Long-term morbidity and mortality following hypoxaemic lower respiratory tract infection in Gambian children

Acute lower respiratory infections (ALRI) are the main cause of death in yo ung children worldwide. We report here the results of a study to determine the long-term survival of children admitted to hospital with severe pneumon ia. The study was conducted on 190 Gambian children admitted to hospital in 1992-94 for ALRI who survived to discharge. Of these, 83 children were hyp oxaemic and were treated with oxygen, and 107 were not. On follow-up in 199 6-97, 62% were traced. Of the children with hypoxaemia, 8 had died, compare d with 4 of those without. The mortality rates were 4.8 and. 2.2 deaths per 100 child-years of follow-up for hypoxaemic and non-hypoxaemic children, r espectively(P = 0.2). Mortality was higher for children who had been malnou rished (Z-score <-2) when seen in hospital (rate ratio = 3.2; 95% confidenc e interval (CI)= 1.03-10.29; P = 0.045). Children with younger siblings exp erienced less frequent subsequent respiratory infections (rate ratio for fu rther hospitalization with respiratory illness = 0.15; 95% Ci = 0.04-0.50; P =0.002). Children in Gambia who survive hospital admission with hypoxaemi c pneumonia have a good prognosis. Survival depends more on nutritional sta tus than on having been hypoxaemic. Investment in oxygen therapy appears ju stified, and efforts should be made to improve nutrition in malnourished ch ildren with pneumonia.