Clinical Signs of Pneumonia, Sepsis and Meningitis in Young Infants
Keywords
Infant
Young Infant
Newborn Infant
Infant Fever
Pneumonia
Sepsis
Meningitis
Pneumonia in Children
Meningitis in Children
Sepsis in Children
WHO ARI Young Infant Multicenter Study
This dataset contains 4552 observations and 97 variables. This dataset is from The World Health Organization Multicentre Acute Respiratory Infection (WHO ARI) Study of Clinical Signs and Etiological Agents of Pneumonia, Sepsis, and Meningitis in Young Infants.
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This dataset came from the Department of Biostatistics of Vanderbilt University. Frank E. Harrell, together with colleagues, and the World Health Organization Multicentre Acute Respiratory Infection (WHO ARI) Young Infant Multicentre Study Group conducted a study titled, “The World Health Organization Multicentre Study of Clinical Signs and Etiological Agents of Pneumonia, Sepsis, and Meningitis in Young Infants”. This study was conducted to develop a clinical prediction model to assist health workers in developing countries in the presentation of an acutely ill young infant.
One of the most difficult problems faced by health workers in all parts of the world is the presentation of an acutely ill young infant. Infants under 3 months of age face serious infections which are the main causes of morbidity and mortality, particularly in developing countries. Diagnosis proves to be difficult as in the case of meningitis, pneumonia or sepsis. The ability to detect serious bacterial infection early in young infants is important in defining appropriate prevention and treatment strategies hence a better clinical prediction rule to be used by health workers both in developing and industrialized countries is needed in order to accurately predict which combination of clinical signs of infant determine meningitis, sepsis or pneumonia.
This study was undertaken in Ethiopia, The Gambia, Papua New Guinea and the Philippines where data was collected and used to come up with better screening criteria for finding infants at high risk of serious infection. There are 47 clinical signs collected from this study and a single variable was coded 0—3 representing sign not present, mild, moderate, severe.
From this study, researchers were able to develop a clinical prediction model for an ordinal scale to determine the combinations of clinical signs of infant that determine meningitis, sepsis or pneumonia.
For more information about this study, see related studies: Frank E. Harrell, Peter A. Margolis, Sandy Gove, Karen E. Mason, E. Kim Mulholland, Deborah Lehmann, Lulu Muhe, Salvacion Gatchalian, and Heinz F. Eichenwald. Development of a clinical prediction model for an ordinal outcome: The World Health Organization ARI Multicentre Study of clinical signs and etiologic agents of pneumonia, sepsis, and meningitis in young infants. Stat Med, 17:909-944, 1998 and Peter Margolis, E. Kim Mulholland, Frank E. Harrell, Sandy Gove, and the WHO Young Infants Study Group. Clinical prediction of serious bacterial infections in young infants in developing countries. Pediatric Infectious Disease Journal, 18S:S23-S31, 1999.
About this Dataset
Data Info
Date Created
2008-01-17
Last Modified
2008-01-17
Version
2008-01-17
Update Frequency
Never
Temporal Coverage
1998
Spatial Coverage
Ethiopia, The Gambia, Papua New Guinea, Philippines
Source
John Snow Labs; Department of Biostatistics, Vanderbilt University;
Source License URL
Source License Requirements
N/A
Source Citation
N/A
Keywords
Infant, Young Infant, Newborn Infant, Infant Fever, Pneumonia, Sepsis, Meningitis, Pneumonia in Children, Meningitis in Children, Sepsis in Children
Other Titles
Development of a Clinical Prediction Model, Clinical Signs of Pneumonia, Sepsis and Meningitis in Young Infants
Data Fields
Name
Description
