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首页> 外文期刊>Annals of Tropical Paediatrics >Hypoxaemia among children in rural hospitals in Papua New Guinea: epidemiology and resource availability--a study to support a national oxygen programme.
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Hypoxaemia among children in rural hospitals in Papua New Guinea: epidemiology and resource availability--a study to support a national oxygen programme.

机译：巴布亚新几内亚乡村医院儿童的低氧血症：流行病学和资源可获得性-一项支持国家氧气计划的研究。

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AIMS: To support a national approach to oxygen systems in Papua New Guinea, we conducted a study to document the incidence of hypoxaemia, its geographical distribution, epidemiological determinants and resource availability in several regions of the country. We also established baseline mortality rate data for all children admitted to five hospitals, for children with a diagnosis of pneumonia and for neonates to evaluate a future intervention. METHODS: Data were collected prospectively from over 1300 hospital admissions in five hospitals in 2004. To establish the baseline case fatality rates, data on outcome were collected retrospectively over 3 years (2001-2003) for over 20,000 children admitted to five hospitals. RESULTS: A total of 1313 admissions were studied prospectively in the five hospitals. Altogether, 384 (29.25%, 95% CI 26.8-31.8) had hypoxaemia, defined as SpO(2) <90%. The incidence of hypoxaemia was much greater in highland hospitals (40% of all admissions) than on the coast (10% of all admissions). This large difference in incidence persisted when the uniform definition of hypoxaemia was adjusted for altitude, and was largely because of differences in the incidence of acute respiratory tract infection. Oxygen was not available on the day of admission for 22% of children (range between hospitals, 3-38), including 13% of all children with hypoxaemia. Oxygen was less available in remote rural district hospitals than in provincial hospitals in regional towns. Clinical signs proposed by WHO as indicators for oxygen would have missed 29% of children with hypoxaemia and, if these clinical signs were used, 30% of children without hypoxaemia would have been considered in need of supplemental oxygen. CONCLUSIONS: Based on this study, an approach to improving the detection of hypoxaemia and the availability of oxygen has been trialled in these five hospitals where a programme of clinical and technical training in the use and maintenance of pulse oximetry and oxygen concentrators has been introduced.
机译：目的：为了支持巴布亚新几内亚对氧气系统采取国家措施，我们进行了一项研究，以记录该国几个地区低氧血症的发生率，其地理分布，流行病学决定因素和资源可用性。我们还为所有进入五家医院的儿童，诊断为肺炎的儿童和新生儿建立了基线死亡率数据，以评估未来的干预措施。方法：前瞻性地收集了2004年来自五家医院的1300例入院患者的数据。为确定基线病死率，回顾性收集了3年（2001-2003年）入院至五家医院的20,000例儿童的结局数据。结果：前瞻性研究了五家医院的1313名患者。总共384（29.25％，95％CI 26.8-31.8）有低氧血症，定义为SpO（2）<90％。高地医院（占所有住院病人的40％）中低氧血症的发生率比沿海地区（占所有住院病人的10％）高得多。当对低氧血症的统一定义进行海拔高度调整时，这种大的发病率差异依然存在，这在很大程度上是由于急性呼吸道感染的发病率差异所致。入院当天22％的儿童（在医院之间，介于3-38之间）没有氧气，包括所有低氧血症儿童的13％。偏远农村地区医院的氧气供应量少于区域城镇的省级医院。 WHO提出的作为氧气指标的临床体征将使29％的低氧血症儿童漏诊，如果使用这些临床体征，则将30％的无低氧血症的儿童视为需要补充氧气。结论：基于这项研究，在这五家医院试用了一种改善低氧血症和氧气供应的方法，并引入了使用和维护脉搏血氧仪和氧气浓缩器的临床和技术培训计划。

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