Abstract
Serum procalcitonin (PCT) was measured in 228 children aged 1 month to 15 years at an emergency department of a hospital located in an area without local malaria transmission in children with suspected infections; 21% (49) children had a clinical syndrome for suspected bacterial infections (Syndrome +ve). In children with Syndrome+ve criteria, 27/49 (55.1%) had PCT ≥ 0.5 μg/l but only 59/179 (32.9%) of those Syndrome +ve had abnormal PCT, χ 2 = 8.0, p = 0.005; positive likelihood ratio = 2.0 [95% confidence interval (CI) 1.2–3.3]; negative likelihood ratio = 0.8 (95% CI 0.7–1.0). In patients with pneumonia, 9/15 (60%) with severe pneumonia had PCT ≥ 0.5 μg/l compared to 11/21 (52.4%) with non-severe pneumonia, χ 2 = 0.2, p = 0.65. Children with clinical signs of pneumonia or clinical signs suggestive of bacterial infections fulfilling clinical syndromic definitions for suspected bacterial infections commonly have elevated PCT level. PCT levels are associated with disease severity and antibiotic trials guided by PCT levels may be needed where cultures are not available.
Highlights
Pneumonia and other infections still cause many deaths in children aged
We primarily aimed to investigate whether children with clinical diagnosis of pneumonia or with certain clinical syndromes derived from World Health Organization (WHO) guidance, which are used to target antibiotics prescriptions, have elevated PCT (!0.5 mg/l)
The rest of remaining 179 participants were SyndromeÀve, 146 of whom had presented with history of cough or difficulty in breathing but had neither tachypnoea nor chest indrawing and 33 had none of the syndromes and had no history of cough or difficulty in breathing
Summary
Pneumonia and other infections still cause many deaths in children aged
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