Type
Constraints
Sticker_Number
Sticker number of young infants
string
-
Weight_Criteria_Met
Infants in the study sample meeting the inclusion criteria for weight where an infant with a birth weight <1500 g and less than 48 hours old is excluded, either Yes, No, or Maybe
string
-
Laboratory_Evaluation_Criteria_Met
Infants in the study sample meeting the prescribed criteria for laboratory evaluation and underwent blood culture and chest radiography, either No, Refused, Sampled, Yes
string
-
White_Blood_Cell_Result
White blood cell result
integer
level : Ratio
Lumbar_Puncture_Cell_Count
Cell count from a lumbar puncture culture
integer
level : Ratio
Number_Days_Ill
Number of days ill
integer
level : Nominal
Birthweight
Birthweight of infants
number
level : Ratio
Head_Circumference
Head circumference of infants
number
level : Ratio
Weight_in_Grams
Weight in grams of infants
integer
level : Ratio
Length_in_Centimeters
Length in centimeters of infants
number
level : Ratio
Temperature
Temperature of infants
number
level : Ratio
Chronic_Inflammatory_Demyelinating_Polyneuropathy
Cdip, either Yes, No, or S
string
-
Heart_Rate_Oximeter
Heart rate
number
level : Ratio
Country
Country either Ethiopia, Gambia, Manila or Papua New Guinea
string
-
Age_in_Days
Age in days of infants
number
level : Ratio
Adjusted_Respiratory_Rate
Adjusted respiratory rate
integer
level : Ratio
Chest_Radiograph_Protocol
Chest radiograph either None, Cold,cough, Pneumonia, Severe pneumonia or Very severe disease
string
-
Mother_Report_Respiratory_Problems
Mother report respiratory problems, either No problem, Hy respir/no chest, Hy respir/chest
string
-
Implications
Implications, either No Pneumonia, Sepsis or Meningitis, No Pneunomia, Sepsis, Meningitis - other, Pneumonia only, Sepsis only, Meningitis only, Pneumonia and Sepsis, Pneumonia and Meningitis, Meningitis and Sepsis, and Pneumonia, Meningitis and Sepsis
string
-
Arterial_Oxygen_Saturation
Arterial oxygen saturation where the adjusted oxygen saturation measurements used placed infants into three risk categories equivalent to SaO2 values of <90%, 90 to 94% and >94%.
string
-
Polymorphonuclear_Cell_Ratio
Polymorphonuclear cell ratio
number
level : Ratio
Days_to_Death_or_Discharge
Days to death or discharge
integer
level : Ordinal
Blood_Culture_Rank
Blood culture rank
integer
level : Ordinal
Weight_for_Age_Zscore
Weight for age Zscore
number
level : Ratio
Weight_for_Age_Percent_Median
Weight for age in percent median
number
level : Ratio
Dead
If infant died, either L, N, P, or Y
string
-
Is_Omphalitis_Present
Presence or absence of omphalitis as a clinical sign
boolean
-
Is_Conjunctivitis_Present
Presence of absence of conjunctivitis as a clinical sign
boolean
-
Is_Disease_Present_or_Absent
Primary study outcome measure which indicates the presence or absence of disease, as well as its severity.
boolean
-
Total_Number_of_Xray_Readings
Total number of xray readings
integer
level : Ordinal
Pneumonia
Number of pneumonia
integer
level : Ordinal
Number_of_Definite_Pneumonia
Number of definite pneumonia
integer
level : Ordinal
Number_Normal
Number of normal
integer
level : Ordinal
Number_of_Probable_Pneumonia
Number of probable pneumonia
integer
level : Ordinal
Is_Associated_with_Death
Diagnoses ranked in a hierarchic fashion based on their association with the most severe outcome which is death.
boolean
-
Is_Associated_with_Bacterial_Infection
Diagnoses not strongly related to death examined with respect to their association with the presence of a positive blood culture or CSF result. This measure was selected because it would allow infants to be included in the clinical prediction rule who might have negative cultures (e.g. those with low oxygen saturation and positive radiographs), but who still might benefit from treatment because they were at increased risk of bacterial infection.
