Others titles

  • Development of a Clinical Prediction Model
  • 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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Description

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_NumberSticker number of young infantsstring-
Weight_Criteria_MetInfants 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 Maybestring-
Laboratory_Evaluation_Criteria_MetInfants in the study sample meeting the prescribed criteria for laboratory evaluation and underwent blood culture and chest radiography, either No, Refused, Sampled, Yesstring-
White_Blood_Cell_ResultWhite blood cell resultintegerlevel : Ratio
Lumbar_Puncture_Cell_CountCell count from a lumbar puncture cultureintegerlevel : Ratio
Number_Days_IllNumber of days illintegerlevel : Nominal
BirthweightBirthweight of infantsnumberlevel : Ratio
Head_CircumferenceHead circumference of infantsnumberlevel : Ratio
Weight_in_GramsWeight in grams of infantsintegerlevel : Ratio
Length_in_CentimetersLength in centimeters of infantsnumberlevel : Ratio
TemperatureTemperature of infantsnumberlevel : Ratio
Chronic_Inflammatory_Demyelinating_PolyneuropathyCdip, either Yes, No, or Sstring-
Heart_Rate_OximeterHeart ratenumberlevel : Ratio
CountryCountry either Ethiopia, Gambia, Manila or Papua New Guineastring-
Age_in_DaysAge in days of infantsnumberlevel : Ratio
Adjusted_Respiratory_RateAdjusted respiratory rateintegerlevel : Ratio
Chest_Radiograph_ProtocolChest radiograph either None, Cold,cough, Pneumonia, Severe pneumonia or Very severe diseasestring-
Mother_Report_Respiratory_ProblemsMother report respiratory problems, either No problem, Hy respir/no chest, Hy respir/cheststring-
ImplicationsImplications, 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 Sepsisstring-
Arterial_Oxygen_SaturationArterial 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_RatioPolymorphonuclear cell rationumberlevel : Ratio
Days_to_Death_or_DischargeDays to death or dischargeintegerlevel : Ordinal
Blood_Culture_RankBlood culture rankintegerlevel : Ordinal
Weight_for_Age_ZscoreWeight for age Zscorenumberlevel : Ratio
Weight_for_Age_Percent_MedianWeight for age in percent mediannumberlevel : Ratio
DeadIf infant died, either L, N, P, or Ystring-
Is_Omphalitis_PresentPresence or absence of omphalitis as a clinical signboolean-
Is_Conjunctivitis_PresentPresence of absence of conjunctivitis as a clinical signboolean-
Is_Disease_Present_or_AbsentPrimary study outcome measure which indicates the presence or absence of disease, as well as its severity.boolean-
Total_Number_of_Xray_ReadingsTotal number of xray readingsintegerlevel : Ordinal
PneumoniaNumber of pneumoniaintegerlevel : Ordinal
Number_of_Definite_PneumoniaNumber of definite pneumoniaintegerlevel : Ordinal
Number_NormalNumber of normalintegerlevel : Ordinal
Number_of_Probable_PneumoniaNumber of probable pneumoniaintegerlevel : Ordinal
Is_Associated_with_DeathDiagnoses ranked in a hierarchic fashion based on their association with the most severe outcome which is death.boolean-
Is_Associated_with_Bacterial_InfectionDiagnoses 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_AbnormalityPrimary 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 abnormalityboolean-
Is_Mild_HypoxemiaPrimary 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 pneumoniaboolean-
Is_Severe_HypoxemiaPrimary 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 meningitisboolean-
Is_Sleep_MoreSleeping more as a clinical signboolean-
Is_Sleep_LessSleeping less as a clinical signboolean-
Is_Wake_Less_EasyWakes less easy as a clinical signboolean-
Is_ConvulsionPresence or absence of convulsion as a clinical signboolean-
History_of_Abnormal_FeedingHistory of abnormal feeding where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
Is_Fast_BreathingFast breathing as a clinical signboolean-
Is_History_of_FeverHistory of fever as a clinical signboolean-
