Hypoxaemia in Hospitalised Children at the Emergency Unit of a Specialist Hospital in Gusau, North- Western Nigeria

Abstract

Introduction: Hypoxaemia is a common complication in hospitalised children, which can be detected using pulse oximeter, a valuable non-invasive and cost- effective tool. Indeed, in most developing countries, hypoxaemia is usually identified by clinical signs alone, and this has been shown to be insensitive. Objective: To determine the prevalence of hypoxaemia, socio-demographic and clinical predictors associated with hypoxaemia among hospitalised children in a Specialist Hospital in Gusau, Zamfara State, North-Western Nigeria. Methodology: A prospective, cross-sectional study of admissions into the Emergency Paediatric Unit of Ahmad Sani Yariman Bakura Specialist Hospital (ASYBSH), Gusau over a three (3) month period. Relevant information was recorded in a proforma and analysed accordingly. Hypoxaemia is defined as oxygen saturation <90% and all hypoxaemic children were provided with oxygen. Results: 217 children were studied of which 141(65.0%) were males with a M:F ratio of 1.9:1. Majority were diagnosed with severe malaria 59(27.2%), followed by Severe Acute Malnutrition (SAM) 39(18.0%) and Pneumonia 24(11.0%). Hypoxaemia was present in 26(12.0%) children, equally seen in both sexes. Predictors of hypoxaemia were tachypnoea (p=0.012, 95%CI 0.430-0.680) and chest indrawing (p=0.008, 95% CI 0.380-0.615). A total of 194 children (89.4%) were discharged while 18 (8.3%) died. Seven (38.9%) of the mortality had hypoxaemia. Case fatality rate for hypoxaemic children was high (i.e. 7/26=26.9%), and this was significant (Fischer’s exact=0.001). Conclusion: Hypoxaemia was common among children admitted to the emergency unit and found to be common in children with severe malaria. Tachypnoea and chest indrawing were associated with hypoxaemia. It was found to be associated with death irrespective of the diagnosis.  Pulse oximetry and blood gas analysis for diagnosis are highly recommended to reduce morbidity and mortality.