boolean
-
Is_No_Abnormality
Primary study outcome measure on an ordinal scale that summarized the presence or absence of disease, as well as its severity where first level of disease severity is no abnormality
boolean
-
Is_Mild_Hypoxemia
Primary study outcome measure on an ordinal scale that summarized the presence or absence of disease, as well as its severity where second level of disease severity is mild hypoxemia (90% ≧ SaO2 < 95%) or radiologic pneumonia
boolean
-
Is_Severe_Hypoxemia
Primary study outcome measure on an ordinal scale that summarized the presence or absence of disease, as well as its severity where third level of disease severity is severe hypoxemia (SaO2 < 90%) or bacteremia or meningitis
boolean
-
Is_Sleep_More
Sleeping more as a clinical sign
boolean
-
Is_Sleep_Less
Sleeping less as a clinical sign
boolean
-
Is_Wake_Less_Easy
Wakes less easy as a clinical sign
boolean
-
Is_Convulsion
Presence or absence of convulsion as a clinical sign
boolean
-
History_of_Abnormal_Feeding
History of abnormal feeding where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical sign
string
-
Is_Fast_Breathing
Fast breathing as a clinical sign
boolean
-
Is_History_of_Fever
History of fever as a clinical sign
boolean
-
Is_History_of_Stop_Breathing
History of stop breathing as a clinical sign
boolean
-
Is_Less_Activity
Less activity as a clinical sign
boolean
-
Is_More_Cry
More crying as a clinical sign
boolean
-
Is_Less_Cry
Less crying as a clinical sign
boolean
-
Is_History_of_Diarrhea
History of diarrhea as a clinical sign
boolean
-
Is_Vomit_More
Vomitting more as a clinical sign
boolean
-
Is_Birth_Preterm
Birth preterm as a clinical sign
boolean
-
Is_Fever_at_Delivery
Fever at delivery as a clinical sign
boolean
-
Is_History_of_Child_Death
History of child death as a clinical sign
boolean
-
Is_Engorged_Breasts
Engorged breasts as a clinical sign
boolean
-
Is_Water_Broke
Water breaking as a clinical sign
boolean
-
Days_in_Labour
Days in labour
number
level : Ratio
Respiratory_Distress
Respiratory distress, where 0=sign no present, 1=mild, 2=moderate, as clinical sign
string
-
State_Respiratory_1
State of respiratory distress (1) where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical sign
string
-
State_Respiratory_2
State of respiratory distress (2) where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical sign
string
-
Is_Apnea
Apnea as a clinical sign
boolean
-
Lower_Chest_Indrawing
Lower chest indrawing where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical sign
string
-
Nasal_Flare
Nasal flare where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical sign
string
-
Stridor
Stridor where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Grunt
Grunt where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Is_Cough_Heard
Cough heard as a clinical sign
boolean
-
Is_Central_Cyanosis
Central cyanosis as a clinical sign
boolean
-
Is_Jaundice
Jaundice as a clinical sign
boolean
-
Drowsy_State
Drowsy state where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Is_Agitated_State
Agitated state as a clinical sign
boolean
-
Arousal
Arousal where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Quality_of_Crying
Quality of crying where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Consolability
Consolability where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Attentive
Attentive where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Amount_of_Movement
Amount of movement where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Drinking_Ability
Drinking ability where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Sucking_Ability
Sucking ability where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Skin_Turgor
Skin turgor where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Dehydrate
Dehydration where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Digital_Capillary_Refill
Digital capillary refill where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Crepitation
Crepitation where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Skin_Rash
Skin rash where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Is_Bulging_Fontanelle
Bulging fontanelle as a clinical sign
boolean
-
Is_Sunken_Fontanelle
Sunken fontanelle as as clinical sign
boolean
-
Hypotonia
Hypotonia where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical sign
string
-
Is_Wheeze
Wheeze as a clinical sign
boolean
-
Is_Difficult_Breathing
Difficulty breathing as a clinical sign
boolean
-
Smile_Adjust_for_Age
Smile adjustability for age where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Is_Pustular_Skin_Rash
Pustular skin rash as a clinical sign
boolean
-
Abdominal_Distention_Score
Abdominal distention score where 0=sign no present, 1=mild, 2=moderate, 3=severe, 4=very severe as clinical sign
string
-
Nutritional_Status_Score
Nutritional status score where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical sign
string
-
Otoscopy_Impression
Otoscopy where 0=sign no present, 1=mild, 2=moderate as clinical sign
string
-
Severity_Illness
Severity of illness where 0=sign no present, 1=mild, 2=moderate, 3=severe, 4=very severe as clinical sign
string
-
Is_Sclerema_or_Hypertonicity
Sclerema or hypertonicity as a clinical sign
boolean
-
Is_Positive_Lumbar_Puncture
Positive lumbar puncture as a clinical sign
boolean
-
Treatment_Indicated
Treatment indicated where 0=sign no present, 1=mild, 2=moderate as clinical sign