Is_History_of_Stop_BreathingHistory of stop breathing as a clinical signboolean-
Is_Less_ActivityLess activity as a clinical signboolean-
Is_More_CryMore crying as a clinical signboolean-
Is_Less_CryLess crying as a clinical signboolean-
Is_History_of_DiarrheaHistory of diarrhea as a clinical signboolean-
Is_Vomit_MoreVomitting more as a clinical signboolean-
Is_Birth_PretermBirth preterm as a clinical signboolean-
Is_Fever_at_DeliveryFever at delivery as a clinical signboolean-
Is_History_of_Child_DeathHistory of child death as a clinical signboolean-
Is_Engorged_BreastsEngorged breasts as a clinical signboolean-
Is_Water_BrokeWater breaking as a clinical signboolean-
Days_in_LabourDays in labournumberlevel : Ratio
Respiratory_DistressRespiratory distress, where 0=sign no present, 1=mild, 2=moderate, as clinical signstring-
State_Respiratory_1State of respiratory distress (1) where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
State_Respiratory_2State of respiratory distress (2) where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
Is_ApneaApnea as a clinical signboolean-
Lower_Chest_IndrawingLower chest indrawing where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
Nasal_FlareNasal flare where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
StridorStridor where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
GruntGrunt where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Is_Cough_HeardCough heard as a clinical signboolean-
Is_Central_CyanosisCentral cyanosis as a clinical signboolean-
Is_JaundiceJaundice as a clinical signboolean-
Drowsy_StateDrowsy state where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Is_Agitated_StateAgitated state as a clinical signboolean-
ArousalArousal where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Quality_of_CryingQuality of crying where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
ConsolabilityConsolability where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
AttentiveAttentive where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Amount_of_MovementAmount of movement where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Drinking_AbilityDrinking ability where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Sucking_AbilitySucking ability where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Skin_TurgorSkin turgor where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
DehydrateDehydration where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Digital_Capillary_RefillDigital capillary refill where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
CrepitationCrepitation where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Skin_RashSkin rash where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Is_Bulging_FontanelleBulging fontanelle as a clinical signboolean-
Is_Sunken_FontanelleSunken fontanelle as as clinical signboolean-
HypotoniaHypotonia where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
Is_WheezeWheeze as a clinical signboolean-
Is_Difficult_BreathingDifficulty breathing as a clinical signboolean-
Smile_Adjust_for_AgeSmile adjustability for age where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Is_Pustular_Skin_RashPustular skin rash as a clinical signboolean-
Abdominal_Distention_ScoreAbdominal distention score where 0=sign no present, 1=mild, 2=moderate, 3=severe, 4=very severe as clinical signstring-
Nutritional_Status_ScoreNutritional status score where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
Otoscopy_ImpressionOtoscopy where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Severity_IllnessSeverity of illness where 0=sign no present, 1=mild, 2=moderate, 3=severe, 4=very severe as clinical signstring-
Is_Sclerema_or_HypertonicitySclerema or hypertonicity as a clinical signboolean-
Is_Positive_Lumbar_PuncturePositive lumbar puncture as a clinical signboolean-
