Objective: To determine the prevalence of hypoxaemia among under-five children admitted to hospital with clinical severe pneumonia and to assess the performance to diagnose hypoxaemia of models based on clinical signs.
Methods: We conducted a hospital-based survey in a district hospital from Southern Mozambique.
Results: A total of 825 children were recruited after obtaining an informed consent. The prevalence of hypoxaemia on admission was 27.9%, and 19.8% of these children died (OR compared with non-hypoxaemic children 3.22, 95% CI 1.98-5.21, P < 0.001). The model with larger area under the ROC curve (AUC-ROC) to predict hypoxaemia included cyanosis or thoracoabdominal breathing or respiratory rate ≥70 breaths per minute. None of the models performed well when tested in different case scenarios of oxygen availability through mathematical modelling, with over 50% of hypoxaemic children not receiving oxygen even in favourable case scenarios.
Conclusions: Clinical signs alone or in combination are not suitable to diagnose hypoxaemia. The use of pulse oximeters should be strongly encouraged.
Keywords: Mozambique; child; clinical decision-making; enfant; hipoxemia; hypoxaemia; hypoxémie; infant; lactante; neumonía; niño, preescolar; nourrisson; pneumonia; pneumonie; preschool; prise de décision clinique; préscolaire; toma de decisiones clínica.
© 2016 John Wiley & Sons Ltd.