@article{fdi:010097449,
  title = {{A}dded value of routine pulse oximetry use within {I}ntegrated {M}anagement of {C}hildhood {I}llness guidelines in primary care in {W}est {A}frica : insight from {AIRE}},
  author = {{H}edible, {G}. {B}. and {Z}air, {Z}. and {L}ouart, {S}. and {Y}ugbar{\'e}, {S}. {O}. and {D}iakite, {A}. {A}. and {D}iallo, {I}. {S}. and {A}barry, {H}. {S}. and {T}riclin, {F}. and {V}ignon, {M}. and {L}amontagne, {F}. and {R}idde, {V}al{\'e}ry and {L}eroy, {V}. and {A}ire {R}es {S}tudy {G}roup,},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {I}ntegrated {M}anagement of {C}hildhood {I}llness ({IMCI}) guidelines, used alone, fail to reliably identify severe hypoxaemia ({S}p{O}(2)<90%), a predictor of mortality in children under five. {T}he {AIRE} ({A}m & eacute;liorer l'{I}dentification des {D} & eacute;tresses {R}espiratoires chez l'{E}nfant; in {E}nglish, {I}mproving {I}dentification of {R}espiratory {D}istress in {C}hildren) operational research project introduced routine use of pulse oximetry ({PO}) within {IMCI} consultations in {B}urkina {F}aso, {G}uinea, {M}ali and {N}iger. {W}e estimated the added value of incorporating {PO} within {IMCI} ({IMCI}+{PO}) for improving the diagnosis and subsequent management of severe hypoxaemia in primary healthcare centres ({PHC}s). {M}ethods {A}ll children aged 0-59 months attending {IMCI} consultations were eligible for {S}p{O}(2) measurement, except those 2-59 months classified as simple non-respiratory cases using {IMCI}. {M}onthly aggregated data were collected from 202 {AIRE} {PHC}'s through a cross-sectional study to estimate the added value of {PO} within {IMCI} in diagnosing severe cases ({SC}s) which should be referred. {T}he added value was defined as the number of additional {IMCI} {SC}s with severe hypoxaemia, diagnosed using {IMCI}+{PO}, divided by the number of {SC}s diagnosed using {IMCI} alone. {I}n a subset of 16 {PHC}s, we conducted a 14-day cohort follow-up for {SC}s. {W}e analysed their management and mortality according to hypoxaemia status. {R}esults {O}f the 514 901 {IMCI} consultations between {J}une 2021 and {D}ecember 2022, 74.2% were eligible for {PO} use. {O}f those, 5.4% were {SC}s diagnosed using {IMCI}+{PO}. {T}he added value of {PO} was +4.9% (+962 {SC}s; 95% {CI} 4.6% to 5.2%). {T}his was similar for all countries except {G}uinea (+0.9%). {H}ealthcare workers' referral decisions were significantly higher for {SC}s with severe hypoxaemia (74.5%) than for those without (22.2%), p value <0.0001. {I}n the research {PHC}s, the 142 {SC}s with severe hypoxaemia were significantly more likely to be referred and admitted to hospital, although their survival rates were similar. {H}owever, oxygen therapy remained suboptimal. {C}onclusion {A}t {PHC} level, {PO} improves the diagnosis of {SC}s with severe hypoxaemia and is associated with improved management. {H}owever, subsequent care in these settings remains challenging.},
  keywords = {{A}frica {S}outh of the {S}ahara ; {D}elivery of {H}ealth {C}are ; {D}iagnostics and tools ; {C}hild health ; {AFRIQUE} {DE} {L}'{OUEST} ; {AFRIQUE} {SUBSAHARIENNE}},
  booktitle = {},
  journal = {{BMJ} {G}lobal {H}ealth},
  volume = {10},
  numero = {{S}uppl. 8},
  pages = {e017304 [14 p.]},
  ISSN = {2059-7908},
  year = {2026},
  DOI = {10.1136/bmjgh-2024-017304},
  URL = {https://www.documentation.ird.fr/hor/fdi:010097449},
}