ArticleArchives of disease in childhood2012
Predicting mortality for paediatric inpatients where malaria is uncommon.
Article in Archives of disease in childhood, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Application of Sepsis Definitions to Pediatric Patients Admitted With Suspected Infections in Uganda.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2016Trial
- Pediatric in-Hospital Death from Infectious Disease in Uganda: Derivation of Clinical Prediction Models.PloS one · 2016Trial
- Predicting Mortality for Adolescent and Adult Patients with Fever in Resource-Limited Settings.The American journal of tropical medicine and hygiene · 2018Article
- Variation in and risk factors for paediatric inpatient all-cause mortality in a low income setting: data from an emerging clinical information network.BMC pediatrics · 2017Article
- Teaching Pediatric Life Support in Limited-Resource Settings: Contextualized Management Guidelines.Journal of pediatric intensive care · 2017Review
- Etiologies of illness among patients meeting integrated management of adolescent and adult illness district clinician manual criteria for severe infections in northern Tanzania: implications for empiric antimicrobial therapy.The American journal of tropical medicine and hygiene · 2015Article
- Invasive Salmonella infections in areas of high and low malaria transmission intensity in Tanzania.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2014Article
- Etiology of severe non-malaria febrile illness in Northern Tanzania: a prospective cohort study.PLoS neglected tropical diseases · 2013Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
Abstract
objectiveAs the proportion of children living low malaria transmission areas in sub-Saharan Africa increases, approaches for identifying non-malarial severe illness need to be evaluated to improve child outcomes.
designAs a prospective cohort study, we identified febrile paediatric inpatients, recorded data using Integrated Management of Childhood Illness (IMCI) criteria, and collected diagnostic specimens.
settingTertiary referral centre, northern Tanzania.
resultsOf 466 participants with known outcome, median age was 1.4 years (range 2 months-13.0 years), 200 (42.9%) were female, 11 (2.4%) had malaria and 34 (7.3%) died. Inpatient death was associated with: Capillary refill >3 s (OR 9.0, 95% CI 3.0 to 26.7), inability to breastfeed or drink (OR 8.9, 95% CI 4.0 to 19.6), stiff neck (OR 7.0, 95% CI 2.8 to 17.6), lethargy (OR 5.2, 95% CI 2.5 to 10.6), skin pinch >2 s (OR 4.8, 95% CI 1.9 to 12.3), respiratory difficulty (OR 4.0, 95% CI 1.9 to 8.2), generalised lymphadenopathy (OR 3.6, 95% CI 1.6 to 8.3) and oral candidiasis (OR 3.4, 95% CI 1.4 to 8.3). BCS <5 (OR 27.2, p<0.001) and severe wasting (OR 6.9, p<0.001) were independently associated with inpatient death.
conclusionsIn a low malaria transmission setting, IMCI criteria performed well for predicting inpatient death from non-malarial illness. Laboratory results were not as useful in predicting death, underscoring the importance of clinical examination in assessing prognosis. Healthcare workers should consider local malaria epidemiology as malaria over-diagnosis in children may delay potentially life-saving interventions in areas where malaria is uncommon.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.