ArticleNature communications2021
Risk-stratification of febrile African children at risk of sepsis using sTREM-1 as basis for a rapid triage test.
Article in Nature communications, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05591924 (Prospective Observational Study of Biology of Critical Illness), which is not on this map. Cited by 22 papers.
What it found
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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
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.
Prospective Observational Study of Biology of Critical Illness
Who cites it
22 citing papers in PubMed, 37 citations in OpenAlex.
- Predicting referral need for febrile children in low-resource community settings in South and Southeast Asia.Nature medicine · 2026Article
- Soluble triggering receptor expressed on myeloid cells-1 as a predictive biomarker in sepsis: insights into cut-offs, mortality risk, and treatment guidance-secondary analysis of the Next GeneSiS-Trial.Critical care (London, England) · 2026Observational
- Elevated Soluble Urokinase-Type Plasminogen Activator Receptor Levels, Organ Dysfunction, and Death in Children Hospitalized With Malaria: Considerations for Use as a Risk Stratification Tool.The Journal of infectious diseases · 2026Article
- sTREM-1 as a biomarker for sepsis diagnosis and prognosis following abdominal surgery.Laboratory medicine · 2026Article
- Community health workers identify children requiring health center admission in Northern Uganda: prehospital risk prediction using vital signs and advanced point-of-care tests.Global health action · 2025Observational
- Risk stratification of childhood infection using host markers of immune and endothelial activation in Asia (Spot Sepsis): a multi-country, prospective, cohort study.The Lancet. Child & adolescent health · 2025Observational
- Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) predicts mortality in patients with febrile illness in southern Mozambique.Communications medicine · 2025Article
- Soluble triggering receptor expressed on myeloid cells 1 is associated with hemoconcentration and endothelial activation in children and young adults with dengue virus infection in the Philippines.PLoS neglected tropical diseases · 2025Article
- Host biomarkers and parasite biomass are associated with severe malaria in Mozambican children: a case-control study.Scientific reports · 2025Article
- Observational
- Angiogenesis-associated pathways play critical roles in neonatal sepsis outcomes.Scientific reports · 2024Article
- sTREM-1: A Biomarker of Mortality in Severe Malaria Impacted by Acute Kidney Injury.The Journal of infectious diseases · 2024Article
- Pediatric Malaria with Respiratory Distress: Prognostic Significance of Point-of-Care Lactate.Microorganisms · 2023Article
- Prognostic accuracy of biomarkers of immune and endothelial activation in Mozambican children hospitalized with pneumonia.PLOS global public health · 2023Article
- MICROVASCULAR ENDOTHELIAL ACTIVATION/DYSFUNCTION AND DYSREGULATION OF THE ANGIOPOIETIN-TIE2 SYSTEM IN THE PATHOGENESIS OF LIFE-THREATENING INFECTIONS.Transactions of the American Clinical and Climatological Association · 2023Article
- Low lymphocyte to high-density lipoprotein ratio predicts mortality in sepsis patients.Frontiers in immunology · 2023Article
- Diagnosis of cerebral malaria: Tools to reduceFrontiers in cellular and infection microbiology · 2023Review
- Article
- Blackwater fever and acute kidney injury in children hospitalized with an acute febrile illness: pathophysiology and prognostic significance.BMC medicine · 2022Observational
- Immune and endothelial activation markers and risk stratification of childhood pneumonia in Uganda: A secondary analysis of a prospective cohort study.PLoS medicine · 2022Article
Corrections and comments
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Authors and funding
12 authors at 8 institutions in 3 countries.
Funding
Abstract
Identifying febrile children at risk of sepsis in low-resource settings can improve survival, but recognition triage tools are lacking. Here we test the hypothesis that measuring circulating markers of immune and endothelial activation may identify children with sepsis at risk of all-cause mortality. In a prospective cohort study of 2,502 children in Uganda, we show that Soluble Triggering Receptor Expressed on Myeloid cells-1 (sTREM-1) measured at first clinical presentation, had high predictive accuracy for subsequent in-hospital mortality. sTREM-1 had the best performance, versus 10 other markers, with an AUROC for discriminating children at risk of death of 0.893 in derivation (95% CI 0.843-0.944) and 0.901 in validation (95% CI 0.856-0.947) cohort. sTREM-1 cutoffs corresponding to a negative likelihood ratio (LR) of 0.10 and a positive LR of 10 classified children into low (1,306 children, 53.1%), intermediate (942, 38.3%) and high (212, 8.6%) risk zones. The estimated incidence of death was 0.5%, 3.9%, and 31.8%, respectively, suggesting sTREM-1 could be used to risk-stratify febrile children. These findings do not attempt to derive a risk prediction model, but rather define sTREM-1 cutoffs as the basis for rapid triage test for all cause fever syndromes in children in low-resource settings.
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