biostudies-literatureUnknown10(Suppl 8)Hedible KGB<h4>Background</h4>The Integrated Management of Childhood Illness (IMCI) guidelines are symptom-based algorithms used to identify critically ill children under five in primary health centres (PHC) in resource-limited countries. Hypoxaemia, a life-threatening event, is clinically underdiagnosed. The Amélioration de l'Identification des détresses Respiratoires de l'Enfant/Improving Identification of Respiratory Distress in Children (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 Burkina Faso, Guinea, Mali and Niger. In this context, we measured the prevalence of severe cases and their associated social and structural factors among outpatients.<h4>Methods</h4>In 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. Severe IMCI+PO cases were IMCI severe cases or those with severe hypoxaemia.<h4>Results</h4>From June 2021 to June 2022, 968 neonates (0-59 days) and 14 868 children (2-59 months) were included. Prevalence of severe IMCI+PO cases was heterogeneous between countries: 5.0% in Burkina Faso, 6.1% in Niger, 18.9% in Mali and 44.6% in Guinea. Among 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. The 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.<h4>Conclusion</h4>The prevalence of seriously ill children under five, including severe hypoxaemia, was high in PHC, particularly in neonates. The high between-country heterogeneity may be explained by differences in case definitions (Guinea) and structural factors (accessibility). Improving early access to primary care could be an actionable lever to improve the health of West African children.BMJ global healthe017299https://www.ebi.ac.uk/biostudies/studies/S-EPMC12673552biostudies-literaturePrevalence and factors associated with severe illness in West African children under 5 years of age detected with routine pulse oximetry in primary care.PMC12673552Bah FKeita FKSoumah MKargougou GDdi Mauro NDembele BLouart STriclin FTougouma SMeda LBToviho XSemde NSavadogo ASNoel GNyoka KSow ATSama Cherif MHedible KGBCoulidiati Lompo OBTiegna SOuedraogo ADesmonde SBah MGneissien ZNacoulma NDicko AGuilavogui JPYNiome MSeini FYougbare JHaba MOpoue VAIRE Research Study GroupBah TIShepherd SGnongoue CAbdou AAmina SMeda BLeroy VSahabi ASoumah AKouam PKeita ASanou OGuilavogui MHamani ZKarantao MHamidou MGGres ESanon Zombre VMBaguido MSangala FBalima ISylla STapsoba LBakyono ROuedraogo Yugbare SLamontagne FAgbeci HKonare TMahaman IN'Chot CSani SMDagobi AEBecquet RVignon MAssoumane SOPeters Bokol LSani Alio KMamoudou IDiallo ISKam SOuattara BOuattara ABouille SKargougou DGKolie JSDiallo NDiarra DDiakite AASeri BOuattara IDiallo SCousien ASidi MAnago GAbdou IHCoulibaly ADiarra SSylla MNBarry LCoulibaly DDuparc Haba EDiarra YRidde VIssaka IGoita ODoumbia MSSangare IYoda SMaiga AGaye SSougue SGana SToure AOSidibe ATidjani IssaganaDikouma FCongo HYamponi STraore BTraore HSawadogo AGJournot VTraore MKolie JSani SAba PDahourou DLDougabka MBarry DFSidibe TYao CWangraoua LDia PSHarouna KHLeno SBriand VSanouna IHedible GBNgaradoum MBayala MCoulibaly SEBadiane DKeita SGana MoustaphaChetima BKaba DFDouamba FKinda MDioiri SKabirou IBalde AAgbokou RHema ABusiere SWango FBalde BAbdoul RKadio KBalde HLompo YASalifou SDounfangadouno SFMoutari BNanema ZYaro JBZongo DMahamane ACalmettes SYugbare Ouedraogo SOusmane BSore GNeboua DCatala LTaokreo WMalgoubri BKone ISakho NZair ZBayala SISangare YTavarez JMillimouno KCAbarry Souleymane HLenaud SDiabate FfalsePrevalence and factors associated with severe illness in West African children under 5 years of age detected with routine pulse oximetry in primary care.<h4>Background</h4>The Integrated Management of Childhood Illness (IMCI) guidelines are symptom-based algorithms used to identify critically ill children under five in primary health centres (PHC) in resource-limited countries. Hypoxaemia, a life-threatening event, is clinically underdiagnosed. The Amélioration de l'Identification des détresses Respiratoires de l'Enfant/Improving Identification of Respiratory Distress in Children (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 Burkina Faso, Guinea, Mali and Niger. In this context, we measured the prevalence of severe cases and their associated social and structural factors among outpatients.<h4>Methods</h4>In 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. Severe IMCI+PO cases were IMCI severe cases or those with severe hypoxaemia.<h4>Results</h4>From June 2021 to June 2022, 968 neonates (0-59 days) and 14 868 children (2-59 months) were included. Prevalence of severe IMCI+PO cases was heterogeneous between countries: 5.0% in Burkina Faso, 6.1% in Niger, 18.9% in Mali and 44.6% in Guinea. Among 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. The 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.<h4>Conclusion</h4>The prevalence of seriously ill children under five, including severe hypoxaemia, was high in PHC, particularly in neonates. The high between-country heterogeneity may be explained by differences in case definitions (Guinea) and structural factors (accessibility). Improving early access to primary care could be an actionable lever to improve the health of West African children.2025-01-01T00:00:00Z2025 Nov2026-06-05T22:10:07.849Z2026-05-22T03:15:26.136ZS-EPMC126735524130914810.1136/bmjgh-2024-017299