Title:
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Hypoxaemia in Mozambican children < 5 years of age admitted
to hospital with clinical severe pneumonia: clinical features
and performance of predictor models
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Author:
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Bassat Orellana, Quique; Lanaspa, Miguel; Machevo, Sonia; O'Callaghan Gordo, Cristina; Madrid, Lola; Nhampossa, Tacilta; Acácio, Sozinho; Roca, A.; Alonso, Pedro
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Abstract:
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OBJECTIVE: To determine the prevalence of hypoxaemia among
under-five children admitted to hospital with clinical severe
pneumonia, and to assess the performance to diagnose hypoxaemia
of models based on clinical signs. METHODS: We conducted a
hospital-based survey in a district hospital from Southern
Mozambique. RESULTS: A total of 825 children were recruited
after obtaining an informed consent. The prevalence of
hypoxaemia on admission was 27.9%, and 19.8% of these children
died (OR compared to non-hypoxaemic children 3.22, 95%CI 1.98 -
5.21, p<0.001). The model with larger area under the ROC
curve (AUC-ROC) to predict hypoxaemia included cyanosis or
thoracoabdominal breathing or respiratory rate >/= 70 breaths
per minute. None of the models performed well when tested in
different case scenarios of oxygen availability through
mathematical modelling, with over 50% of hypoxaemic children not
receiving oxygen even in favourable case scenarios. CONCLUSIONS:
Clinical signs alone or in combination are not suitable to
diagnose hypoxaemia. The use of pulse oximeters should be
strongly encouraged. This article is protected by copyright. All
rights reserved. |
Subject(s):
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-Infants -Pneumònia -Moçambic -Children -Pneumonia -Mozambique |
Rights:
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(c) Wiley Online Library, 2016
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Document type:
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Article Article - Accepted version |
Published by:
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Wiley Online Library
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