RT Journal Article
SR Electronic
T1 Prediction of disease severity in young children presenting with acute febrile illness in resource-limited settings: a protocol for a prospective observational study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e045826
DO 10.1136/bmjopen-2020-045826
VO 11
IS 1
A1 Arjun Chandna
A1 Endashaw M Aderie
A1 Riris Ahmad
A1 Eggi Arguni
A1 Elizabeth A Ashley
A1 Tanya Cope
A1 Vu Quoc Dat
A1 Nicholas P J Day
A1 Arjen M Dondorp
A1 Victor Illanes
A1 Joanne De Jesus
A1 Carolina Jimenez
A1 Kevin Kain
A1 Keang Suy
A1 Constantinos Koshiaris
A1 Estrella Lasry
A1 Mayfong Mayxay
A1 Dinesh Mondal
A1 Rafael Perera
A1 Tiengkham Pongvongsa
A1 Sayaphet Rattanavong
A1 Michael Rekart
A1 Melissa Richard-Greenblatt
A1 Mohammad Shomik
A1 Phouthalavanh Souvannasing
A1 Veronica Tallo
A1 Claudia Turner
A1 Paul Turner
A1 Naomi Waithira
A1 James A Watson
A1 Mikhael Yosia
A1 Sakib Burza
A1 Yoel Lubell
YR 2021
UL http://bmjopen.bmj.com/content/11/1/e045826.abstract
AB 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.