*Co esponding au ho : Umma Id is Abdullahi.
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion Liscense 4.0.
High p e alence o hypoxia in child en wi h se e e pneumonia in u al e ia y
hospi al in Nige ia
Umma Id is Abdullahi *
Depa men o Paedia ics, Fede al Medical Cen e , Bi nin Kudu, Jigawa S a e, Nige ia.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 23(03), 377-382
Publica ion his o y: Recei ed on 09 Augus 2025; e ised on 18 Sep embe 2025; accep ed on 20 Sep embe 2025
A icle DOI: h ps://doi.o g/10.30574/wjbphs.2025.23.3.0841
Abs ac
In oduc ion: Hypoxia is one o he s onges p edic o s o hese dea hs in child en wi h pneumonia. This s udy aimed
o documen he p e alence and ou come o pneumonia in child en wi h pneumonia.
Me hodology: Child en be ween I mo h o 14 yea s wi h diagnosis o se e e pneumonia admi ed du ing he s udy
pe iod we e included in his s udy. Hypoxemia was de ined as an a e ial oxygen sa u a ion (SpO2) o <92% a he poin
o admission.
Resul s: Fi y- ou o he 94 hospi alized child en wi h se e e pneumonia had hypoxia, gi ing a p e alence o 57.4%.
The mean SPO2 in child en wi h hypoxia was 77.2±11.3% while i was 94.4±1.9% in non-hypoxic child en The case
a ali y a e o child en wi h hypoxemia in his s udy is 40.7%, wi h he ela i e isk o dea h o 2 among hypoxic child en
compa ed o hose wi hou .
Conclusion: Hypoxia is p e alen in child en wi h pneumonia and inc eases he isk o mo ali y.
Keywo ds: Pneumonia; Hypoxia; P e alence; child en; mo ali y; ou come; Nige ia; Jigawa
1. In oduc ion
Hypoxemia, de ined as low oxygen sa u a ion in a e ial blood (i.e. SpO2 <90%), is common among child en wi h
pneumonia and o he acu e lowe espi a o y in ec ions, and is one o hei s onges p edic o s o mo ali y.(1–4) In
2019, an es ima ed 7 million hospi aliza ion o child en in he middle and lowe income coun ies we e due hypoxemic
pneumonia.(5)
Hypoxemia can be diagnosed using an inexpensi e and non-in asi e pulse oxime e s, howe e his low-cos echnology
is no eadily a ailable in some sub-Saha an A ican coun ies (3,6) and i s sys ema ic use o moni o and ea child en
in esou ce-poo de eloping coun ies, when coupled wi h a eliable oxygen supply, has been shown o imp o e quali y
o ca e and educes mo ali y in child en wi h pneumonia by app oxima ely 35%.(7)
Abou 28-41.5% o Nige ian Child en hospi alized o pneumonia we e epo ed o ha e hypoxemia.(8–10) howe e
hese epo s we e mainly om he sou he n pa o he coun y wi h e y scan y epo s om he no h- wes e n
egion which disp opo iona ely ha e high mo bidi y and mo ali y due o pneumonia.(11) The e o e, his s udy was
conduc ed o documen he p e alence o hypoxemia in child en wi h se e e pneumonia and i s associa ion wi h
mo ali y. I also hopes ha , he e idence gene a ed will assis policymake s o e ec i ely p io i ize ele an
in e en ions a all le els o imp o e clinical ou come o pneumonia in child en.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 23(03), 377-382
378
2. Ma e ials and Me hod
This was a e ospec i e s udy o child en aged 6-mon hs o 14 yea s admi ed and managed o pneumonia om
Janua y 2020 o Decembe 2021, in he eme gency pedia ics uni (EPU) o Fede al medical cen e Bi nin-kudu
(FMCBKD), Jigawa S a e. The hospi al is a e ia y acili y loca ed in Bi nin Kudu, No h wes , Nige ia. The EPU has a 14-
bed capaci y wi h an a e age o annual 600 admissions. The p o ocol o managemen o communi y acqui ed
pneumonia in ou se ing included esusci a ion, an ibio ic ea men , oxygen he apy and o he suppo i e ea men .
The e was no Pedia ics In ensi e Ca e Uni a he ime o conduc ing his s udy. Bi nin Kudu. The a e age ele a ion o
he own is 437m.(12)
2.1. Eligibili y C i e ia
All consecu i e eco ds o child en managed o se e e pneumonia du ing he s udy pe iod we e e ie ed. The
diagnosis was based on WHO classi ica ion and ea men guidelines o pneumonia ea men in child en.(13) Child en
wi h b onchial as hma and hose wi h incomple e eco ds we e excluded.
2.2. Exposu e a iables
The age, gende , immuniza ion s a us, du a ion o admission, oxygen sa u a ion and ou come o admission we e no ed
in he pa ien s’ hospi al eco ds.
