Supportive care in the management of severe pneumonia in Nigerian children

Abstract

According to 2008 estimates, about 177,000 children under the age of five years died of pneumonia in Nigeria, which was the third commonest cause of the 1 million deaths in Nigerian under-5s. Detecting hypoxemia with the use of simple pulse oximeters and providing immediate, cost- effective oxygen treatment may be effective in decreasing the mortality due to childhood pneumonia in Nigeria. During the period .June I, 2010 through August 31, 2010 children aged between 2 and 59 months with severe and very severe pneumonia were enrolled and treated with standard therapy as well as supplemental oxygen via oxygen concentrator or cylinder at University College Hospital, Ibadan. There were no significant differences found in the socio-demographic data (age, sex, socioeconomic class) between the oxygen concentrator and cylinder groups (p>O.1 for each variable). Forty-five out of80 patients (56%) admitted were hypoxic (Sp02 < 90%). Twenty-three were commenced on oxygen therapy via oxygen concentrator and 22 via oxygen cylinder. The majority of patients (98%) recovered without sequelae (44). 6 patients experienced complications during admission and one child died. There were no significant differences found in the outcome parameters between the two groups (p>0.05) except a decrease in the days to resolution of nasal flaring in the oxygen concentrator group (p<0.05)The data that has been gathered in this study suggests that the use of oxygen concentrators as a mode of oxygen delivery for hypoxemic children with pneumonia is as effective as the use of oxygen cylinders.