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Title

A novel electronic algorithm using host biomarker point-of-care tests for the management of febrile illnesses in Tanzanian children (e-POCT): A randomized, controlled non-inferiority trial

Authors
Keitel, Kristina
Kagoro, Frank
Samaka, Josephine
Masimba, John
Said, Zamzam
Temba, Hosiana
Mlaganile, Tarsis
Sangu, Willy
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Published in PLOS Medicine. 2017, vol. 14, no. 10, p. e1002411
Abstract The management of childhood infections remains inadequate in resource-limited countries, resulting in high mortality and irrational use of antimicrobials. Current disease management tools, such as the Integrated Management of Childhood Illness (IMCI) algorithm, rely solely on clinical signs and have not made use of available point-of-care tests (POCTs) that can help to identify children with severe infections and children in need of antibiotic treatment. e-POCT is a novel electronic algorithm based on current evidence; it guides clinicians through the entire consultation and recommends treatment based on a few clinical signs and POCT results, some performed in all patients (malaria rapid diagnostic test, hemoglobin, oximeter) and others in selected subgroups only (C-reactive protein, procalcitonin, glucometer). The objective of this trial was to determine whether the clinical outcome of febrile children managed by the e-POCT tool was non-inferior to that of febrile children managed by a validated electronic algorithm derived from IMCI (ALMANACH), while reducing the proportion with antibiotic prescription.
Keywords Age of OnsetAlgorithmsAnti-Bacterial Agents/therapeutic useBiomarkers/bloodChildPreschoolClinical Decision-MakingCommunicable Diseases/diagnosis/drug therapy/mortality/physiopathologyDecision Support TechniquesDiagnosisComputer-Assisted/instrumentationDiagnosisDifferentialFemaleFever/diagnosis/drug therapy/mortality/physiopathologyHeart RateHumansInfantMaleMobile ApplicationsNutritional StatusPatient ReadmissionPatient SelectionPoint-of-Care SystemsPoint-of-Care TestingPredictive Value of TestsReproducibility of ResultsRespirationRisk FactorsSeverity of Illness IndexSmartphoneTanzania
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PMID: 29059253
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Article (Published version) (6.8 MB) - public document Free access
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Research group Etiologie des pneumonies et marqueurs inflammatoires chez l'enfant fébrile (183)
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KEITEL, Kristina et al. A novel electronic algorithm using host biomarker point-of-care tests for the management of febrile illnesses in Tanzanian children (e-POCT): A randomized, controlled non-inferiority trial. In: PLOS Medicine, 2017, vol. 14, n° 10, p. e1002411. https://archive-ouverte.unige.ch/unige:107577

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Deposited on : 2018-09-11

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