Last Updated: 17/10/2018
Electronic algorithms based on host biomarkers Point of Care Tests to decide on admission and antibiotic prescription in Tanzanian febrile children (e-POCT project)
Objectives
The main objectives of this project are to improve the management of febrile children through the design of a new approach based not on tests that detect microorganisms but on new tests that measure factors that reflect the patient’s body’s response to infection (rather than infection) itself, which therefore have the advantage of being able to distinguish between significant illness (requiring treatment and / or care at the hospital) and benign.
The results of these new rapid tests are combined with some key clinical signs in the form of a decision tree built on an electronic medium (Android tablet).
The primary objective of the study is to evaluate the safety of this new approach by comparing the cure rate of children in care with this tool to that of children in care as usual.
Swiss Tropical and Public Health Institute (Swiss TPH), Switzerland
University of Basel, Switzerland
Ifakara Health Institute (IHI), Tanzania
Health professionals in developing countries have limited ability to identify children at risk of dying and those in need of antibiotics. The main reasons are limited clinical skills and time, unavailability of diagnostic tests (laboratory or x-ray) and non-adherence to practice guidelines. Child mortality is, therefore, higher than it should be.
Etiological diagnostic tests (detecting microorganisms) may not always help since the distinction between infection and disease and between mild or severe disease is not straightforward. Overprescription of antibiotics is therefore widespread and leads to the development of drug resistance.
To address these challenges, decision charts for the management of febrile illness will be developed and include
- few clinical parameters simple to assess, and
- POCTs results based on specific host markers that can discriminate between mild and severe disease, pneumonia and upper respiratory tract infections, and unspecified fevers of bacterial and of viral origin.
The development of such a tool will decrease mortality due to delayed admission, At the same time, it will decrease irrational use of antibiotics, and hence drug pressure and emergence of drug resistance, which represents one of the most important public health threats our world is facing today.
This project has the potential of huge applicability since it is specifically designed for end-users with limited medical skills and low resources, as it is the case in most areas of developing countries.
SNF e-POCT ProjectSwiss National Science Foundation, project
Jan 2014 — Jun 2017
$458,000
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