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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Childhood anemia at high altitude: Risk factors for poor outcomes in severe pneumonia
Pediatrics, Volume 132, No. 5, Year 2013
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Description
BACKGROUND: Pneumonia is the leading cause of mortality in young children globally, and factors that affect tissue delivery of oxygen may affect outcomes of pneumonia. We studied whether altitude and anemia influence disease severity and outcomes in young children with World Health Organization-defined severe pneumonia. METHODS: We analyzed data from the SPEAR (Severe Pneumonia Evaluation Antimicrobial Research) study, a World Health Organization- And USAID-sponsored multinational randomized controlled trial of antibiotics for severe pneumonia among children aged 2 to 59 months in resource-poor settings. The trial enrolled 958 children in 8 sites at varying elevations, classified as high ($2000 m) or low (,2000 m) altitude. We compared illness severity and assessed the effect of anemia on treatment outcome at high and low altitudes, adjusting for potential confounders and study site. RESULTS: Children at high altitudes had significantly lower oxygen saturation on presentation, more cyanosis, lower systolic blood pressure, and higher hemoglobin. After adjusting for potential confounders, anemia predicted treatment failure in children living at high altitude (relative risk: 4.07; 95% confidence interval: 2.60-6.38) but not at low altitude (relative risk: 1.12; 95% confidence interval: 0.96-1.30). Children at high altitude took longer to reach normoxemia than did children at lower altitudes (5.25 vs 0.75 days; P , .0001). CONCLUSIONS: Children at high altitude present with more severe disease, and children with anemia at high altitude are at greater risk of poor outcome when being treated for severe pneumonia. Given the high global prevalence of anemia among young children, prevention and treatment of anemia should be a priority in children living at high altitude and could improve outcomes of pneumonia. Pediatrics 2013;132:e1156-e1162. Copyright © 2013 by the American Academy of Pediatrics.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3812558/bin/supp_132_5_e1156__index.html
https://efashare.b-cdn.net/share/pmc/articles/PMC3812558/bin/peds.2013-0761_peds.2013-0761SupplementaryData.pdf
Authors & Co-Authors
Moschovis, Peter P.
United States, Boston
Massachusetts General Hospital
Banajeh, Salem
Yemen, Sana'a
Sana'a University
MacLeod, William Bruce
United States, Boston
School of Public Health
Saha, Samir Kumar
Bangladesh, Dhaka
Dhaka Shishu Hospital
Hayden, Douglas L.
United States, Boston
Massachusetts General Hospital
Christiani, David C.
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard T.h. Chan School of Public Health
Miño, Greta
Ecuador, Guayaquil
Children's Hospital dr Francisco de Ycaza Bustamante
Santosham, Mathuram
United States, Baltimore
Johns Hopkins University
Thea, Donald M.
United States, Boston
School of Public Health
Qazi, Shamim Ahmad
Switzerland, Geneva
Organisation Mondiale de la Santé
Hibberd, Patricia L.
United States, Boston
Massachusetts General Hospital
Statistics
Citations: 28
Authors: 11
Affiliations: 8
Identifiers
Doi:
10.1542/peds.2013-0761
ISSN:
00314005
e-ISSN:
10984275
Research Areas
Maternal And Child Health
Noncommunicable Diseases
Study Design
Cross Sectional Study
Study Approach
Qualitative
Quantitative