Mortality risk associated with clinical signs of possible serious bacterial infection (PSBI) in young infants in Africa and Asia: protocol for a secondary pooled analysis.

Journal: BMJ open
Published Date: Jun 24, 2025

Abstract

INTRODUCTION: The WHO's Integrated Management of Childhood Illness (IMCI) in young infants <2 months of age includes the identification and management of signs of possible serious bacterial infection (PSBI). However, equal importance is given to all the PSBI signs, which signal the need for referral and hospital management, except for fast breathing in infants aged 7-59 days, for which outpatient treatment by clinical staff working at a health facility is recommended. Moreover, studies to validate the importance of clinical signs of PSBI have mostly used the need for hospitalisation as the outcome. There is a need to further examine the association of signs of PSBI individually and in combination with risk of mortality and to analyse global data to inform global recommendations.

Authors

  • Gary L Darmstadt
    March of Dimes Prematurity Center, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
  • Vaishnavi Bhamidi
    Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA.
  • Khusbu Adhikari
    Department of Computer Science, Stanford University, Stanford, California, USA.
  • Ivana Marić
    Department of Pediatrics, Stanford University, Stanford, California, USA.
  • Mohammad Shahidul Islam
    Child Health Research Foundation, Dhaka, Bangladesh.
  • Shamim Ahmad Qazi
    Independent Consultant Paediatrician, Geneva, Switzerland.
  • Saifuddin Ahmed
    Department of Population, Family and Reproductive Health, Johns Hopkins University, Baltimore, Maryland, USA.
  • Antoinette Tshefu Kitoto
    University of Kinshasa, Kinshasa, Congo (Democratic Republic of the Congo).
  • Fabian Esamai
    Department of Child Health and Paediatrics, Moi University, Eldoret, Uasin Gishu County, Kenya.
  • Adejumoke Idowu Ayede
    University of Ibadan College of Medicine, Ibadan, Oyo, Nigeria.
  • Ebunoluwa A Adejuyigbe
    Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria.
  • Robinson D Wammanda
    Ahmadu Bello University Teaching Hospital, Zaria, Kaduna state, Nigeria, Zaria, Kaduna, Nigeria.
  • Samir K Saha
    Child Health Research Foundation, Dhaka, Bangladesh.
  • Yasir Bin Nisar
    Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneve, Switzerland.

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