@article{fdi:010095832,
  title = {{P}revalence and factors associated with severe illness in {W}est {A}frican children under 5 years of age detected with routine pulse oximetry in primary care},
  author = {{H}edible, {K}. {G}. {B}. and {S}awadogo, {A}. {G}. and {Z}air, {Z}. and {K}argougou, {D}. {G}. and {A}gbeci, {H}. and {M}eda, {B}. and {B}okol, {L}. {P}. and {K}oli{\'e}, {J}. and {L}ouart, {S}. and {Y}ugbar{\'e}, {S}. {O}. and {D}iakite, {A}. {A}. and {D}iallo, {I}. {S}. and {S}ouleymane, {H}. {A}. and {N}eboua, {D}. and {V}ignon, {M}. and {B}usi{\`e}re, {S}. and {L}amontagne, {F}. and {R}idde, {V}al{\'e}ry and {L}eroy, {V}. and {A}ire {R}esearch {S}tudy {G}roup,},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {T}he {I}ntegrated {M}anagement of {C}hildhood {I}llness ({IMCI}) guidelines are symptom-based algorithms used to identify critically ill children under five in primary health centres ({PHC}) in resource-limited countries. {H}ypoxaemia, a life-threatening event, is clinically underdiagnosed. {T}he {A}m{\'e}ioration de l'{I}dentification des d{\'e}tresses {R}espiratoires de l'{E}nfant/{I}mproving {I}dentification of {R}espiratory {D}istress in {C}hildren ({AIRE}) project implemented the routine use of pulse oximetry ({PO}) within {IMCI} consultations to improve the diagnosis and management of severe hypoxaemia (pulse blood oxygen saturation <90%) at {PHC} level in {B}urkina {F}aso, {G}uinea, {M}ali and {N}iger. {I}n this context, we measured the prevalence of severe cases and their associated social and structural factors among outpatients. {M}ethods {I}n 16 {AIRE} research {PHC} (4/country), all the children under five attending {IMCI} consultations, except those aged 2-59 months classified as simple case without cough or breathing difficulties, were eligible for the use of {PO} and enrolled in a cross-sectional study with parental consent. {S}evere {IMCI}+{PO} cases were {IMCI} severe cases or those with severe hypoxaemia. {R}esults {F}rom {J}une 2021 to {J}une 2022, 968 neonates (0-59 days) and 14 868 children (2-59 months) were included. {P}revalence of severe {IMCI}+{PO} cases was heterogeneous between countries: 5.0% in {B}urkina {F}aso, 6.1% in {N}iger, 18.9% in {M}ali and 44.6% in {G}uinea. {A}mong neonates, 21.9% (95% {CI} 19.3 to 24.6) were severe cases versus 12.0% (95% {CI} 11.4 to 12.5) in older children, of which 3.3% versus 0.8%, respectively (p<0.001), had severe hypoxaemia. {T}he adjusted social and structural factors associated with disease severity common to all four countries were as follows: age <2 months or >2 years, {IMCI} consultation delay >2 days, home to {PHC} travel time >30 min. {C}onclusion {T}he prevalence of seriously ill children under five, including severe hypoxaemia, was high in {PHC}, particularly in neonates. {T}he high between-country heterogeneity may be explained by differences in case definitions ({G}uinea) and structural factors (accessibility). {I}mproving early access to primary care could be an actionable lever to improve the health of {W}est {A}frican children.},
  keywords = {{C}hild health ; {H}ealth systems evaluation ; {C}ross-sectional survey ; {E}pidemiology ; {O}ther diagnostic or tool ; {BURKINA} {FASO} ; {GUINEE} ; {MALI} ; {NIGER} ; {AFRIQUE} {SUBSAHARIENNE} ; {AFRIQUE} {DE} {L}'{OUEST}},
  booktitle = {},
  journal = {{BMJ} {G}lobal {H}ealth},
  volume = {10},
  numero = {{S}uppl. 8},
  pages = {e017299 [13 p.]},
  ISSN = {2059-7908},
  year = {2025},
  DOI = {10.1136/bmjgh-2024-017299},
  URL = {https://www.documentation.ird.fr/hor/fdi:010095832},
}