Paediatric Oxygen Therapy in Nigeria: A Survey of Health Workers

Abstract

Abstract Rationale Oxygen therapy, one of the most common medical interventions in the acute care setting is indicated in a variety of medical conditions that can result in hypoxaemia. Globally, about 20% of hospitalized children with hypoxaemia will require oxygen and 1.4 million deaths have been reported due to a lack of / suboptimal oxygen therapy. Previous studies focused on oxygen therapy practice among health workers caring for adults, leaving out the paediatric cohort in whom respiratory illnesses constitute a huge burden. The study sought to determine the overall knowledge (knowledge and oxygen delivery practice) of paediatric health workers in Nigeria. Methods This was a cross-sectional study of doctors and nurses in 22 tertiary centres across Nigeria (a minimum of three centres each from the six political zones). Subjects were recruited via multi-staged sampling. A validated acute oxygen therapy AOT questionnaire was used to collect data from subjects via self-administration. The overall AOT scores were classified as good (score ≥80%), fair (60-<80%) and poor (< 60%). Results Of the 1127 respondents, 717 (63.6%) were females and 410 (36.4%) were males, with an overall mean ± SD age of 35.89 (± 8.81) years. About half (602, 53.4%) of the subjects were aware of guidelines for AOT and 499 (43.7%) had applied it in clinical practice. The overall mean (SD) AOT score was 71.17 (11.1). The proportion of respondents with overall good, fair and poor AOT knowledge were 284 (25.2%), 668 (59.3%) and 171 (15.1%), respectively. Junior cadre workers constituted the majority (132, 75.4%) with poor knowledge. Lower proportion of doctors (93/799) had poor AOT knowledge compared to nurses (82/328). Odds ratio (OR) 0.40; 95% CI: 0.28-0.55. There was no significant difference in the proportion of health workers with good AOT knowledge who had no formal training on AOT [135/585} compared to those with formal training (149/542) OR 0.79 95% C.I. 0.06-1.04. The mean oxygen delivery practice score of the participants was 6.74 ± 2.03 (total score obtainable was 11). Doctors had significantly higher mean oxygen delivery practice scores than nurses. Health workers who had worked for more than 10 years had higher mean oxygen delivery practice scores compared to those who had worked for ≤ 10 years. Conclusion Knowledge of paediatric AOT is suboptimal and can lead to increased morbidity and mortality in children. Interventions like periodic Training of paediatric health workers in Nigeria can result in improved health indices.