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Table 1 Study definitions

From: Clinical management and outcomes of acute febrile illness in children attending a tertiary hospital in southern Ethiopia

Clinical signs

 

 Tachycardia

A high pulse rate for age (age: 2-11 m, > 160 beats/min; 12-47 m, > 130 beats/min; 48 m-5y, > 120 beats/min; 6-8y, > 115 beats/min; 9-12y, > 110 beats/min) [28]

 Tachypnea

A high respiratory rate for age (age: 2-11 m, ≥ 50 breaths/min; 12-59 m, ≥ 40 breaths/min; 5-12y, ≥ 30 breaths/min) [28]

Illnesses

 

 Acute respiratory infection

Presentation with at least one respiratory sign or symptom of less than 14 days and localized to the respiratory tract (upper or lower)

 Pneumonia

A history of cough and/or difficult breathing, plus sign of (a) tachypnea OR (b) chest findings OR (c) auscultatory findings OR (d) radiologic findings [28]

 Acute tonsillopharyngitis

Presentation with (a) pharyngeal redness and enlarged tonsils or (b) neck lymph node and enlarged tonsils or (c) tonsillar exudate, which are suggestive of bacterial infection based on the national guidelines [28]

 Unspecified upper respiratory tract infections

Presentation with at least one respiratory sign or symptom (e.g. cough, rhinorrhoea) in the absence of features consistent with other specified respiratory illnesses

 Acute diarrhoea

Presentation with diarrhoea (stool frequency > 3 loose or liquid stools per day on at least one day in the week prior to enrolment) lasting less than 14 days [28]

 Meningitis

Presentation with stiff neck, positive meningeal signs, or findings on cerebrospinal fluid analysis and diagnosed by clinicians as a case of meningitis [28]

 Sepsis

The presence of systemic inflammation response syndrome with suspected or proven infection, or with some form of organ dysfunction [29]

 Anaemia

A low haematocrit value for age (age: 2 m, < 28%; 3-6 m, < 29%; 7-24 m, < 33%; 25 m-6y, < 34%; 7-12y, < 35%) [30]

 Malaria

A positive blood smear microscopy for asexual stage of Plasmodium species

 Bloodstream infections (bacteraemia/candidaemia)

A positive blood culture for pathogenic bacteria/yeast cells

Urinary tract infection

Urine culture showing a significant bacteriuria (≥ 105 and ≥ 104 colony-forming-unit/ml of urine collected by clean catch and urethral catheterization, respectively) [31]

 Undifferentiated fever

Cases with no identified source of infection for the fever on clinical and laboratory investigations conducted

Outcomes

 

 Resolved fever

Absence of fever for 2 consecutive days prior to day 7(± 1) / day 14(± 1) as reported by caregivers or measured temperature of 36.4ºC -37.5ºC

 Persisting fever

Fever episode within 2 days prior to day 7(± 1) / day 14(± 1) as reported by caregivers or measured temperature of ≥ 37.5ºC

 Relapsed fever

Fever reported at day 14(± 1) in a child who had resolved fever at day 7(± 1), potentially linked to the initial febrile illness

 Hospitalization

Admission to hospital for treatment in relation to the presenting febrile illness

Death

Mortality within 14(± 1) days follow-up period, and potentially linked to the initial febrile illness as judged by attending clinicians