Pulse oximetry in paediatric primary care in low-income and middle-income countries

McCollum, Eric D.; King, Carina; Colbourn, Tim; Graham, Hamish; Bernstein, Mike; Wilson, Iain

doi:10.1016/s2213-2600(19)30358-3

Cited by 16 publications

(23 citation statements)

References 10 publications

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“…Previous studies suggest that if these HCWs were provided with equipment, training, and modification of their treatment guidelines they could quickly become skilled at using oximetry and using it to improve decision-making. 1 10 14 15 37 Similarly, caregivers in our study were not familiar with oximetry and it was not used to explain or persuade. Hospital experience from Nigeria suggests that caregivers respond positively to oximetry and may be more likely to follow HCW recommendations if hypoxaemia is explained.…”

Section: Discussionmentioning

confidence: 98%

“…[6][7][8] However, despite WHO primary care guidelines encouraging pulse oximetry screening for young children with respiratory illness, 9 pulse oximetry availability and use in primary care settings is rare. [10][11][12] Previous studies in Africa and Asia-Pacific regions have shown that very few HCWs in primary care facilities have pulse oximeters or are trained to use them, even though it is a simple and acceptable technology. [10][11][12][13][14][15] The COVID19 pandemic has brought overdue public urgency and awareness of the longstanding need to strengthen pulse oximetry and oxygen systems in healthcare facilities in low-and middle-income countries (LMICs) -but we have limited data to guide implementation in primary care settings.…”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12] Previous studies in Africa and Asia-Pacific regions have shown that very few HCWs in primary care facilities have pulse oximeters or are trained to use them, even though it is a simple and acceptable technology. [10][11][12][13][14][15] The COVID19 pandemic has brought overdue public urgency and awareness of the longstanding need to strengthen pulse oximetry and oxygen systems in healthcare facilities in low-and middle-income countries (LMICs) -but we have limited data to guide implementation in primary care settings. [16][17][18][19][20][21][22] Limited data suggests that pulse oximetry performed by primary care healthcare workers (HCWs) is feasible and can improve clinical decision-making and referral outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…numbers of patient referred and burden on larger hospitals). 10 This study aimed to assess the prevalence and management of hypoxaemia among children and adults presenting to level III health centres (HCIII) facilities in Busoga and North Buganda regions in Uganda.…”

Section: Introductionmentioning

confidence: 99%

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Hypoxaemia prevalence and management among children and adults presenting to primary care facilities in Uganda: a prospective cohort study

Graham

Kamuntu²,

Miller

et al. 2021

Preprint

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Introduction Hypoxaemia (low blood oxygen) is common among hospitalised patients, increasing risk of death five-fold and requiring prompt detection and treatment. However, we know little about hypoxaemia prevalence in primary care and the role for pulse oximetry and oxygen therapy. This study assessed the prevalence and management of hypoxaemia at primary care facilities in Uganda. Methods Prospective cohort study in 30 primary care facilities in Uganda, Feb-Apr 2021. Clinical data collectors assessed blood oxygen level (SpO2) of all acutely unwell children, adolescents, and adults, and followed up children aged under 15 years with SpO2<93% to determine subsequent care and outcome. Primary outcome: proportion of children under 5 years of age with severe hypoxaemia (SpO2<90%). Secondary outcomes: severe/moderate hypoxaemia (SpO2 90-93%) by age/sex/complaint. Results Among children U5, the prevalence of severe hypoxaemia was 1.3% (95% CI 0.9 to 2.1); an additional 4.9% (3.9 to 6.1) had moderate hypoxaemia. Performing pulse oximetry according to World Health Organization guidelines exclusively on children with respiratory complaints would have missed 14% (3/21) of severe hypoxaemia and 11% (6/55) of moderate hypoxaemia. Hypoxaemia prevalence was low among children 5-14 years (0.3% severe, 1.1% moderate) and adolescents/adults 15+ years (0.1% severe, 0.5% moderate). A minority (12/27, 44%) of severely hypoxaemic patients were referred; 3 (12%) received oxygen. Conclusion Hypoxaemia is common among acutely unwell children under five years of age presenting to Ugandan primary care facilities. Routine pulse oximetry has potential to improve referral, management and clinical outcomes. Effectiveness, acceptability, and feasibility of pulse oximetry and oxygen therapy for primary care should be investigated in implementation trials.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hypoxaemia prevalence and management among children and adults presenting to primary care facilities in Uganda: a prospective cohort study

Graham

Kamuntu²,

Miller

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…There is no rapid diagnostic test for pneumonia, and the most effective tool to identify patients with severe pneumonia (pulse oximetry) is absent in most low resource facilities. 7 Studies have shown that access to pulse oximetry, oxygen, and antibiotics is alarmingly low. 8,9 However, SARS-CoV-2 has created the conditions to address some of these glaring gaps.…”

mentioning

confidence: 99%