@article{Kiemde2018-od,

title = {Can clinical signs or symptoms combined with basic hematology  data be used to predict the presence of bacterial infections in  febrile children under - 5 years?},

author = {Francois Kiemde and Massa Dit Achille Bonko and Marc Christian Tahita and Palpouguini Lompo and Halidou Tinto and Petra F Mens and Henk D F H Schallig and Michael Boele Hensbroek},

doi = {10.1186/s12887-018-1340-3},

issn = {1471-2431},

year  = {2018},

date = {2018-11-01},

urldate = {2018-11-01},

journal = {BMC Pediatr.},

volume = {18},

number = {1},

pages = {370},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: Infectious diseases in children living in 

 resource-limited settings are often presumptively managed on the 

 basis of clinical signs and symptoms. Malaria is an exception. 

 However, the interpretation of clinical signs and symptoms in 

 relation to bacterial infections is often challenging, which may 

 lead to an over prescription of antibiotics when a malaria 

 infection is excluded. The present study aims to determine the 

 association between clinical signs and symptoms and basic 

 hematology data, with laboratory confirmed bacterial infections. 

 METHODS: A health survey was done by study nurses to collect 

 clinical signs/symptoms in febrile (axillary temperature $geq$ 

 37.5 °C) children under - 5 years of age. In addition, blood, 

 stool and urine specimen were systematically collected from each 

 child to perform bacterial culture and full blood cell counts. 

 To determine the association between a bacterial infection with 

 clinical signs/symptoms, and if possible supported by basic 

 hematology data (hemoglobin and leucocyte rates), a univariate 

 analysis was done. This was followed by a multivariate analysis only on those variables with a p-value p 39.5 °C (p = 0.002), diarrhea (p = 0.019) and edema (p = 0.017). There was no 

 association found between bacterial infections and basic 

 haematological findings. If diarrhea and edema were absent, a 

 good negative predictive value (100%) of a bacterial 

 bloodstream infection was found, but the positive predictive 

 value was low (33.3%) and the confidence interval was very 

 large (2.5-100; 7.5-70.1). CONCLUSION: Our study demonstrates 

 that clinical signs and symptoms, combined with basic hematology 

 data only, cannot predict bacterial infections in febrile 

 children under - 5 years of age. The development of practical 

 and easy deployable diagnostic tools to diagnose bacterial 

 infections remains a priority.},

keywords = {Bacteria; Children; Fever; Malaria; Signs; Symptoms},

pubstate = {published},

tppubtype = {article}

}