ArticlePediatric nephrology (Berlin, Germany)2026
Clinical phenotypes and severity stratification in pediatric diethylene glycol poisoning: a latent class analysis of the Gambia acute kidney injury outbreak.
Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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.
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.
Who cites it
3 citing papers in PubMed.
- Comorbidity phenotypes and the incidence and severity of acute kidney injury in older critically ill patients: a retrospective cohort study.BMC geriatrics · 2026Article
- Gender disparities and treatment cascade gaps in The Gambia's HIV epidemic: 35-year trends, male disadvantage, and scenarios toward UNAIDS 2030 targets.BMC infectious diseases · 2026Article
- Protective factors against acute kidney injury in children exposed to diethylene glycol-contaminated medicines: A case-case-control analysis from The Gambia outbreak.PLOS global public health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBetween June and September 2022, an outbreak of acute kidney injury (AKI) among children in The Gambia caused 66 deaths among 82 cases, linked to medicines contaminated with diethylene glycol (DEG) and ethylene glycol. Clinical heterogeneity in DEG poisoning remains poorly characterized, limiting risk stratification and resource allocation in outbreak settings. We used latent class analysis to identify distinct clinical phenotypes and their predictors.
methodsWe conducted a secondary analysis of a case-cohort study involving 63 AKI cases and 258 controls aged ≤ 8 years. Latent class analysis, a statistical approach that identifies naturally occurring patient subgroups based on symptom patterns, used 13 binary symptom indicators to identify clinical phenotypes via an expectation-maximization algorithm. We compared models with 2-5 classes using the Bayesian Information Criterion and entropy. Multinomial logistic regression examined predictors of phenotype membership.
resultsFour distinct phenotypes were identified: Classic Kidney-Fever (30.2%), Gastrointestinal-Kidney (22.2%), Cardio-Respiratory-Kidney (19.0%), and Mild/Atypical (28.6%). The 4-class model demonstrated excellent classification certainty (entropy = 0.910). The Cardio-Respiratory-Kidney phenotype showed the highest DEG exposure (83.3% vs. 44.4% in Mild/Atypical, p = .015) and was strongly predicted by exposure intensity (adjusted RRR = 6.82, 95% CI [1.45-32.10]) and younger age. Multisystem involvement (≥ 3 organ systems) occurred in 28.6% of cases vs. 0% of controls.
conclusionsDEG-induced AKI manifests as four distinct clinical phenotypes with differing severity and exposure patterns. The severe Cardio-Respiratory-Kidney phenotype represents a critical target for prioritized intervention in resource-constrained settings. Importantly, nearly 30% of cases presented with atypical or minimally symptomatic features, underscoring the need for comprehensive case-finding and close follow-up during outbreak investigations.
Indexed as
Identifiers
41580573What OpenQuestion holds
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.