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    Validation of c-reactive protein in the early diagnosis of neonatal sepsis in a tertiary care hospital in Kenya

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    Date
    2010-06
    Author
    Kumar, R
    Musoke, R
    Macharia, W M
    Revathi, G
    Type
    Article
    Language
    en
    Metadata
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    Abstract
    OBJECTIVE: To evaluate utility of C-reactive protein (CRP) in the early diagnosis of neonatal sepsis in a tertiary care Newborn Unit in Kenya. DESIGN: Cross-sectional study. SETTING: Newborn Unit, Kenyatta National Hospital. SUBJECTS: All neonates admitted to Newborn Unit, Kenyatta National Hospital during the study period with suspected sepsis based on specified clinical criteria. RESULTS: Of the 310 infants, there were 83 episodes of proven sepsis and 94 episodes of probable sepsis. Using the standard CRP cut-off value of 5 mg/dl, a sensitivity of 95.2% in proven sepsis and 98.9% for probable septic episodes were noted. In proven sepsis, a specificity of 85.3%, positive predictive value of 80.6%, and a negative predictive value of 96.5% were noted. In probable sepsis, a specificity of 83.3%, positive predictive value of 80.9% and a negative predictive value of 99.1% were noted. The overall accuracy in proven sepsis was 96.5%, and in probable sepsis was noted to be 99.1%. Sub-analysis showed a lower positive predictive value (61.5%) for early onset sepsis compared to 93% for late onset sepsis. Repeat CRP tests were done in 33 babies. Twenty two of the 29 with proven/probable infection had a ten-fold increase in CRP levels, but levels were noted to be low or reducing in seven (24.1%) babies showing signs of improvement clinically. Using a receiver operator characteristic curve, the optimal cut-off point for CRP was found to be 5 mg/dl. CONCLUSIONS: Serum CRP is an accurate indicator of neonatal sepsis, with high sensitivity, specificity and predictive values, at the standard cut-off of 5. CRP is a better screening test for late-onset than early-onset neonatal sepsis. The standard recommended CRP cut -off point of 5 is appropriate for local use
    URI
    http://www.ncbi.nlm.nih.gov/pubmed/23057268
    http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/30053
    Citation
    East Afr Med J. 2010 Jun;87(6):255-61
    Publisher
    University of Nairobi.
     
    Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, Kenya
     
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    • College of Health Sciences (CHS) [9822]

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