ArticlePloS one2009
The diagnostic and prognostic accuracy of five markers of serious bacterial infection in Malawian children with signs of severe infection.
Article in PloS one, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 4 of them syntheses that pooled it.
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Who cites it
45 citing papers in PubMed, 4 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Investigating Blood Biomarkers That Can Facilitate the Diagnosis of Meningitis-A Systematic Literature Review.International journal of molecular sciences · 2025Pooled it
- Diagnostic value of soluble triggering receptor expressed on myeloid cells in paediatric sepsis: a systematic review.Italian journal of pediatrics · 2016Pooled it
- Clinical and Cost-Effectiveness of Procalcitonin Test for Prodromal Meningococcal Disease-A Meta-Analysis.PloS one · 2015Pooled it
- What clinical signs best identify severe illness in young infants aged 0-59 days in developing countries? A systematic review.Archives of disease in childhood · 2011Pooled it
- The accuracy of CRP to detect bacteraemia in Malawian children.BMC infectious diseases · 2026Article
- Performance of procalcitonin point-of-care tests in predicting bacterial causes of acute febrile illness in Northwest Ethiopia.BMC infectious diseases · 2025Article
- Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) predicts mortality in patients with febrile illness in southern Mozambique.Communications medicine · 2025Article
- Factors influencing C-reactive protein status on admission in neonates after birth.BMC pediatrics · 2024Article
- Identifying critically ill children in Malawi: A modified qSOFA score for low-resource settings.PLOS global public health · 2024Article
- Predictive biomarker of mortality in children with infectious diseases: a nationwide data analysis.Frontiers in pediatrics · 2024Article
- Prognostic accuracy of biomarkers of immune and endothelial activation in Mozambican children hospitalized with pneumonia.PLOS global public health · 2023Article
- Article
- Risk-stratification of febrile African children at risk of sepsis using sTREM-1 as basis for a rapid triage test.Nature communications · 2021Article
- Infection Manager System (IMS) as a new hemocytometry-based bacteremia detection tool: A diagnostic accuracy study in a malaria-endemic area of Burkina Faso.PLoS neglected tropical diseases · 2021Article
- The performance of the alarmin HMGB1 in pediatric diseases: From lab to clinic.Immunity, inflammation and disease · 2021Review
- Influenza-like illness is associated with high pneumococcal carriage density in Malawian children.The Journal of infection · 2020Article
- Point-of-Care Biomarkers to Guide Antibiotic Prescription for Acute Febrile Illness in Sub-Saharan Africa: Promises and Caveats.Open forum infectious diseases · 2020Review
- The good and the bad: using C reactive protein to distinguish bacterial from non-bacterial infection among febrile patients in low-resource settings.BMJ global health · 2020Review
- Host-Based Prognostic Biomarkers to Improve Risk Stratification and Outcome of Febrile Children in Low- and Middle-Income Countries.Frontiers in pediatrics · 2020Article
- Diagnostic and Prognostic Value of IL-6 and sTREM-1 in SIRS and Sepsis in Children.Mediators of inflammation · 2020Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundEarly recognition and prompt and appropriate antibiotic treatment can significantly reduce mortality from serious bacterial infections (SBI). The aim of this study was to evaluate the utility of five markers of infection: C-reactive protein (CRP), procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), CD163 and high mobility group box-1 (HMGB1), as markers of SBI in severely ill Malawian children. METHODOLOGY AND PRINCIPAL
findingsChildren presenting with a signs of meningitis (n = 282) or pneumonia (n = 95), were prospectively recruited. Plasma samples were taken on admission for CRP, PCT, sTREM-1 CD163 and HMGB1 and the performance characteristics of each test to diagnose SBI and to predict mortality were determined. Of 377 children, 279 (74%) had SBI and 83 (22%) died. Plasma CRP, PCT, CD163 and HMGB1 and were higher in HIV-infected children than in HIV-uninfected children (p<0.01). In HIV-infected children, CRP and PCT were higher in children with SBI compared to those with no detectable bacterial infection (p<0.0005), and PCT and CD163 were higher in non-survivors (p = 0.001, p = 0.05 respectively). In HIV-uninfected children, CRP and PCT were also higher in children with SBI compared to those with no detectable bacterial infection (p<0.0005), and CD163 was higher in non-survivors (p = 0.05). The best predictors of SBI were CRP and PCT, and areas under the curve (AUCs) were 0.81 (95% CI 0.73-0.89) and 0.86 (95% CI 0.79-0.92) respectively. The best marker for predicting death was PCT, AUC 0.61 (95% CI 0.50-0.71).
conclusionsAdmission PCT and CRP are useful markers of invasive bacterial infection in severely ill African children. The study of these markers using rapid tests in a less selected cohort would be important in this setting.
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