Evidence map›Paper›PMID 25909192›Full record

ArticlePloS one2015

Predictors of time to recovery in infants with probable serious bacterial infection.

Prashant Singh, Nitya Wadhwa, Rakesh Lodha, Halvor Sommerfelt, Satinder Aneja, Uma Chandra Mouli Natchu, Jagdish Chandra, Bimbadhar Rath, Vinod Kumar Sharma, Mohini Kumari and 4 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00347386 (Zinc as an Immunomodulator in the Treatment of Possible Serious Bacterial Infections in Infants 7 Days and up to 4 Months of Age), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.2field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00347386 phase2 / phase3completednot on this map

Zinc as an Immunomodulator in the Treatment of Possible Serious Bacterial Infections in Infants 7 Days and up to 4 Months of Age

TypeinterventionalSponsorCentre For International HealthRan2005 to 2008Enrolled700ConditionsSepsis, Bacterial Infections, PneumoniaArmsDrug: Zinc (zinc sulphate), Placebo
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 2 countries.

Prashant SinghTranslational Health Science and Technology Institute, Gurgaon, India; Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Nitya WadhwaTranslational Health Science and Technology Institute, Gurgaon, India; Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Rakesh LodhaDepartment of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Halvor SommerfeltCentre for Intervention Science in Maternal and Child Health (CISMAC), Centre for International Health, University of Bergen, Bergen, Norway; Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway.
Satinder AnejaDepartment of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India.
Uma Chandra Mouli NatchuTranslational Health Science and Technology Institute, Gurgaon, India.
Jagdish ChandraDepartment of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India.
Bimbadhar RathDepartment of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India.
Vinod Kumar SharmaDepartment of Pediatrics, Deen Dayal Upadhyay Hospital, New Delhi, India.
Mohini KumariDepartment of Pediatrics, Deen Dayal Upadhyay Hospital, New Delhi, India.
Savita SainiDepartment of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Sushil Kumar KabraDepartment of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Shinjini BhatnagarTranslational Health Science and Technology Institute, Gurgaon, India; Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Tor A StrandCentre for Intervention Science in Maternal and Child Health (CISMAC), Centre for International Health, University of Bergen, Bergen, Norway; Division of Medical Services, Innlandet Hospital Trust, Lillehammer, Norway.
All India Institute of Medical Sciences · INKalawati Saran Children's Hospital · INTranslational Health Science and Technology Institute · INDeen Dayal Upadhyay Hospital · INInnlandet Hospital Trust · NONorwegian Institute of Public Health · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSerious bacterial infections continue to be an important cause of death and illness among infants in developing countries. Time to recovery could be considered a surrogate marker of severity of the infection. We therefore aimed to identify clinical and laboratory predictors of time to recovery in infants with probable serious bacterial infection (PSBI).

methodsWe used the dataset of 700 infants (7-120 days) enrolled in a randomised controlled trial in India in which 10mg of oral zinc or placebo was given to infants with PSBI. PSBI was defined as signs/symptoms of possible serious bacterial infection along with baseline C-reactive protein(CRP) level >12mg/L. Time to recovery was defined as time from enrolment to the end of a 2-day period with no symptoms/signs of PSBI and daily weight gain of at least 10g over 2 succesive days on exclusive oral feeding. Cox proportional hazard regression was used to measure the associations between relevant variables and time to recovery.

resultsInfants who were formula fed prior to illness episode had 33% longer time to recovery (HR-0.67, 95%CI-0.52, 0.87) than those who were not. Being underweight (HR-0.84, 95%CI-0.70, 0.99), lethargic (HR-0.77, 95%CI-0.62, 0.96) and irritable (HR-0.81, 95%CI-0.66, 0.99) were independent predictors of time to recovery. Baseline CRP was significantly associated with time to recovery (P<0.001), higher CRP was associated with longer time to recovery and this association was nearly linear.

conclusionSimple clinical and laboratory parameters such as formula feeding prior to the illness, being underweight, lethargic, irritable and having elevated CRP levels could be used for early identification of infants with PSBI at risk for protracted illness and could guide prompt referral to higher centers in resource limited settings. This also provides prognostic information to clinicians and family as longer recovery time has economic and social implications on the family in our setting.

trial registrationClinicalTrials.gov NCT00347386.

Indexed as

Bacterial InfectionsBiomarkersC-Reactive ProteinFemaleHumansIndiaInfantInfant, NewbornMaleOutcome Assessment, Health CarePrognosisSeverity of Illness IndexTime FactorsBiomarkersC-Reactive Protein

Identifiers

PMID25909192
PMCPMC4409397
OpenAlexW2065542966

What OpenQuestion holds

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LicenceCC BY
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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.