Clinical Hypoxemia Score for Outpatient Child Pneumonia Care Lacking Pulse Oximetry in Africa and South Asia

Authors

Holly B Schuh
Shubhada Hooli
Salahuddin Ahmed
Carina King
Arunangshu D Roy
Norman Lufesi
Asmd Ashraful Islam
Tisungane Mvalo
Nabidul H Chowdhury
Amy Sarah Ginsburg
Tim Colbourn
William Checkley
Abdullah H Baqui
Eric D McCollum

Publication Date

1-1-2023

Journal

Frontiers in Pediatrics

DOI

10.3389/fped.2023.1233532

PMID

37859772

PMCID

PMC10582699

PubMedCentral® Posted Date

10-4-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

hypoxia, clinical decision rules, pediatrics, primary health care, low-income countries, respiratory tract infection (RTI)

Abstract

BACKGROUND: Pulse oximeters are not routinely available in outpatient clinics in low- and middle-income countries. We derived clinical scores to identify hypoxemic child pneumonia.

METHODS: This was a retrospective pooled analysis of two outpatient datasets of 3-35 month olds with World Health Organization (WHO)-defined pneumonia in Bangladesh and Malawi. We constructed, internally validated, and compared fit & discrimination of four models predicting SpO

RESULTS: 12,712 observations were included. The independent and composite LASSO models discriminated moderately (both C-statistic 0.77) between children with a SpO

CONCLUSIONS: In the absence of pulse oximeters, both LASSO models better identified outpatient hypoxemic pneumonia cases than the WHO guidelines. Score external validation and implementation are needed.