Evaluation of procalcitonin as a marker of bacterial sepsis in children in Owerri, Nigeria.

Background: Paediatric sepsis is a significant cause of morbidity and mortality, particularly in low- and middle-income countries. Timely diagnosis remains a challenge due to the limitations of conventional blood culture. This study evaluates procalcitonin as a biomarker for bacterial sepsis in children aged 0-59 months in a resource-limited setting. Methods: This cross-sectional study was carried out between June 2023 and February 2024. It involved 298 children aged 0-59 months with systemic inflammatory response syndrome (SIRS) who were admitted to the Emergency Pediatric Unit and Special Care Baby Unit of Federal Teaching Hospital, Owerri. Serum procalcitonin levels were measured using ELISA, and blood cultures were processed using the BacT/Alert system. Sensitivity, specificity, and predictive values of procalcitonin were compared against blood culture results. Results: Of the 298 children, 142 (47.7%) had culture-proven sepsis. The sensitivity, specificity, positive predictive value, and negative predictive value of serum procalcitonin were 66.9%, 89.7%, 85.6%, and 74.9%, respectively. The area under the curve (AUC) for serum procalcitonin was 0.80 across all age groups which were statistically significant. Conclusions: Procalcitonin has a good diagnostic accuracy in detecting bacterial sepsis in children and can complement blood culture in resource-limited settings. Further studies are recommended to explore its application in routine clinical practice.