Project Details

A pediatric early warning score to recognize serious illness in low- and middle-income countries

Joany Zachariasse, MD, PhD

Summary

BACKGROUND: In acute care settings, recognition of children at risk of serious illness is essential in preventing morbidity and mortality, and contributes to efficient allocation of resources. This is particularly relevant in low- and middle-income countries (LMIC) where large numbers of patients seek emergency care, and resources, including the availability of staff, are limited. GAP: Pediatric Early Warning Scores (PEWS) are scoring systems solely based on vital signs, and are considered a promising tool in the initial assessment of children: they can be obtained fast and objectively by any health professional with basic training. To date, evidence to support the use of a specific PEWS in LMIC is limited. HYPOTHESIS: The Emergency Department - Pediatric Early Warning Score (ED-PEWS), a simple score solely based on vital signs showed good performance in European countries. The ED-PEWS could be a valuable tool in prioritizing children in acute care in LMIC. METHODS: In this multicenter observational study, we apply innovative statistical methods for the validation and updating of prediction rules to assess and improve the ED-PEWS in four databases originally established for other studies. We include children younger than 16 years of age, seeking emergency care, in different settings in low and middle income countries: The Gambia urban, The Gambia rural, Tanzania rural, and Surinam urban. RESULTS: Pending. IMPACT: The proposed research potentially results in the development of a simple tool for the accurate prioritization of children in LMIC. After validation, we intend to implement and audit the results to improve the early recognition of serious illness in LMIC, ultimately resulting in better health outcomes.

Publications:

Kemps N, Holband N, Boeddha NP, Faal A, Juliana AE, Kavishe GA, et al. (2024) Validation of the Emergency Department-Paediatric Early Warning Score (ED-PEWS) for use in low- and middle-income countries: A multicentre observational study. PLOS Glob Public Health 4(3): e0002716.