Diagnostic accuracy of clinical signs and symptoms and C-reactive protein and their risk of having serious bacterial infection in children with fever of 5 days or more
| Sensitivity | Specificity | PPV | NPV | dOR | |
| Clinical warning signs | |||||
| Tachypnoea | 0.41 (0.32–0.50) | 0.69 (0.67–0.71) | 0.08 (0.06–0.11) | 0.94 (0.93–0.95) | 1.52 (1.06–2.18) |
| Tachycardia | 0.43 (0.37–0.50) | 0.68 (0.67–0.70) | 0.11 (0.09–0.13) | 0.93 (0.92–0.94) | 1.64 (1.27–2.13) |
| Ill appearance | 0.31 (0.26–0.37) | 0.85 (0.84–0.86) | 0.16 (0.13–0.19) | 0.93 (0.92–0.94) | 2.57 (1.98–3.33) |
| Increased work of breathing | 0.17 (0.13–0.22) | 0.91 (0.90–0.92) | 0.15 (0.11–0.20) | 0.92 (0.91–0.93) | 2.18 (1.54–3.08) |
| Prolonged capillary refill | 0.04 (0.02–0.07) | 0.99 (0.98–0.99) | 0.19 (0.09–0.32) | 0.92 (0.91–0.93) | 2.79 (1.38–5.62) |
| Oxygen saturations <94% | 0.06 (0.03–0.09) | 0.96 (0.95–0.97) | 0.12 (0.07–0.19) | 0.92 (0.91–0.93) | 1.50 (0.86–2.62) |
| Non-blanching rash | 0.02 (0.01–0.04) | 0.97 (0.97–0.98) | 0.07 (0.02–0.14) | 0.91 (0.90–0.92) | 0.74 (0.32–1.71) |
| Seizure | 0.03 (0.01–0.06) | 0.99 (0.99–0.99) | 0.21 (0.10–0.37) | 0.92 (0.91–0.93) | 3.24 (1.54–6.84) |
| Neurological signs | 0.01 (0.00–0.03) | 0.99 (0.99–1.00) | 0.13 (0.03–0.32) | 0.92 (0.91–0.93) | 1.68 (0.50–5.66) |
| Any warning sign | 0.92 (0.87–0.95) | 0.24 (0.22–0.26) | 0.11 (0.09–0.12) | 0.97 (0.95–0.98) | 3.52 (2.12–5.84) |
| Duration of fever (days) | |||||
| 7 | 0.47 (0.42–0.53) | 0.62 (0.60–0.63) | 0.10 (0.09–0.12) | 0.93 (0.92–0.94) | 1.45 (1.16–1.83) |
| 10 | 0.21 (0.17–0.26) | 0.85 (0.84–0.86) | 0.12 (0.09–0.15) | 0.92 (0.91–0.93) | 1.54 (1.16–2.05) |
| Non-specific signs and symptoms | |||||
| Other type of rash* | 0.08 (0.05–0.12) | 0.85 (0.84–0.86) | 0.05 (0.03–0.07) | 0.91 (0.90–0.92) | 0.51 (0.33–0.79) |
| Gastrointestinal symptoms | 0.38 (0.33–0.44) | 0.66 (0.64–0.68) | 0.10 (0.08–0.11) | 0.92 (0.91–0.93) | 1.20 (0.93–1.54) |
| Respiratory symptoms | 0.38 (0.32–0.44) | 0.49 (0.47–0.51) | 0.07 (0.05–0.08) | 0.90 (0.88–0.91) | 0.60 (0.46–0.77) |
| Biomarkers | |||||
| C-reactive protein ≥10 mg/L | 0.94 (0.90–0.96) | 0.36 (0.34–0.39) | 0.16 (0.14–0.18) | 0.98 (0.96–0.99) | 8.40 (5.02–14.06) |
| C-reactive protein ≥20 mg/L | 0.92 (0.87–0.95) | 0.52 (0.50–0.54) | 0.20 (0.18–0.23) | 0.98 (0.97–0.99) | 11.84 (7.50–18.67) |
| C-reactive protein ≥60 mg/L | 0.82 (0.76–0.86) | 0.81 (0.79–0.82) | 0.36 (0.32–0.40) | 0.97 (0.96–0.98) | 18.42 (13.12–25.87) |
| C-reactive protein ≥80 mg/L | 0.66 (0.60–0.72) | 0.86 (0.85–0.88) | 0.39 (0.34–0.44) | 0.95 (0.94–0.96) | 12.20 (9.11–16.35) |
*This excludes any non-blanching rash including petechiae and purpura.
dOR, diagnostic OR; NPV, negative predictive value; PPV, positive predictive value.