Centre for International Health

Predicting recovery time in sick infants

Being better able to identify the most seriously ill infants is of great importance in terms of being best able to prioritise health resources, particularly is developing countries where such resources are limited. Two researchers from the Centre for Intervention Science in Maternal and Child Health (CISMAC) were part of a study that has identified predictors of recovery time in infants with Probably Serious Bacterial Infection (PSBI).

seriously ill infants
Vicki Francis/Department for International Development (Flickr, CC license)

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Probably Serious Bacterial Infections (PSBI) are a significant cause of infant death globally (about 20%). Despite medical advances in terms of treatment and facilities, many seriously ill infants in developing countries may not even be prioritised to reach treatment facilities (see the Fact Box for some disturbing statistics).

Having relatively easy-to-use, quantifiable indicators for accessing illness severity will enable health care workers to make more effective decisions regarding health care resources. This in turn will have positive economic and social effects for communities in developing countries.

Identifying simple indicators

Time to recovery is used as an indicator of the severity of the PSBI, which in turn relates to identifying infants who should receive special treatment, including more lengthy hospital stay, which also, in turn has an economic and social impact on both the family and health system. This study found several simple clinical and laboratory parameters that could be used as early identifiers of infants with PSBI at risk for longer recovery times. These include

  • Formula feeding prior to illness
  • Being underweight
  • Being lethargic and/or irritable
  • Poor breast suckling
  • Having elevated CRP levels (≥12mg/L)

Although it requires more resources to measure than some of the others, CRP levels could be a simple, easily quantifiable tool for predicting illness severity and for making clinical management decisions. (C-reactive protein (CRP) is produced by the liver. Its level rises when there is inflammation in the body.)

Read more about this study:

Predictors of Time to Recovery in Infants with Probable Serious Bacterial Infection.         
Singh P, Wadhwa N, Lodha R, Sommerfelt H, Aneja S, Natchu UC, Chandra J, Rath B, Sharma VK, Kumari M, Saini S, Kabra SK, Bhatnagar S, Strand TA.         PLoS One.  Apr 2015

Tor A. Strand, an Adjunct Professor from CISMAC and the Reproductive Health, Child Health and Nutrition research group at the Centre for International Health and the Department of Global Public Health and Primary Care and Halvor Sommerfelt, Leader of CISMAC and a Professor at the Centre for International Health, and the Department of Global Public Health and Primary Care were part of a group a researchers who studied a dataset of 700 infants with PSBI. The aim was to identify predictors of children needing special attention as this has relevance to both the family’s economy and that of the health system. The dataset was collected on infants hospitalised at three tertiary hospitals in New Delhi, India.