ArticleThe Lancet. Global health2020
Effects of high altitude on respiratory rate and oxygen saturation reference values in healthy infants and children younger than 2 years in four countries: a cross-sectional study.
Article in The Lancet. Global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02944682 (Household Air Pollution and Health), which is not on this map. Cited by 22 papers.
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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.
Household Air Pollution and Health: A Multi-country LPG Intervention Trial
Who cites it
22 citing papers in PubMed, 41 citations in OpenAlex.
- Exposure to Household Air Pollution From Biomass Cooking and Severe Pneumonia in Infants.JAMA network open · 2025Trial
- Liquefied Petroleum Gas or Biomass Cooking and Severe Infant Pneumonia.The New England journal of medicine · 2024Trial
- Facing the Realities of Pragmatic Design Choices in Environmental Health Studies: Experiences from the Household Air Pollution Intervention Network Trial.International journal of environmental research and public health · 2022Trial
- Variations in Pulse-Oxygen Saturation and Physical Development within the First 2 Hours after Birth Among Healthy Term Neonates Different Altitudes.Physiological research · 2026Article
- Newborn brain development comparison of plateau and plain regions: insights from quantitative EEG.Pediatric research · 2026Article
- Reconstructing severe acute respiratory infection dynamics from ICD-10 hospital discharge data: a 10-year analysis of 11.2 million discharges in Ecuador, 2014-2023.Frontiers in public health · 2026Article
- Exacerbation of Asthma Among Pediatric Patients Presenting to the Emergency Department.Journal of clinical medicine · 2025Review
- Sepsis in Critically Ill Children in Bolivia: Multicenter Retrospective Evaluation of the Phoenix Criteria for Sepsis in a 2023 Cohort.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2025Article
- Normative pulse oximetry values in healthy children: A cross-sectional study from Jeddah, Saudi Arabia.Saudi medical journal · 2025Article
- Pulse Oximetry Screening for Critical Congenital Heart Defects: Effectiveness and Implementation across Clinical Settings.Cardiology and cardiovascular medicine · 2025Article
- Respiratory rates among rural Gambian children: a community-based cohort study.Scientific reports · 2024Article
- [Cerebral oxygen metabolism and brain electrical activity of healthy full-term neonates in high-altitude areas: a multicenter clinical research protocol].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2024Article
- High-altitude cerebral oxygen saturation detection using wireless wearable cerebral oximeter.Frontiers in neurology · 2024Article
- Resources and Geographic Access to Care for Severe Pediatric Pneumonia in Four Resource-limited Settings.American journal of respiratory and critical care medicine · 2022Article
- Vital sign predictors of severe influenza among children in an emergent care setting.PloS one · 2022Article
- Defining hypoxaemia from pulse oximeter measurements of oxygen saturation in well children at low altitude in Bangladesh: an observational study.BMJ open respiratory research · 2021Observational
- The diagnosis of respiratory disease in children using a phone-based cough and symptom analysis algorithm: The smartphone recordings of cough sounds 2 (SMARTCOUGH-C 2) trial design.Contemporary clinical trials · 2021Article
- [Paediatric Life Support].Notfall & rettungsmedizin · 2021Review
- A Risk Assessment Tool for Resumption of Research Activities During the COVID-19 Pandemic.Research square · 2020Article
- Pulse oximetry curves in healthy children living at moderate altitude: a cross-sectional study from the Ecuadorian Andes.BMC pediatrics · 2020Article
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Authors and funding
14 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundIn resource-limited settings, pneumonia diagnosis and management are based on thresholds for respiratory rate (RR) and oxyhaemoglobin saturation (SpO
methodsIn this cross-sectional study, we enrolled healthy children aged 0-23 months who lived within the study areas in India, Guatemala, Rwanda, and Peru. Participants were excluded if they had been born prematurely (<37 weeks gestation); had a congenital heart defect; had history in the past 2 weeks of overnight admission to a health facility, diagnosis of pneumonia, antibiotic use, or respiratory or gastrointestinal signs; history in the past 24 h of difficulty breathing, fast breathing, runny nose, or nasal congestion; and current runny nose, nasal congestion, fever, chest indrawing, or cyanosis. We measured RR either automatically with the Masimo Rad-97, manually, or both, and measured SpO
findingsBetween Nov 24, 2017, and Oct 10, 2018, we screened 2027 children for eligibility. 335 were ineligible, leaving 1692 eligible participants. 30 children were excluded because of missing values and 92 were excluded because of measurement or data entry errors, leaving 1570 children in the final analysis. 404 participants were from India (altitude 1-919 m), 389 were from Guatemala (1036-2017 m), 341 from Rwanda (1449-1644 m), and 436 from Peru (3827-4348 m). Mean age was 7·2 months (SD 7·2) and 796 (50·7%) of 1570 participants were female. Although average age was mostly similar between settings, the average participant age in Rwanda was noticeably younger, at 5·5 months (5·9). In the 1570 children included in the analysis, mean RR was 31·9 breaths per min (SD 7·1) in India, 41·5 breaths per min in Guatemala (8·4), 44·0 breaths per min in Rwanda (10·8), and 48·0 breaths per min in Peru (9·4). Mean SpO
interpretationWHO cutoffs for fast breathing and hypoxaemia overlap with RR and SpO
fundingUS National Institutes of Health, Bill & Melinda Gates Foundation.
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