Clinical algorithms for the identification of sick newborns in community-based settings

Clinical algorithms can be powerful tools for the identification of sick newborns at risk of neonatal mortality. Several studies have evaluated clinical signs for newborns aged 0-60 days to identify severe illness; however, few studies have focused specifically on the most vulnerable time period for neonatal death, the first week of life. Therefore, we reviewed the studies that evaluated clinical signs in newborns 0-60 days, focusing on infants 0 to <7 days. Based on a comparison of relevant studies, we then identified the common, important clinical signs shown to be useful for the identification of at-risk newborns by health workers in community-based and low-resource settings.

We concluded that further work is urgently needed to develop a clinical algorithm for widespread validation in various community-based settings, which focuses specifically on newborns <7 days at risk of early neonatal mortality.