Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Infants 21–90 days presenting with a possible serious bacterial infection are evaluation algorithms from high income countries applicable in the
South African public health sector?
Dublin Core
Title
Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Infants 21–90 days presenting with a possible serious bacterial infection are evaluation algorithms from high income countries applicable in the
South African public health sector?
African Journal of Emergency Medicine
Infants 21–90 days presenting with a possible serious bacterial infection are evaluation algorithms from high income countries applicable in the
South African public health sector?
Subject
Serious bacterial infection
Invasive bacterial infection
Fever
Infants
Evaluation algorithms
Invasive bacterial infection
Fever
Infants
Evaluation algorithms
Description
Background: Young infants with a possible serious bacterial infection (SBI) are a very common presentation to
emergency centres (ECs). It is often difficult to distinguish clinically between self-limiting viral infections and an
SBI. Available evaluation algorithms to assist clinicians are mostly from high-income countries. Data to inform
clinical practice in low- and middle-income countries are lacking.
Objectives: To determine the period prevalence of SBI and invasive bacterial infection (IBI) and describe current
practice in the assessment and management of young infants aged 21–90 days presenting with a possible SBI to a
Paediatric Emergency centre (PEC) in Cape Town, South Africa.
Methods: A retrospective cross-sectional review of infants 21–90 days old presenting to the Tygerberg Hospital
PED between 1 January 2016 and 31 May 2016.
Results: A total of 248 infants 21–90 days were included in the study. Sixty-two patients (25%, 95% CI 20–30)
had an SBI and 13 (5.2%, 95% CI 3–8) had an IBI. One hundred and sixty-five infants had a possible SBI based on
WHO IMCI criteria. The sensitivity of the WHO IMCI criteria in detecting SBI was 82.3% (95% CI 70.5–90.8) and
the specificity 38.7% (95% CI 31.7–46.1). More than half (51.2%) of the infants received antibiotics within the
48 h prior to presentation, of which 33.5% included intramuscular injection of Ceftriaxone. Only 20 (8.0%)
patients in this age group were discharged home after initial evaluation. A significant relationship was noted
between fever and the risk of SBI (p-value 0.010) and IBI (p-value 0.009). There also appeared to be a significant
relationship between nutritional status and IBI (p-value 0.013).
Conclusion: Period prevalence of SBI and IBI was higher compared to that published in the literature. Validated
evaluation algorithms to stratify risk of SBI are needed to assist clinicians in diagnosing and managing infants
appropriately in low- and middle-income settings.
emergency centres (ECs). It is often difficult to distinguish clinically between self-limiting viral infections and an
SBI. Available evaluation algorithms to assist clinicians are mostly from high-income countries. Data to inform
clinical practice in low- and middle-income countries are lacking.
Objectives: To determine the period prevalence of SBI and invasive bacterial infection (IBI) and describe current
practice in the assessment and management of young infants aged 21–90 days presenting with a possible SBI to a
Paediatric Emergency centre (PEC) in Cape Town, South Africa.
Methods: A retrospective cross-sectional review of infants 21–90 days old presenting to the Tygerberg Hospital
PED between 1 January 2016 and 31 May 2016.
Results: A total of 248 infants 21–90 days were included in the study. Sixty-two patients (25%, 95% CI 20–30)
had an SBI and 13 (5.2%, 95% CI 3–8) had an IBI. One hundred and sixty-five infants had a possible SBI based on
WHO IMCI criteria. The sensitivity of the WHO IMCI criteria in detecting SBI was 82.3% (95% CI 70.5–90.8) and
the specificity 38.7% (95% CI 31.7–46.1). More than half (51.2%) of the infants received antibiotics within the
48 h prior to presentation, of which 33.5% included intramuscular injection of Ceftriaxone. Only 20 (8.0%)
patients in this age group were discharged home after initial evaluation. A significant relationship was noted
between fever and the risk of SBI (p-value 0.010) and IBI (p-value 0.009). There also appeared to be a significant
relationship between nutritional status and IBI (p-value 0.013).
Conclusion: Period prevalence of SBI and IBI was higher compared to that published in the literature. Validated
evaluation algorithms to stratify risk of SBI are needed to assist clinicians in diagnosing and managing infants
appropriately in low- and middle-income settings.
Creator
Juanita Lishman , Liezl Smit, Andrew Redfern
Source
www.elsevier.com/locate/afjem
Publisher
elsevier
Date
21 September 2020
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Citation
Juanita Lishman , Liezl Smit, Andrew Redfern, “Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Infants 21–90 days presenting with a possible serious bacterial infection are evaluation algorithms from high income countries applicable in the
South African public health sector?,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/2467.
African Journal of Emergency Medicine
Infants 21–90 days presenting with a possible serious bacterial infection are evaluation algorithms from high income countries applicable in the
South African public health sector?,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/2467.