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Updated: Jun 24, 2026
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
The prevalence of hypoxaemia among ill children in developing countries: a systematic review
Rami Subhi1, Matthew Adamson, Harry Campbell
1Centre for International Child Health, University of Melbourne Department of Paediatrics, MCRI, Royal Children's Hospital, Parkville, Victoria, Australia.
Insights
Hypoxaemia, or low oxygen, is a frequent complication of childhood pneumonia and other infections. Increased awareness and improved oxygen systems are crucial for reducing child mortality globally.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Hypoxaemia is a common, yet often overlooked, complication in childhood infections, particularly pneumonia.
- It is a significant risk factor for mortality and correlates with disease severity in pediatric pneumonia, a leading cause of death in developing countries.
- Limited access to accurate diagnostic tools like pulse oximetry and oxygen therapy contributes to its neglect in global child mortality reduction strategies.
Purpose of the Study:
- To review the prevalence and impact of hypoxaemia in childhood illnesses, especially acute lower respiratory tract infections.
- To highlight the underestimation of hypoxaemia in global health strategies for pneumonia control and child mortality.
- To emphasize the need for increased awareness and improved oxygen systems in resource-limited settings.
Main Methods:
- Systematic review of published and unpublished studies on acute lower respiratory tract infections.
- Analysis of hypoxaemia prevalence in WHO-defined pneumonia requiring hospitalization (severe and very severe classifications).
Main Results:
- The median prevalence of hypoxaemia in hospitalized WHO-defined pneumonia was 13%, with wide variations.
- This translates to an estimated 1.5 to 2.7 million annual cases of hypoxaemic pneumonia presenting to healthcare facilities.
- A significant number of children with hypoxaemia do not access healthcare facilities.
Conclusions:
- Hypoxaemia is a substantial burden in childhood illness, particularly in severe pediatric pneumonia.
- Current global strategies for pneumonia control and child mortality reduction inadequately address hypoxaemia.
- There is an urgent need for greater awareness and implementation of effective oxygen systems to improve outcomes in resource-limited healthcare settings.
Abstract:
Hypoxaemia is a common complication of childhood infections, particularly acute lower respiratory tract infections. In pneumonia-a disease that disproportionately impacts developing countries, and accounts for more than two million deaths of children worldwide-hypoxaemia is a recognised risk factor for death, and correlates with disease severity. Hypoxaemia also occurs in severe sepsis, meningitis, common neonatal problems, and other conditions that impair ventilation and gas exchange or increase oxygen demands. Despite this, hypoxaemia has been overlooked in worldwide strategies for pneumonia control and reducing child mortality. Hypoxaemia is also often overlooked in developing countries, mainly due to the low accuracy of clinical predictors and the limited availability of pulse oximetry for more accurate detection and oxygen for treatment. In this Review of published and unpublished studies of acute lower respiratory tract infection, the median prevalence of hypoxaemia in WHO-defined pneumonia requiring hospitalisation (severe and very severe classifications) was 13%, but prevalence varied widely. This corresponds to at least 1.5 to 2.7 million annual cases of hypoxaemic pneumonia presenting to health-care facilities. Many more people do not access health care. With mounting evidence of the impact that improved oxygen systems have on mortality due to acute respiratory infection in limited-resource health-care facilities, there is a need for increased awareness of the burden of hypoxaemia in childhood illness.
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