Retrospective study on the usefulness of pulse oximetry for the identification of young children with severe illnesses and severe pneumonia in a rural outpatient clinic of Papua New Guinea
| Autor: | Mario Gehri, Noémie Boillat-Blanco, Ivo Mueller, Blaise Genton, Julien Blanc, Nicolas Senn, Isabella Locatelli, Patricia Rarau |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Pediatric respiratory diseases Ambulatory Care/methods Ambulatory Care/organization & administration Child Preschool Community Health Centers/organization & administration Feasibility Studies Female Health Plan Implementation/organization & administration Humans Hypoxia/diagnosis Hypoxia/etiology Infant Oximetry Papua New Guinea Pneumonia/complications Pneumonia/diagnosis Randomized Controlled Trials as Topic Retrospective Studies Rural Health Services/organization & administration Severity of Illness Index Science macromolecular substances law.invention 03 medical and health sciences Papua Nova Guinea 0302 clinical medicine Randomized controlled trial law 030225 pediatrics Severity of illness medicine Ambulatory Care Outpatient clinic 030212 general & internal medicine Hypoxia Pneumologia pediàtrica Integrated Management of Childhood Illness Multidisciplinary medicine.diagnostic_test business.industry Health Plan Implementation Retrospective cohort study Community Health Centers Pneumonia medicine.disease Pulse oximetry Cohort Medicine Rural Health Services business |
| Zdroj: | Dipòsit Digital de la UB Universidad de Barcelona PloS one, vol. 14, no. 4, pp. e0213937 PLoS ONE, Vol 14, Iss 4, p e0213937 (2019) Recercat. Dipósit de la Recerca de Catalunya instname |
| Popis: | ObjectiveThis secondary analysis of data of a randomized controlled trial (RCT) retrospectively investigated the performance of pulse oximetry in identifying children with severe illnesses, with and without respiratory signs/symptoms, in a cohort of children followed for morbid episodes in an intervention trial assessing the efficacy of Intermittent Preventive Treatment for malaria in infants (IPTi) in Papua New Guinea (PNG) from June 2006 to May 2010.SettingThe IPTi study was conducted in a paediatric population visiting two health centres on the north coast of PNG in the Mugil area of the Sumkar District.ParticipantsA total of 669 children visited the clinic and a total of 1921 illness episodes were recorded. Inclusion criteria were: age between 3 and 27 months, full clinical record (signs/symptoms) and pulse oximetry used systematically to assess sick children at all visits. Children were excluded if they visited the clinic in the previous 14 days.OutcomesThe outcome measures were severe illness, severe pneumonia, pneumonia, defined by the Integrated Management of Childhood Illness (IMCI) definitions, and hospitalization.ResultsOut of 1921 illness episodes, 1663 fulfilled the inclusion criteria. A total of 139 severe illnesses were identified, of which 93 were severe pneumonia. The ROC curves of pulse oximetry (continuous variable) showed an AUC of 0.63, 0.68 and 0.65 for prediction of severe illness, severe pneumonia and hospitalization, respectively. Pulse oximetry allowed better discrimination between severe and non-severe illness, severe and non-severe pneumonia, admitted and non-admitted patients, in children ≤12-months of age relative to older patients. For the threshold of peripheral arterial oxygen saturation ≤ 94% measured by pulse oximetry (SpO2), unadjusted odds ratios for severe illness, severe pneumonia and hospitalization were 6.1 (95% Confidence Interval (CI) 3.9-9.8), 8.5 (4.9-14.6) and 5.9 (3.4-10.3), respectively.ConclusionPulse oximetry was helpful in identifying children with severe illness in outpatient facilities in PNG. A SpO2 of 94% seems the most discriminative threshold. Considering its affordability and ease of use, pulse oximetry could be a valuable additional tool assisting the decision to admit for treatment. |
| Databáze: | OpenAIRE |
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