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African Health Sciences
Makerere University Medical School
ISSN: 1680-6905
EISSN: 1680-6905
Vol. 2, No. 14, 2014, pp. 397-407
Bioline Code: hs14059
Full paper language: English
Document type: Research Article
Document available free of charge

African Health Sciences, Vol. 2, No. 14, 2014, pp. 397-407

 en Hypoxemia predicts death from severe falciparum malaria among children under 5 years of age in Nigeria: the need for pulse oximetry in case management
Adebola, Orimadegun; Babatunde, Ogunbosi & Bose, Orimadegun

Abstract

Background: Oxygen saturation is a good marker for disease severity in emergency care. However, studies have not considered its use in identifying individuals infected with Plasmodium falciparum check for this species in other resources at risk of deaths.
Objective: To investigate the prevalence and predictive value of hypoxaemia for deaths in under-5s with severe falciparum malaria infection.
Methods: Oxygen saturation was prospectively measured alongside other indicators of disease severity in 369 under-5s admitted to a tertiary hospital in Nigeria. Participants were children in whom falciparum malaria parasitaemia was confirmed with blood film microscopy in the presence of any of the World Health Organization-defined life-threatening features for malaria.
Results: Overall mortality rate was 8.1%. Of the 16 indicators of the disease severity assessed, hypoxaemia (OR=7.54; 95% CI=2.80, 20.29), co-morbidity with pneumonia (OR=19.27; 95% CI=2.87, 29.59), metabolic acidosis (OR=6.21; 95% CI=2.21, 17.47) and hypoglycaemia (OR=19.71; 95% CI=2.61, 25.47) were independent predictors of death. Cerebral malaria, male gender, wasting, hypokalaemia, hyponatriaemia, azotaemia and renal impairment were significantly associated with death in univariate analysis but not logistic regression model.
Conclusions: Hypoxaemia predicts deaths in Nigerian children with severe malaria, irrespective of other features. Efforts should always be made to measure oxygen saturation as part of the treatments for severe malaria in children.

Keywords
Severe malaria; Under-5 mortality; Oxygen saturation; Hypoxaemia

 
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