Electronic Algorithms Based on Host Biomarkers to Manage Febrile Children
Condition: Acute Febrile Illness
MeSH terms: Hyperthermia; Fever
Study type: Interventional

Summary: 
      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 i) few clinical parameters simple to assess, and ii)
      POCTs results based on specific host markers that can discriminate between mild and severe
      disease, pneumonia and upper respiratory tract infections, and unspecific fevers of bacterial
      and of viral origin. This algorithm combining clinical and bedside laboratory tests will be
      built on an electronic support (android tablet). The first objective of the study is to
      assess the safety of new electronic decision trees that integrate simple clinical assessment
      and POCTs results (oxygen saturation and a combination of specific biomarkers of
      inflammation) as a triage tool to decide on admitting febrile children; the second objective
      is to assess the usefulness and safety of new electronic decision trees that integrate simple
      clinical assessment and POCT results (a combination of specific biomarkers of inflammation)
      as decision-making tool to prescribe antibiotics to non-severe febrile children. 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 threat 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.
    


Intervention name(s): Management of febrile children using e-POCT; Management of febrile children using ALMANACH
Intervention type(s): Other; Other
Intervention description(s): Use of the e-POCT tool by study clinicians for the clinical management of febrile episodes. The e-POCT tool is an electronic algorithm that integrates key clinical elements with the results of malaria and host biomarkers point-of-care test results (including oximetry).; Management of febrile children by study clinicians using ALMANACH. ALMANACH is an improved IMCI algorithm on mobile phone or tablet
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: fever; point-of-care tests; clinical algorithms; electronic support; host biomarkers