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Pulse oximetry for children with pneumonia treated as outpatients in rural Malawi

McCollum, ED; King, C; Deula, R; Zadutsa, B; Mankhambo, L; Nambiar, B; Makwenda, C; ... Colbourn, T; + view all (2016) Pulse oximetry for children with pneumonia treated as outpatients in rural Malawi. Bulletin of the World Health Organization , 94 (12) pp. 893-902. 10.2471/BLT.16.173401. Green open access

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Abstract

OBJECTIVE: To investigate implementation of outpatient pulse oximetry among children with pneumonia, in Malawi. METHODS: In 2011, 72 health-care providers at 18 rural health centres and 38 community health workers received training in the use of pulse oximetry to measure haemoglobin oxygen saturations. Data collected, between 1 January 2012 and 30 June 2014 by the trained individuals, on children aged 2-59 months with clinically diagnosed pneumonia were analysed. FINDINGS: Of the 14 092 children included in the analysis, 13 266 (94.1%) were successfully checked by oximetry. Among the children with chest indrawing and/or danger signs, those with a measured oxygen saturation below  90% were more than twice as likely to have been referred as those with higher saturations (84.3% [385/457] vs 41.5% [871/2099]; P < 0.001). The availability of oximetry appeared to have increased the referral rate for severely hypoxaemic children without chest indrawing or danger signs from 0% to 27.2% (P < 0.001). In the absence of oximetry, if the relevant World Health Organization (WHO) guidelines published in 2014 had been applied, 390/568 (68.7%) severely hypoxaemic children at study health centres and 52/84 (61.9%) severely hypoxaemic children seen by community health workers would have been considered ineligible for referral. CONCLUSION: Implementation of pulse oximetry by our trainees substantially increased the referrals of Malawian children with severe hypoxaemic pneumonia. When data from oximetry were excluded, retrospective application of the guidelines published by WHO in 2014 failed to identify a considerable proportion of severely hypoxaemic children eligible only via oximetry.

Type: Article
Title: Pulse oximetry for children with pneumonia treated as outpatients in rural Malawi
Location: Switzerland
Open access status: An open access version is available from UCL Discovery
DOI: 10.2471/BLT.16.173401
Publisher version: http://dx.doi.org/10.2471/BLT.16.173401
Language: English
Additional information: All articles are available under the Creative Commons Attribution 3.0 IGO licence (CC BY 3.0 IG0) (https://creativecommons.org/licenses/by/3.0/igo/)
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/1534025
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