Related Experiment Videos
Recognition of illness in very young infants by inexperienced health workers
J P Brady1, F B Awan, E M Wafula
1Department of Paediatrics, Kenyatta National Hospital, University of Nairobi, Kenya.
Insights
Inexperienced health workers can accurately diagnose severe infections in infants under 3 months old. This study shows their correct diagnosis rate was 89%, aiding timely treatment decisions for infant health.
Area of Science:
- Pediatrics
- Infectious Diseases
- Global Health
Background:
- Accurate diagnosis of severe infections in young infants is critical for timely treatment.
- Inexperienced health workers often face challenges in recognizing severe illness in neonates and infants.
Purpose of the Study:
- To evaluate the ability of inexperienced health workers to identify severe infections in infants younger than 3 months.
- To assess the diagnostic accuracy of specific symptoms and signs for severe infant illness.
Main Methods:
- A study involving 200 infants under 3 months presenting with cough, fever, or malaise.
- Health workers recorded specific symptoms and signs, making an initial diagnosis.
- An experienced pediatrician confirmed diagnoses, serving as the gold standard for analysis.
Main Results:
- Inexperienced health workers correctly diagnosed severe illness in 89% of infants.
- Key indicators for severe illness included poor feeding, appearing ill, chest indrawing, and grunting.
- A respiratory rate of >= 60/min showed 78% sensitivity and 69% specificity.
Conclusions:
- Inexperienced health workers can reliably recognize severe infections in infants under 3 months.
- The findings support training and empowering frontline health workers in infant diagnosis and management.
- Improved diagnostic capabilities at the primary care level can significantly impact infant mortality rates.
Abstract:
To determine whether inexperienced health workers can recognize severe infection in infants less than 3 months of age, a study was conducted of 200 infants with cough, fever or 'not feeling well'. The presence or absence of five symptoms: cough, difficulty in breathing, feeding problem, fever or history of convulsions, and ten signs: appearing ill, respiratory rate > or = 60/min, chest indrawing, grunting, cyanosis, wheeze, lethargy, 'too hot', 'too cold' or abdominal distension, were recorded by a health worker, who made a diagnosis of 'ill' or 'mildly ill'. Each infant was then reviewed by an experienced paediatrician who made a diagnosis of 'ill' (pneumonia, sepsis, meningitis or other severe illness) or 'mildly ill'. Using these diagnoses as the 'gold standard', the sensitivity, specificity, and positive predictive values of each parameter were calculated. In 89% of the 200 infants, the health worker made the correct diagnosis. Forty infants were admitted. In 36 instances (90%) the health worker made the correct decision. The most discriminating symptoms and signs were 'not feeding well', 'appears ill', chest indrawing and grunting. A respiratory rate > or = 60/min was 78% sensitive and 69% specific. Our study suggests that inexperienced health workers can recognize severe illness in infants under 3 months of age.