Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jun;14(2):397-407.
doi: 10.4314/ahs.v14i2.16.

Hypoxemia predicts death from severe falciparum malaria among children under 5 years of age in Nigeria: the need for pulse oximetry in case management

Adebola Orimadegun  1 , Babatunde Ogunbosi  2 , Bose Orimadegun  3
Affiliations

Hypoxemia predicts death from severe falciparum malaria among children under 5 years of age in Nigeria: the need for pulse oximetry in case management

Adebola Orimadegun et al. Afr Health Sci. 2014 Jun.

Abstract

Background: Oxygen saturation is a good marker for disease severity in emergency care. However, studies have not considered its use in identifying individuals infected with Plasmodium falciparum at risk of deaths.

Objective: To investigate the prevalence and predictive value of hypoxaemia for deaths in under-5s with severe falciparum malaria infection.

Methods: Oxygen saturation was prospectively measured alongside other indicators of disease severity in 369 under-5s admitted to a tertiary hospital in Nigeria. Participants were children in whom falciparum malaria parasitaemia was confirmed with blood film microscopy in the presence of any of the World Health Organization-defined life-threatening features for malaria.

Results: Overall mortality rate was 8.1%. Of the 16 indicators of the disease severity assessed, hypoxaemia (OR=7.54; 95% CI=2.80, 20.29), co-morbidity with pneumonia (OR=19.27; 95% CI=2.87, 29.59), metabolic acidosis (OR=6.21; 95% CI=2.21, 17.47) and hypoglycaemia (OR=19.71; 95% CI=2.61, 25.47) were independent predictors of death. Cerebral malaria, male gender, wasting, hypokalaemia, hyponatriaemia, azotaemia and renal impairment were significantly associated with death in univariate analysis but not logistic regression model.

Conclusions: Hypoxaemia predicts deaths in Nigerian children with severe malaria, irrespective of other features. Efforts should always be made to measure oxygen saturation as part of the treatments for severe malaria in children.

Keywords: Hypoxaemia; Oxygen saturation; Severe malaria; Under-5 mortality.

PubMed Disclaimer

Figures

Figure 2
Figure 2
Prevalence of hypoxaemia by severe malaria category
None
See this image and copyright information in PMC

References

    1. Watson R. Mortality rates from malaria in children under 5 fall sharply in 10 countries. BMJ. 2008;336(7657):1331. - PMC - PubMed
    1. Murray CJ, Rosenfeld LC, Lim SS, Andrews KG, Foreman KJ, Haring D, Fullman N, Naghavi M, Lozano R, Lopez AD. Global malaria mortality between 1980 and 2010: a systematic analysis. Lancet. 2012;379(9814):413–431. - PubMed
    1. Ramroth H, Ndugwa RP, Muller O, Ye Y, Sie A, Kouyate B, Becher H. Decreasing childhood mortality and increasing proportion of malaria deaths in rural Burkina Faso. Glob Health Action. 2009:2. - PMC - PubMed
    1. Ndugwa RP, Ramroth H, Muller O, Jasseh M, Sie A, Kouyate B, Greenwood B, Becher H. Comparison of all-cause and malaria-specific mortality from two West African countries with different malaria transmission patterns. Malar J. 2008;7:15. - PMC - PubMed
    1. Federal Ministry of Health, author. National Guidelines for Diagnosis and Treatment of Malaria. Abuja-Nigeria: Federal Ministry of Health, National Malaria and Vector Control Division; 2011.

Publication types

MeSH terms

LinkOut - more resources