The clinical predictors of acute lower respiratory infections and oxygen desaturation in young children
Abstract
Two hundred and eighty children aged between 7 days to 36
months with a history of a cough less than 7 days duration were
examined for the presence of acute lower respiratory Infections
(ALRI) and oxygen desaturation. The presence of ALRI was
confirmed using chest radiographs and the oxygen desaturation
was measured using a pulse oximeter. Fifty eight point six
percent of the children studied were males and 41.4% were
females, and 46.1% were children aged 0 to 6 months.Fifty four
percent of the children studied had pneumonia radiologically
proved.Fifty nine percent of the children were desaturated with
oxygen saturation of less than 90%.
Supraclavicular recessions, respiratory rate greater 60 per
minute, and grunting, were the signs which had the best
correlation with pneumonia and desaturation in all the ag'e groups
(P=o.015,O.0001,O.004) respectively. Crepitations and rhonchi
were also good indicators of LRI in children older than 6
months(P=0.008, 0.0007) respectively.
Refusal to breast feed, grunting, and rapid breathing can be
used by the mother or community health worker to seek better
treatment in hospital in infants less than 6 months old. The
presence of the the above symptoms, other than refusal to breast
feed can be used to seek treatment in the older children.
The presence of chest indrawing, more specifically
supraclavicular recessions indicates severe LRI which warrants
hospital care in all the age groups.
Of the 280 patients studied, 8 ..6% died.The mortality was low
compared with earlier studies (1,5).The author followed the
patients for 5 days only, this could explain why the mortality in
this study was low.
Citation
Degree of Master of Medicine (paediatrics)Publisher
University of Nairobi Department Of Paediatrics
Description
A dissertation submitted in part fulfillment
for the Degree of Master of Medicine (paediatrics)
in the University of Nairobi