Abstract | BACKGROUND: METHODOLOGY AND PRINCIPAL FINDINGS: Children presenting with a signs of meningitis (n = 282) or pneumonia (n = 95), were prospectively recruited. Plasma samples were taken on admission for CRP, PCT, sTREM-1 CD163 and HMGB1 and the performance characteristics of each test to diagnose SBI and to predict mortality were determined. Of 377 children, 279 (74%) had SBI and 83 (22%) died. Plasma CRP, PCT, CD163 and HMGB1 and were higher in HIV-infected children than in HIV-uninfected children (p<0.01). In HIV-infected children, CRP and PCT were higher in children with SBI compared to those with no detectable bacterial infection (p<0.0005), and PCT and CD163 were higher in non-survivors (p = 0.001, p = 0.05 respectively). In HIV-uninfected children, CRP and PCT were also higher in children with SBI compared to those with no detectable bacterial infection (p<0.0005), and CD163 was higher in non-survivors (p = 0.05). The best predictors of SBI were CRP and PCT, and areas under the curve (AUCs) were 0.81 (95% CI 0.73-0.89) and 0.86 (95% CI 0.79-0.92) respectively. The best marker for predicting death was PCT, AUC 0.61 (95% CI 0.50-0.71). CONCLUSIONS: Admission PCT and CRP are useful markers of invasive bacterial infection in severely ill African children. The study of these markers using rapid tests in a less selected cohort would be important in this setting.
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Authors | Enitan D Carrol, Limangeni A Mankhambo, Graham Jeffers, Deborah Parker, Malcolm Guiver, Paul Newland, Daniel L Banda, IPD Study Group, Elizabeth M Molyneux, Robert S Heyderman, Malcolm E Molyneux, C Anthony Hart |
Journal | PloS one
(PLoS One)
Vol. 4
Issue 8
Pg. e6621
(Aug 13 2009)
ISSN: 1932-6203 [Electronic] United States |
PMID | 19675669
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adolescent
- Bacterial Infections
(diagnosis, mortality, pathology)
- Biomarkers
(analysis)
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Malawi
(epidemiology)
- Male
- Prognosis
- Prospective Studies
- Reproducibility of Results
- Severity of Illness Index
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