Clinical predictors of hypoxaemia in Gambian children with acute lower respiratory tract infection: prospective cohort study

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Abstract
Objectives: To determine clinical correlates and outcome of hypoxaemia in children admitted to hospital with an acute lower respiratory tract infection. Design: Prospective cohort study. Setting: Paediatric wards of the Royal Victoria Hospital and the hospital of the Medical Research Council's hospital in Banjul, the Gambia. Subjects: 1072 of 42 848 children, aged 2 to 33 months, who were enrolled in a randomised trial of a Haemophilus influenzae type b vaccine in the western region of the Gambia, and who were admitted with an acute lower respiratory tract infection to two of three hospitals. Main outcome measures: Prevalence of hypoxaemia, defined as an arterial oxygen saturation Results: 1072 children aged 2-33 months were enrolled. Sixty three (5.9%) had an arterial oxygen saturation Conclusion: In children with an acute lower respiratory tract infection, simple physical signs that require minimal expertise to recognise can be used to determine oxygen therapy and to aid in screening for referral. The association between hypoxaemia and death highlights the need for early recognition of the condition and the potential benefit of treatment.