ArticleBMJ global health2025
Care management and determinants of day 14 mortality in severely ill children aged under 5 years subsequent to hypoxaemia diagnosed using routine pulse oximetry in primary care: evidence from the AIRE project.
Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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21 citing papers in PubMed.
- Increasing equitable access to pulse oximetry: progress and considerations for sustainable scale-up in a changing global health landscape.BMJ global health · 2026Article
- Beyond pulse oximetry: lessons from the AIRE project on translating innovation into improved child survival.BMJ global health · 2026Article
- Added value of routine pulse oximetry use within Integrated Management of Childhood Illness guidelines in primary care in West Africa: insight from AIRE.BMJ global health · 2026Article
- Added value of routine pulse oximetry use within Integrated Management of Childhood Illness guidelines in primary care in West Africa: insight from AIRE.BMJ global health · 2026Article
- Added value of routine pulse oximetry use within Integrated Management of Childhood Illness guidelines in primary care in West Africa: insight from AIRE.BMJ global health · 2026Article
- Added value of routine pulse oximetry use within Integrated Management of Childhood Illness guidelines in primary care in West Africa: insight from AIRE.BMJ global health · 2026Article
- Added value of routine pulse oximetry use within Integrated Management of Childhood Illness guidelines in primary care in West Africa: insight from AIRE.BMJ global health · 2026Article
- Added value of routine pulse oximetry use within Integrated Management of Childhood Illness guidelines in primary care in West Africa: insight from AIRE.BMJ global health · 2026Article
- Acceptability of the routine use of pulse oximetry by healthcare workers and caregivers within primary healthcare in West Africa: mixed-methods study.BMJ global health · 2025Article
- Acceptability of the routine use of pulse oximetry by healthcare workers and caregivers within primary healthcare in West Africa: mixed-methods study.BMJ global health · 2025Article
- Acceptability of the routine use of pulse oximetry by healthcare workers and caregivers within primary healthcare in West Africa: mixed-methods study.BMJ global health · 2025Article
- Acceptability of the routine use of pulse oximetry by healthcare workers and caregivers within primary healthcare in West Africa: mixed-methods study.BMJ global health · 2025Article
- Understanding health innovation adoption: a realist evaluation of pulse oximeter implementation in primary care for children under 5 in four West African countries.BMJ global health · 2025Article
- Understanding health innovation adoption: a realist evaluation of pulse oximeter implementation in primary care for children under 5 in four West African countries.BMJ global health · 2025Article
- Understanding health innovation adoption: a realist evaluation of pulse oximeter implementation in primary care for children under 5 in four West African countries.BMJ global health · 2025Article
- Understanding health innovation adoption: a realist evaluation of pulse oximeter implementation in primary care for children under 5 in four West African countries.BMJ global health · 2025Article
- Prevalence and factors associated with severe illness in West African children under 5 years of age detected with routine pulse oximetry in primary care.BMJ global health · 2025Article
- Prevalence and factors associated with severe illness in West African children under 5 years of age detected with routine pulse oximetry in primary care.BMJ global health · 2025Article
- Prevalence and factors associated with severe illness in West African children under 5 years of age detected with routine pulse oximetry in primary care.BMJ global health · 2025Article
- Prevalence and factors associated with severe illness in West African children under 5 years of age detected with routine pulse oximetry in primary care.BMJ global health · 2025Article
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18 authors.
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Abstract
backgroundThe Amélioration de l'Identification des détresses Respiratoires de l'Enfant (AIRE) project introduced the routine use of pulse oximetry (PO) into Integrated Management of Childhood Illness (IMCI) consultations within primary health centres (PHCs) in Burkina Faso, Guinea, Mali and Niger. We analysed how severe cases were managed and 14-day mortality by hypoxaemia severity.
methodsAll children aged under 5 years attending IMCI consultations integrating PO use at 16 research PHCs and classified as severe cases (severe IMCI cases or severe hypoxemia: SpO
resultsFrom July 2021 to July 2022, 1998 severe cases were enrolled, including 10.6% aged <2 months; 7.1% had severe hypoxaemia, and 10.5% had moderate hypoxaemia (90%≤oxygen saturation≤93%). By day 14, 625 (31.3%) were referred, 463 (23.2%) hospitalised, and 95 children (4.8%) had died. Referral decisions, hospitalisations and oxygen therapy rates were significantly higher for severe hypoxaemic cases (83.8%, 82.3% and 34.5%, respectively) than for moderate hypoxaemic cases (32.7%, 26.5% and 7.1%, respectively) and cases without hypoxaemia (26.3%, 17.5% and 1.4%, respectively). Similarly, day 14 mortality rates were 26.1%, 7.5% and 2.3%, respectively. The aORs for mortality were severe hypoxaemia (9.34, 95% CI 5.08 to 17.16), moderate hypoxaemia (2.32, 95% CI 1.16 to 4.64), age <2 months (3.68, 95% CI 1.67 to 8.13), severe malaria (2.02, 95% CI 1.03 to 3.97) and living in Niger (4.06, 95% CI 1.41 to 11.67).
conclusionRegardless of severity, hypoxaemia was common among outpatients screened using PO and meeting criteria for severity. Its presence was associated with mortality risk. Incorporating PO within IMCI prompted care management of severely hypoxaemic cases, but hospital referrals and access to oxygen remain sub-optimal and are crucial levers for reducing under-five mortality. STUDY REGISTRATION NUMBER: PACTR202206525204526 registered retrospectively on 15 June 2022.
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