Treatment_IndicatedTreatment indicated where 0=sign no present, 1=mild, 2=moderate as clinical signstring-

Data Preview

Sticker NumberWeight Criteria MetLaboratory Evaluation Criteria MetWhite Blood Cell ResultLumbar Puncture Cell CountNumber Days IllBirthweightHead CircumferenceWeight in GramsLength in CentimetersTemperatureChronic Inflammatory Demyelinating PolyneuropathyHeart Rate OximeterCountryAge in DaysAdjusted Respiratory RateChest Radiograph ProtocolMother Report Respiratory ProblemsImplicationsArterial Oxygen SaturationPolymorphonuclear Cell RatioDays to Death or DischargeBlood Culture RankWeight for Age ZscoreWeight for Age Percent MedianDeadIs Omphalitis PresentIs Conjunctivitis PresentIs Disease Present or AbsentTotal Number of Xray ReadingsPneumoniaNumber of Definite PneumoniaNumber NormalNumber of Probable PneumoniaIs Associated with DeathIs Associated with Bacterial InfectionIs No AbnormalityIs Mild HypoxemiaIs Severe HypoxemiaIs Sleep MoreIs Sleep LessIs Wake Less EasyIs ConvulsionHistory of Abnormal FeedingIs Fast BreathingIs History of FeverIs History of Stop BreathingIs Less ActivityIs More CryIs Less CryIs History of DiarrheaIs Vomit MoreIs Birth PretermIs Fever at DeliveryIs History of Child DeathIs Engorged BreastsIs Water BrokeDays in LabourRespiratory DistressState Respiratory 1State Respiratory 2Is ApneaLower Chest IndrawingNasal FlareStridorGruntIs Cough HeardIs Central CyanosisIs JaundiceDrowsy StateIs Agitated StateArousalQuality of CryingConsolabilityAttentiveAmount of MovementDrinking AbilitySucking AbilitySkin TurgorDehydrateDigital Capillary RefillCrepitationSkin RashIs Bulging FontanelleIs Sunken FontanelleHypotoniaIs WheezeIs Difficult BreathingSmile Adjust for AgeIs Pustular Skin RashAbdominal Distention ScoreNutritional Status ScoreOtoscopy ImpressionSeverity IllnessIs Sclerema or HypertonicityIs Positive Lumbar PunctureTreatment Indicated
A0001No602595.8831.0525055.037.5160Ethiopia6244Cold, coughNo problemNo Pneumonia, Sepsis or Meningitis<90%-10.04100.53NFalseFalseFalseFalseFalseFalseFalseFalseFalseFalseFalseFalsesign not presentTrueFalseFalseTrueFalseFalseFalseFalseFalseFalseFalseFalseTrue1mildmildmildFalsesign not presentsign not presentsign not presentmildFalseFalseFalsesign not presentFalsesign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentFalseFalsesign not presentFalseFalsesign not presentFalsesign not presentsign not presentsign not presentmildFalseFalsesign not present
A0002No12225.5534.0235048.037.0160Ethiopia2548Very severe diseaseNo problemNo Pneumonia, Sepsis or Meningitis<90%-1-2.5861.04NFalseTrueFalseFalseFalseFalseFalseFalseFalseTrueFalseFalsemoderateTrueTrueFalseFalseTrueFalseFalseTrueFalseTrueFalseFalseFalse1sign not presentsign not presentsign not presentFalsesign not presentsign not presentsign not presentsign not presentFalseFalseFalsesign not presentFalsesign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentFalseFalsesign not presentFalseFalsesign not presentFalsesign not presentmildsign not presentsign not presentFalseFalsesign not present
A0003No12298.3734.0265047.037.0160Ethiopia2548Very severe diseaseNo problemNo Pneumonia, Sepsis or Meningitis<90%-1-2.2864.36NFalseFalseFalseFalseFalseFalseFalseFalseFalseTrueFalseFalsemildTrueTrueFalseFalseFalseTrueFalseTrueFalseTrueFalseFalseFalse1sign not presentmildmildFalsesign not presentsign not presentsign not presentsign not presentFalseFalseFalsesign not presentFalsesign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentFalseFalsesign not presentFalseFalsesign not presentFalsesign not presentsign not presentsign not presentsign not presentFalseFalsesign not present