2.3. Ou come a iables
The p ima y ou come o in e es was hypoxemia de ined as SPO2 less han o equal o 92% and he seconda y ou come
measu e was in-hospi al mo ali y.
2.4. Da a Ex ac ion
The da a was ex ac ed om he iles using a speci ically designed case epo o m o he s udy and subsequen ly
en e ed in o S a is ical Package o Social Science so wa e ( e sion 17.0; SPSS Inc, Chicago) o analysis.
2.5. E hical conside a ion
The s udy was app o ed by he hospi al e hical esea ch commi ee o FMCBKD FMC/HREC/APP/CLN/001/1/213.
2.6. Sample size conside a ion
All he consecu i e admissions o child en wi h se e e pneumonia o e he 24 mon hs pe iod we e included.
2.7. Da a analysis
Da a we e ans e ed o he SPSS ( e sion 17.0; SPSS Inc, Chicago). The p e alence o hypoxia du ing he s udy pe iod
was calcula ed om he p opo ion o child en wi h hypoxia in child en pneumonia. Con inuous da a we e ep esen ed
as mean o median as app op ia e while ca ego ical da a we e p esen ed as pe cen ages. The χ2 and S uden ’s - es s
we e used o iden i y signi ican di e ences o ca ego ical and con inuous a iables, espec i ely. A p- alue o <0.05
was conside ed signi ican .
3. Resul s and discussion
3.1. Gene al Pa ien s Cha ac e is ics
Nine y- ou child en wi h se e e pneumonia we e admi ed du ing he s udy pe iod o which 53 (56.4%) we e boys
and 41(43.6%) we e gi ls. The median age was 13.5 mon hs and IQR o 17 mon hs. Fo y- i e (47.9%) o he
pa icipan s we e less han 12 mon hs old, 38 (40.4%) 12-59 mon hs old while 11(11.7%) we e 60-mon hs and abo e.
Abou wo- hi d o he child en was om low socio-economic s a us, only 21.3% (20/94) we e ully accina ed o age.
Eigh een (19.1%) o he 63 pa icipan s we e documen ed o ha e been exclusi ely b eas ed. Majo i y (80.8%) o he
child en had clinically diagnosed b onchopneumonia.
3.2. P e alence o hypoxia
Fi y- ou o he 94 hospi alized child en wi h se e e pneumonia had hypoxia, gi ing a p e alence o 57.4%. The mean
SPO2 in child en wi h hypoxia was 77.211.3% while i was 94.4=1.9% in non-hypoxic child en. Table 1 showed he le el
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 23(03), 377-382
379
o oxygen sa u a ion in he s udy pa icipan s. Hypoxia was mo e p e alen among boys and hose less han one yea o
age as shown in Table 2. The mean (s anda d de ia ion) hospi al du a ion o child en wi h hypoxia was 5.7±4.9 days
compa ed o 5.1±2.7 days in hose wi hou hypoxia.
Table 1 Oxygen sa u a ion o hospi alized child en wi h Pneumonia
Le el o SPO2
F equency
Pe cen
<85
41
43.6
85-90
13
13.8
91-92
7
7.4
93-95
21
22.3
95
12
12.8
To al
94
100.0
Table 2 Associa ion be ween hypoxia and some a iables
Va iable
Hypoxia
P – alue
P esen n=54
Absen n=40
Males
30
23
0.85
Females
24
17
Age g oup
Less han 1-yea
32
13
0.71
1-5 yea s
18
23
Mo e han 5 yea s
4
4
Vaccina ion s a us
No ully immunized
40
33
0.41
Fully immunized
14
7
3.3. Ou come o child en wi h hypoxia
Thi y- wo (59.3%) o he 54 child en wi h hypoxia su i ed (29 we e discha ged, 3 we e e e ed o o he acili ies)
and 22 (40.7%) died. The case a ali y a e o child en wi h hypoxemia in his s udy is 40.7%, wi h he ela i e isk o
dea h o 2 among hypoxic child en compa ed o hose wi hou .
Table 3 Ou come based on Hypoxia and le el o SPO2
Su i ed n (%)
Died n (%)
To al
p- alue
Hypoxia
P esen
32(59.3)
22(40.7)
54
0.04
Absen
34(85)
6(15)
40
Le el o SPO2
<85
22 (53.7)
19 (46.3)
41
0.10
86-90
10(76.9)
3 (23.1)
13
91-92
6(85.7)
1(14.3)
7
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 23(03), 377-382
380
93-95
19(90.5)
2(9.5)
21
95
12(100)
0(0)
12
Hypoxemia is a li e- h ea ening condi ion ha equi es ea ly de ec ion and ea men , as oxygen de iciency is o en
associa ed wi h se e e ad e se e en s. Hypoxemia was epo ed among 57.4% o he s udied popula ion. Hypoxemia
was mo e p e alen among boys and hose unde one-yea o age. Twen y- wo o he hypoxemic child en died gi ing a
case a ali y a e o 40.7%. Child en wi h hypoxia had longe median du a ion o hospi al s ay.
