n South African Journal of Child Health - Acute lower respiratory infections in children : editorial




In this issue, we publish an article from Nigeria on the association of hypoxaemia with the outcome in children under the age of 5 years admitted with pneumonia. In this study, children with hypoxaemia (pulse oximetry SpO2 <90%) were 48 times more likely to die, and those who survived were likely to spend almost twice as long in hospital as those who were not hypoxaemic. The overall mortality rate of admitted children with pneumonia was 8.5%, but all the deaths occurred in those who were hypoxaemic on admission (giving a mortality rate of 20% in that group). In a very recent systematic review of risk factors for mortality from acute lower respiratory infections (ALRIs) in <5-year old children in low- and middle-income countries (95% of all deaths from ALRIs occur in these countries), the major risk factors were the diagnosis of very severe pneumonia using the World Health Organization (WHO) definition, being <2 months of age, and having underlying chronic disease, HIV or severe malnutrition. The usual socioeconomic and environmental factors also contributed, namely young maternal age, low maternal education, second-hand smoke exposure and indoor air pollution.


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