Trial reportPediatrics2013
Childhood anemia at high altitude: risk factors for poor outcomes in severe pneumonia.
Trial report in Pediatrics, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- What are the risk factors for death among children with pneumonia in low- and middle-income countries? A systematic review.Journal of global health · 2023Pooled it
- The Effect of Anemia on Mortality in Children Hospitalized with Severe Pneumonia in Uganda.The Journal of pediatrics · 2026Article
- A cross-sectional study on the growth and development of preterm infants during the first year of life in Tibet's Lhasa Region.Medicine · 2026Article
- Development of the Respiratory System During Adolescence.Advances in experimental medicine and biology · 2026Review
- Pediatric pneumonia across altitudes in Ecuador: a countrywide, epidemiological analysis from 2010-2021.Italian journal of pediatrics · 2025Article
- Comparison of the Predictive Capacity of Oxygenation Parameters, Oxygenation Indices, and CURB-65 to Mortality, Mechanical Ventilation, and Vasopressor Support in Community-Acquired Pneumonia at Different Altitudes.Canadian respiratory journal · 2025Article
- Under-5 Malaria and Fever Morbidities as Correlates of Anaemia in Niger: A Heteroscedasticity-Consistent Ordered Probit Approach.International journal of environmental research and public health · 2024Article
- Employing supervised machine learning algorithms for classification and prediction of anemia among youth girls in Ethiopia.Scientific reports · 2024Article
- Epidemiology and mortality predictors for severe childhood community-acquired pneumonia in ICUs: A retrospective observational study.Frontiers in pediatrics · 2023Article
- Anemia is associated with severe illness in COVID-19: A retrospective cohort study.Journal of medical virology · 2021Observational
- Challenges in the diagnosis of paediatric pneumonia in intervention field trials: recommendations from a pneumonia field trial working group.The Lancet. Respiratory medicine · 2019Review
- Infant anemia is associated with reduced TLR-stimulated cytokine responses and increased nasopharyngeal colonization with Moxarella catarrhalis.Scientific reports · 2018Article
- Appropriateness of clinical severity classification of new WHO childhood pneumonia guidance: a multi-hospital, retrospective, cohort study.The Lancet. Global health · 2018Article
- Differences in Nutritional and Health Status in School Children from the Highlands and Lowlands of Bolivia.The American journal of tropical medicine and hygiene · 2018Article
- Etiology of severe pneumonia in Ecuadorian children.PloS one · 2017Observational
- Emergency treatment and nursing of children with severe pneumonia complicated by heart failure and respiratory failure: 10 case reports.Experimental and therapeutic medicine · 2016Article
- Estimating the mutation load in human genomes.Nature reviews. Genetics · 2015Review
- Risk factors for a poor outcome among children admitted with clinically severe pneumonia to a university hospital in Rabat, Morocco.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2014Article
Corrections and comments
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Authors and funding
11 authors at 8 institutions in 5 countries.
Funding
Abstract
backgroundPneumonia is the leading cause of mortality in young children globally, and factors that affect tissue delivery of oxygen may affect outcomes of pneumonia. We studied whether altitude and anemia influence disease severity and outcomes in young children with World Health Organization-defined severe pneumonia.
methodsWe analyzed data from the SPEAR (Severe Pneumonia Evaluation Antimicrobial Research) study, a World Health Organization- and USAID-sponsored multinational randomized controlled trial of antibiotics for severe pneumonia among children aged 2 to 59 months in resource-poor settings. The trial enrolled 958 children in 8 sites at varying elevations, classified as high (≥ 2000 m) or low (<2000 m) altitude. We compared illness severity and assessed the effect of anemia on treatment outcome at high and low altitudes, adjusting for potential confounders and study site.
resultsChildren at high altitudes had significantly lower oxygen saturation on presentation, more cyanosis, lower systolic blood pressure, and higher hemoglobin. After adjusting for potential confounders, anemia predicted treatment failure in children living at high altitude (relative risk: 4.07; 95% confidence interval: 2.60-6.38) but not at low altitude (relative risk: 1.12; 95% confidence interval: 0.96-1.30). Children at high altitude took longer to reach normoxemia than did children at lower altitudes (5.25 vs 0.75 days; P < .0001).
conclusionsChildren at high altitude present with more severe disease, and children with anemia at high altitude are at greater risk of poor outcome when being treated for severe pneumonia. Given the high global prevalence of anemia among young children, prevention and treatment of anemia should be a priority in children living at high altitude and could improve outcomes of pneumonia.
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