Evidence map›Paper›PMID 40692486›Full record

ArticleThe Journal of infectious diseases2026

External Validation of Pediatric Pneumonia and Bronchiolitis Risk Scores to Predict Mortality in Children Hospitalized in Kenya: A Retrospective Cohort Study.

Becky Gordon, Joyce U Nyiro, Harish Nair, Zakariya Sheikh, Esther Katama, Charles N Agoti, Ruonan Pei, Heather Zar, Ting Shi

Abstract readValidation Study
In one paragraph

Article in The Journal of infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. 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

9 authors.

Becky GordonUsher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom.ORCID 0009-0002-3739-179X
Joyce U NyiroEpidemiology and Demography Department, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
Harish NairUsher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom.ORCID 0000-0002-9432-9100
Zakariya SheikhEdinburgh Medical School, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom.ORCID 0000-0003-4147-4205
Esther KatamaEpidemiology and Demography Department, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
Charles N AgotiEpidemiology and Demography Department, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.ORCID 0000-0002-2160-567X
Ruonan PeiUsher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom.ORCID 0009-0003-2932-1473
Heather ZarDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.ORCID 0000-0002-9046-759X
Ting ShiUsher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom.ORCID 0000-0002-4101-4535

Funding

Alan Turing Institute Wellcome 218529/Z/19/ZHealth Data Research UKWellcome Trust
6 · The paper itself

Abstract

backgroundAcute lower respiratory tract infections (ALRIs) are a leading cause of pediatric mortality in low- and middle-income countries. In recent years, substantial research has been done to enhance risk stratification of children presenting with ALRIs, in a bid to improve health outcomes in resource-limited settings. We sought to analyze the performance of several pediatric ALRI risk scores in the prediction of mortality among children hospitalized with ALRIs in Kenya.

methodsWe retrospectively analyzed the data of 2182 children aged 2-24 months who were admitted to Kilifi County Referral Hospital, Kenya with severe ALRIs between January 2015 and December 2024. We evaluated the performance of 6 ALRI risk scores (RISC [HIV-negative], mRISC, RISC-Malawi, PERCH, PREPARE, and ReSVinet) in this population. Additionally, we created and evaluated a modified version of the ReSVinet score by including nutrition status. Discrimination was assessed using the area under the receiver operating characteristic curve (AUROC).

resultsThe mid-upper arm circumference (MUAC) version of the RISC-Malawi score showed the highest discrimination for the outcome of in-hospital mortality (AUROC, 0.83; 95% confidence interval, .79-.86), whilst all other scores showed acceptable discrimination (AUROC, 0.70-0.79). The modification of ReSVinet to include nutrition status significantly improved its AUROC from 0.72 to 0.79.

conclusionsAll risk scores showed at least fair performance in the prediction of in-hospital mortality within our dataset. The RISC-Malawi (MUAC) score appears to be the most promising candidate for future implementation; however, further research is needed to evaluate the calibration, feasibility, and clinical utility of these scores.

Indexed as

BronchiolitisPneumoniaChild, PreschoolFemaleHospitalizationHospital MortalityHumansInfantKenyaMaleRetrospective StudiesRisk AssessmentRisk FactorsROC Curveacute lower respiratory tract infectionspneumoniarisk scoresrisk stratification

Identifiers

PMID40692486
PMCPMC12811851

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.