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Validation of c-reactive protein in the early diagnosis of neonatal sepsis in a tertiary care hospital in Kenya.
MedLine Citation:
PMID:  23057268     Owner:  NLM     Status:  In-Process    
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.
R Kumar; R Musoke; W M Macharia; G Revathi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  East African medical journal     Volume:  87     ISSN:  0012-835X     ISO Abbreviation:  East Afr Med J     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2012-10-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372766     Medline TA:  East Afr Med J     Country:  Kenya    
Other Details:
Languages:  eng     Pagination:  255-61     Citation Subset:  IM    
Gertrude's Children's Hospital, P.O. Box 42325 - 00100, Nairobi, Kenya.
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