Long-term morbidity and mortality following hypoxaemic lower respiratory tract infection in Gambian children.

ABSTRACT

PIP: Acute lower respiratory infections (ALRI) are the main cause of death among children under 5 years old worldwide. Findings are reported from a study conducted to assess the long-term survival of 190 Gambian children under age 5 years admitted to the Royal Victoria Hospital, Banjul, in 1992-94, with severe pneumonia who survived to discharge. 83 of the children were hypoxemic and treated with oxygen. 118 (62%) subjects were traced on follow-up in 1996-97. Of the children with hypoxemia, 8 died, compared to 4 who did not have the condition. Mortality rates were 4.8 and 2.2 deaths per 100 child-years of follow-up for hypoxemic and nonhypoxemic children, respectively. The level of mortality was higher among children who had been malnourished when seen in hospital, while children with younger siblings experienced less frequent subsequent respiratory infections. These findings suggest that children in Gambia who survive hospital admission with hypoxemic pneumonia have a good prognosis. Survival depends more upon nutritional status than upon having been hypoxemic. Investment in oxygen therapy seems justified, and efforts should be made to improve nutrition in malnourished children with pneumonia.