Ehsanur Rahman; Aniqa Tasnim Hossain; Mohammod Jobayer Chisti; David H Dockrell; Harish Nair; Shams El Arifeen; Harry Campbell Journal: J Glob Health Date: 2021-09-11 Impact factor: 4.413
Authors: Hamish Graham; Ayobami A Bakare; Adejumoke I Ayede; Oladapo B Oyewole; Amy Gray; David Peel; Barbara McPake; Eleanor Neal; Shamim A Qazi; Rasa Izadnegahdar; Trevor Duke; Adegoke G Falade Journal: EClinicalMedicine Date: 2019-10-24
Authors: Hamish R Graham; Ayobami A Bakare; Adejumoke I Ayede; Amy Z Gray; Barbara McPake; David Peel; Olatayo Olatinwo; Oladapo B Oyewole; Eleanor F G Neal; Cattram D Nguyen; Shamim A Qazi; Rasa Izadnegahdar; John B Carlin; Adegoke G Falade; Trevor Duke Journal: PLoS Med Date: 2019-11-11 Impact factor: 11.069