A0004NoYes20000.012411.9532.5240044.038.0151Ethiopia698Very severe diseaseHyrespir/no chestNo Pneumonia, Sepsis or Meningitis<90%0.00.00-1.971.04YFalseFalseTrue3.01.00.02.01.0TrueFalseFalseFalseFalseFalseFalseFalseTruesign not presentTrueTrueFalseTrueFalseFalseFalseFalseFalseFalseFalseFalseFalse1sign not presentmildmildFalsemoderatemoderatesign not presentmoderateFalseFalseTruesign not presentFalsesign not presentmildsign not presentmoderatemildmoderatemoderatemildmildsign not presentsign not presentsign not presentTrueTruesign not presentFalseTruesign not presentFalsemoderatesign not presentsign not presentvery severeTrueFalsemoderate
A0005No43500.033.0300052.037.5128Ethiopia5044Cold, coughNo problemNo Pneumonia, Sepsis or Meningitis<90%-1-2.3361.45NFalseFalseFalseFalseFalseFalseFalseFalseFalseFalseFalseFalsesign not presentFalseFalseFalseFalseFalseFalseFalseTrueFalseFalseTrueFalseTrue1sign not presentmildmildFalsesign not presentsign not presentsign not presentsign not presentFalseFalseFalsesign not presentFalsesign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentFalseFalsesign not presentFalseFalsemoderateFalsesign not presentsign not presentsign not presentmildFalseFalsesign not present
A0006NoYes10400.053500.036.0355053.037.5Yes170Ethiopia3060Very severe diseaseHyrespir/chestPneumonia only90 to 94%0.132.00-0.7189.37NFalseFalseTrue3.01.00.02.01.0TrueTrueTrueTrueTrueFalseTrueFalseFalsesign not presentTrueTrueTrueFalseFalseTrueFalseTrueFalseFalseTrueFalseFalse1moderatesign not presentsign not presentFalsemoderatemildsign not presentmildTrueFalseFalsesign not presentFalsemildsign not presentmildsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentFalseFalsesign not presentFalseTruesign not presentFalsesign not presentsign not presentsign not presentmoderateFalseFalsemoderate
A0007NoYes14600.02.012645.3739.0430054.038.3115Ethiopia7348Very severe diseaseHyrespir/no chestMeningitis only<90%0.0714.00-1.3577.92NFalseFalseTrueFalseFalseFalseFalseFalseFalseTrueTrueTruemoderateTrueTrueTrueTrueTrueFalseFalseTrueFalseFalseFalseFalseTrue1moderatemildmildFalsemildmildsign not presentmoderateFalseFalseFalsemildFalsemildmoderatesign not presentmoderatemoderatemildmildsign not presentsign not presentsign not presentsign not presentsign not presentTrueFalsesign not presentFalseTruemoderateFalsesign not presentsign not presentsign not presentsevereTrueFalsemoderate
A0008NoYes10400.00.032150.034.0230050.035.0136Ethiopia3444Very severe diseaseNo problemSepsis only<90%1.01.00-2.9156.52YFalseFalseTrue3.01.00.02.01.0TrueTrueTrueTrueTrueFalseFalseFalseFalsesign not presentFalseFalseFalseTrueFalseFalseTrueFalseFalseFalseFalseFalseTrue1moderatemildmildFalsesign not presentsign not presentsign not presentsign not presentFalseFalseFalsesign not presentFalsemildmildmildmoderatemildmoderatemoderatesign not presentsign not presentmildsign not presentsign not presentFalseFalsemoderateFalseFalsesign not presentFalsesign not presentmoderatesign not presentsevereFalseFalsemoderate
A0009NoYes14800.083446.6441.0550061.537.4Yes160Ethiopia5860Very severe diseaseHyrespir/chestPneumonia only90 to 94%0.044.000.5107.62FalseFalseTrue3.01.00.02.01.0TrueTrueTrueTrueTrueFalseFalseTrueFalsesign not presentTrueTrueFalseTrueFalseFalseTrueTrueFalseFalseTrueFalseTrue3moderatemildmildFalseseveremildsign not presentsign not presentFalseFalseFalsemildFalsemildmildmildmoderatemoderatemoderatemoderatesign not presentsign not presentsign not presentmoderatesign not presentFalseFalsesign not presentFalseTruemoderateFalsesign not presentsign not presentsign not presentsevereFalseFalsemoderate
A0010No11650.036.0315051.037.0170Ethiopia8048Cold, coughHyrespir/no chestNo Pneumonia, Sepsis, Meningitis - other<90%-1-2.7655.26NFalseFalseFalseFalseFalseFalseFalseFalseFalseTrueFalseFalsesign not presentFalseFalseFalseFalseTrueFalseFalseFalseTrueFalseTrueFalseFalse1sign not presentmildmildFalsesign not presentsign not presentsign not presentsign not presentFalseFalseFalsesign not presentFalsesign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentsign not presentFalseFalsesign not presentFalseTruemoderateFalsesign not presentsign not presentsign not presentmildFalseFalsemild