Predictive value of clinical and laboratory features for the main febrile diseases in children living in Tanzania: A prospective observational study

Predictive value of clinical and laboratory features for the main febrile diseases in children living in Tanzania: A prospective observational study

Olga De Santis;Mary Kilowoko;Esther Kyungu;Willy Sangu;Pascal Cherpillod;Laurent Kaiser;Blaise Genton;Valérie D’Acremont;
PloS one 2017 Vol. 12 pp. e0173314-
325
santis2017plospredictive

Abstract

Background To construct evidence-based guidelines for management of febrile illness, it is essential to identify clinical predictors for the main causes of fever, either to diagnose the disease when no laboratory test is available or to better target testing when a test is available. The objective was to investigate clinical predictors of several diseases in a cohort of febrile children attending outpatient clinics in Tanzania, whose diagnoses have been established after extensive clinical and laboratory workup. Method From April to December 2008, 1005 consecutive children aged 2 months to 10 years with temperature ≥38°C attending two outpatient clinics in Dar es Salaam were included. Demographic characteristics, symptoms and signs, comorbidities, full blood count and liver enzyme level were investigated by bi- and multi-variate analyses (Chan, et al., 2008). To evaluate accuracy of combined predictors to construct algorithms, classification and regression tree (CART) analyses were also performed. Results 62 variables were studied. Between 4 and 15 significant predictors to rule in (aLR+>1) or rule out (aLR+

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