Determining predictors of sepsis at triage among children under 5 years of age in resource-limited settings: A modified Delphi process

PLoS One. 2019 Jan 28;14(1):e0211274. doi: 10.1371/journal.pone.0211274. eCollection 2019.

Abstract

Sepsis is a life-threatening dysfunction of the immune system leading to multiorgan failure that is precipitated by infectious diseases and is a leading cause of death in children under 5 years of age. It is necessary to be able to identify a sick child at risk of developing sepsis at the earliest point of presentation to a healthcare facility so that appropriate care can be provided as soon as possible. Our study objective was to generate a list of consensus-driven predictor variables for the derivation of a prediction model that will be incorporated into a mobile device and operated by low-skilled healthcare workers at triage. By conducting a systematic literature review and examination of global guideline documents, a list of 72 initial candidate predictor variables was generated. A two-round modified Delphi process involving 26 experts from both resource-rich and resource-limited settings, who were also encouraged to suggest new variables, yielded a final list of 45 predictor variables after evaluating each variable based on three domains: predictive potential, measurement reliability, and level of training and resources required. The final list of predictor variables will be used to collect data and contribute to the derivation of a prediction model.

MeSH terms

  • Child, Preschool
  • Databases, Factual
  • Delphi Technique*
  • Female
  • Humans
  • Infant
  • Male
  • Predictive Value of Tests
  • Sepsis / diagnosis*
  • Triage*

Grants and funding

The authors received no specific funding for this work.