Prediction of disease severity in young children presenting with acute febrile illness in resource-limited settings: A protocol for a prospective observational study

Chandna, Arjun and Aderie, Endashaw M and Ahmad, Riris and Arguni, Eggi and Ashley, Elizabeth A and Cope, Tanya and Dat, Vu Quoc and Day, Nicholas P J and Dondorp, Arjen M and Illanes, Victor and De Jesus, Joanne and Jimenez, Carolina and Kain, Kevin and Suy, Keang and Koshiaris, Constantinos and Lasry, Estrella and Mayxay, Mayfong and Mondal, Dinesh and Perera, Rafael and Pongvongsa, Tiengkham and Rattanavong, Sayaphet and Rekart, Michael and Richard-Greenblatt, Melissa and Shomik, Mohammad and Souvannasing, Phouthalavanh and Tallo, Veronica and Turner, Claudia and Turner, Paul and Waithira, Naomi and Watson, James A and Yosia, Mikhael and Burza, Sakib and Lubell, Yoel (2021) Prediction of disease severity in young children presenting with acute febrile illness in resource-limited settings: A protocol for a prospective observational study. BMJ Open, 11 (1). ISSN 20446055

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Abstract

Introduction In rural and difficult-to-access settings, early and accurate recognition of febrile children at risk of progressing to serious illness could contribute to improved patient outcomes and better resource allocation. This study aims to develop a prognostic clinical prediction tool to assist community healthcare providers identify febrile children who might benefit from referral or admission for facility-based medical care. Methods and analysis This prospective observational study will recruit at least 4900 paediatric inpatients and outpatients under the age of 5 years presenting with an acute febrile illness to seven hospitals in six countries across Asia. A venous blood sample and nasopharyngeal swab is collected from each participant and detailed clinical data recorded at presentation, and each day for the first 48 hours of admission for inpatients. Multianalyte assays are performed at reference laboratories to measure a panel of host biomarkers, as well as targeted aetiological investigations for common bacterial and viral pathogens. Clinical outcome is ascertained on day 2 and day 28. Presenting syndromes, clinical outcomes and aetiology of acute febrile illness will be described and compared across sites. Following the latest guidance in prediction model building, a prognostic clinical prediction model, combining simple clinical features and measurements of host biomarkers, will be derived and geographically externally validated. The performance of the model will be evaluated in specific presenting clinical syndromes and fever aetiologies. Ethics and dissemination The study has received approval from all relevant international, national and institutional ethics committees. Written informed consent is provided by the caretaker of all participants. Results will be shared with local and national stakeholders, and disseminated via peer-reviewed open-access journals and scientific meetings. Trial registration number NCT04285021. ©

Item Type: Article
Additional Information: Cited by: 8; All Open Access, Gold Open Access
Uncontrolled Keywords: Asia; Child; Child, Preschool; Humans; Models, Statistical; Observational Studies as Topic; Prognosis; Prospective Studies; Severity of Illness Index; C reactive protein; chitinase 3 like protein 1; gamma interferon inducible protein 10; glucose; hemoglobin; intercellular adhesion molecule 1; interleukin 10; interleukin 6; interleukin 8; lactic acid; procalcitonin; thrombomodulin; triggering receptor expressed on myeloid cells 1; tumor necrosis factor receptor 1; vascular adhesion protein 1; Article; blood analysis; child; clinical outcome; controlled study; disease severity; female; fever; follow up; hospital admission; hospital patient; human; major clinical study; male; nasopharyngeal swab; observational study; outcome assessment; outpatient; pediatric patient; prediction; preschool child; prospective study; study design; venous blood; Asia; prognosis; severity of illness index; statistical model
Subjects: R Medicine > RJ Pediatrics
Divisions: Faculty of Medicine, Public Health and Nursing > Public Health and Nutrition
Depositing User: Sri JUNANDI
Date Deposited: 20 Sep 2024 07:09
Last Modified: 20 Sep 2024 07:09
URI: https://ir.lib.ugm.ac.id/id/eprint/4805

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