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.