This s udy ound a high p e alence o hypoxemia among child en hospi alized o se e e pneumonia. The documen ed
p e alence o hypoxemia in his s udy is highe han 41.5% - 49.2% among hospi alized child en wi h pneumonia in
Nige ia.(8, 10, 13) The high p e alence in his s udy may be due o inclusion o child en wi h se e e pneumonia unlike o he
s udies which included all o ms o pneumonia and o o he o ms o ALRI. Fu he mo e, S udy se ing (ou -pa ien o
Eme gency uni ) is epo ed by Lozano (4) Rahman and colleagues (5) in hei ecen sys ema ic e iew epo ed ha
hypoxemia is mo e p e alen in he eme gency se ing. Addi ionally, i al pneumonias we e obse ed o be associa ed
wi h inc eased isk o hypoxemia, p obably due o i s p opensi y o induced di use, bila e al, pulmona y
damage,(15)compa ed wi h bac e ial pneumonia. Also, delay in seeking ca e has also been shown o be associa ed wi h
se e e disease and in a iably hypoxemia in his se ing.(16) In addi ion, he mic obial e iology o espi a o y disease
(especially i al e sus bac e ial), co-mo bidi ies, hos and en i onmen al ac o s, ca e-seeking beha io , a ailabili y o
e ec i e an ibio ics in p ima y-ca e acili ies, and e e al pa e ns migh be impo an in explaining egional
di e ences in epo ed hypoxemia p e alence.
In an s we e ound o be mo e likely o be hypoxemic han olde child en, his is in keeping wi h he epo s om Ilo in,
(3) (10) and Kenya(4). Rela i ely smalle unc ional esidual capaci y, idal olume and bigge dead space and inc eased
basal me abolic a e in in an s pu hem a a g ea e isk o hypoxemia.
Child en wi h hypoxemia had a longe hospi al s ay compa ed o hose wi hou , a inding ha is co obo a ed by au ho s
om Nige ia(8,17) and India.(18) The need o oxygen he apy and equen moni o ing o child en wi h hypoxia may ha e
possibly caused he p olong hospi al s ay. Fu he mo e, p esence o complica ions may be con ibu o y.
This s udy ound ha 2 ou o e e y 5 child en wi h hypoxemia died, and he mo ali y inc eases as he le el o spo2
dec eases u he . The case a ali y a e o se e e pneumonia in his s udy (40.7%) is highe compa ed o he 8.5 -26.2%
epo ed om Nige ia (10,19), 15% om Zambia(20), and 8% om Bangladesh(21), a ied me hodology, di e en se ings,
geog aphical loca ion, and sample size, may make compa ison ac oss hese s udies di icul . Ru al esidency, p e-
hospi al an ibio ic ea men and poo heal h seeking beha io we e epo ed among o he ac o s o be con ibu o y
o he poo clinical ou come in child en wi h pneumonia.(16) P esence o co-mo bidi ies may ha e signi ican ly
inc eased he dea h among child en wi h hypoxia. Addi ionally, cul u al, physical and esou ce- ela ed ba ie s o
accessing ca e may ha e inc eased he isk o dea h as p e iously documen ed.22 Delayed p esen a ion, poo heal h
seeking beha io and low immuniza ion up ake may ha e con ibu ed o he high p e alence o hypoxemia and
mo ali y in his coho . Addi ionally, lack o en ila o y suppo and in ensi e ca e uni played a ole in he ad e se
ou comes in hese child en.
This s udy may be limi ed by i s e ospec i e na u e and small sample size bu i was able o highligh he clinical
bu den o hypoxemic pneumonia in ou acili y and he a endan inc eased isk o dea h. I is he e o e, impe a i e o
he policy make s o ee alua e he in e en ions aimed a con olling pneumonia like he p omo ing exclusi e
b eas eeding, imp o ing immuniza ion up ake, and knowledge a i ude and p ac ices ela ed o pneumonia. Heal h
sys em s eng hening and adequa e aining o he pe sonnel may imp o e he ea ou come o pneumonia, which is
c ucial o a aining he ambi ious UN Sus ainable De elopmen Goal a ge o educing he mo ali y a e o child en
younge han 5 yea s o less han o equal o 25 pe 1000 li e bi hs by 2030.(23)
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
No con lic o in e es o be disclosed.
S a emen o in o med consen
In o med consen was ob ained om all indi idual pa icipan s included in he s udy.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 23(03), 377-382
381
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