WHO ARI Young Infant Multicenter Study

$199 / year

This dataset contains 4552 observations and 97 variables. This dataset is from The World Health Organization Multicentre Acute Respiratory Infection (WHO ARI) Study of Clinical Signs and Etiological Agents of Pneumonia, Sepsis, and Meningitis in Young Infants.

Complexity

This dataset came from the Department of Biostatistics of Vanderbilt University. Frank E. Harrell, together with colleagues, and the World Health Organization Multicentre Acute Respiratory Infection (WHO ARI) Young Infant Multicentre Study Group conducted a study titled, “The World Health Organization Multicentre Study of Clinical Signs and Etiological Agents of Pneumonia, Sepsis, and Meningitis in Young Infants”. This study was conducted to develop a clinical prediction model to assist health workers in developing countries in the presentation of an acutely ill young infant.

One of the most difficult problems faced by health workers in all parts of the world is the presentation of an acutely ill young infant. Infants under 3 months of age face serious infections which are the main causes of morbidity and mortality, particularly in developing countries. Diagnosis proves to be difficult as in the case of meningitis, pneumonia or sepsis. The ability to detect serious bacterial infection early in young infants is important in defining appropriate prevention and treatment strategies hence a better clinical prediction rule to be used by health workers both in developing and industrialized countries is needed in order to accurately predict which combination of clinical signs of infant determine meningitis, sepsis or pneumonia.

This study was undertaken in Ethiopia, The Gambia, Papua New Guinea and the Philippines where data was collected and used to come up with better screening criteria for finding infants at high risk of serious infection. There are 47 clinical signs collected from this study and a single variable was coded 0—3 representing sign not present, mild, moderate, severe.

From this study, researchers were able to develop a clinical prediction model for an ordinal scale to determine the combinations of clinical signs of infant that determine meningitis, sepsis or pneumonia.

For more information about this study, see related studies: Frank E. Harrell, Peter A. Margolis, Sandy Gove, Karen E. Mason, E. Kim Mulholland, Deborah Lehmann, Lulu Muhe, Salvacion Gatchalian, and Heinz F. Eichenwald. Development of a clinical prediction model for an ordinal outcome: The World Health Organization ARI Multicentre Study of clinical signs and etiologic agents of pneumonia, sepsis, and meningitis in young infants. Stat Med, 17:909-944, 1998 and Peter Margolis, E. Kim Mulholland, Frank E. Harrell, Sandy Gove, and the WHO Young Infants Study Group. Clinical prediction of serious bacterial infections in young infants in developing countries. Pediatric Infectious Disease Journal, 18S:S23-S31, 1999.

Date Created

2008-01-17

Last Modified

2008-01-17

Version

2008-01-17

Update Frequency

Never

Temporal Coverage

1998

Spatial Coverage

Ethiopia, The Gambia, Papua New Guinea, Philippines

Source

John Snow Labs => Department of Biostatistics, Vanderbilt University

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

Infant, Young Infant, Newborn Infant, Infant Fever, Pneumonia, Sepsis, Meningitis, Pneumonia in Children, Meningitis in Children, Sepsis in Children

Other Titles

Development of a Clinical Prediction Model, Clinical Signs of Pneumonia, Sepsis and Meningitis in Young Infants

Name Description Type Constraints
Sticker_NumberSticker number of young infantsstring-
Weight_Criteria_MetInfants in the study sample meeting the inclusion criteria for weight where an infant with a birth weight <1500 g and less than 48 hours old is excluded, either Yes, No, or Maybestring-
Laboratory_Evaluation_Criteria_MetInfants in the study sample meeting the prescribed criteria for laboratory evaluation and underwent blood culture and chest radiography, either No, Refused, Sampled, Yesstring-
White_Blood_Cell_ResultWhite blood cell resultintegerlevel : Ratio
Lumbar_Puncture_Cell_CountCell count from a lumbar puncture cultureintegerlevel : Ratio
Number_Days_IllNumber of days illintegerlevel : Nominal
BirthweightBirthweight of infantsnumberlevel : Ratio
Head_CircumferenceHead circumference of infantsnumberlevel : Ratio
Weight_in_GramsWeight in grams of infantsintegerlevel : Ratio
Length_in_CentimetersLength in centimeters of infantsnumberlevel : Ratio
TemperatureTemperature of infantsnumberlevel : Ratio
Chronic_Inflammatory_Demyelinating_PolyneuropathyCdip, either Yes, No, or Sstring-
Heart_Rate_OximeterHeart ratenumberlevel : Ratio
CountryCountry either Ethiopia, Gambia, Manila or Papua New Guineastring-
Age_in_DaysAge in days of infantsnumberlevel : Ratio
Adjusted_Respiratory_RateAdjusted respiratory rateintegerlevel : Ratio
Chest_Radiograph_ProtocolChest radiograph either None, Cold,cough, Pneumonia, Severe pneumonia or Very severe diseasestring-
Mother_Report_Respiratory_ProblemsMother report respiratory problems, either No problem, Hy respir/no chest, Hy respir/cheststring-
ImplicationsImplications, either No Pneumonia, Sepsis or Meningitis, No Pneunomia, Sepsis, Meningitis - other, Pneumonia only, Sepsis only, Meningitis only, Pneumonia and Sepsis, Pneumonia and Meningitis, Meningitis and Sepsis, and Pneumonia, Meningitis and Sepsisstring-
Arterial_Oxygen_SaturationArterial oxygen saturation where the adjusted oxygen saturation measurements used placed infants into three risk categories equivalent to SaO2 values of <90%, 90 to 94% and >94%.string-
Polymorphonuclear_Cell_RatioPolymorphonuclear cell rationumberlevel : Ratio
Days_to_Death_or_DischargeDays to death or dischargeintegerlevel : Ordinal
Blood_Culture_RankBlood culture rankintegerlevel : Ordinal
Weight_for_Age_ZscoreWeight for age Zscorenumberlevel : Ratio
Weight_for_Age_Percent_MedianWeight for age in percent mediannumberlevel : Ratio
DeadIf infant died, either L, N, P, or Ystring-
Is_Omphalitis_PresentPresence or absence of omphalitis as a clinical signboolean-
Is_Conjunctivitis_PresentPresence of absence of conjunctivitis as a clinical signboolean-
Is_Disease_Present_or_AbsentPrimary study outcome measure which indicates the presence or absence of disease, as well as its severity.boolean-
Total_Number_of_Xray_ReadingsTotal number of xray readingsintegerlevel : Ordinal
PneumoniaNumber of pneumoniaintegerlevel : Ordinal
Number_of_Definite_PneumoniaNumber of definite pneumoniaintegerlevel : Ordinal
Number_NormalNumber of normalintegerlevel : Ordinal
Number_of_Probable_PneumoniaNumber of probable pneumoniaintegerlevel : Ordinal
Is_Associated_with_DeathDiagnoses ranked in a hierarchic fashion based on their association with the most severe outcome which is death.boolean-
Is_Associated_with_Bacterial_InfectionDiagnoses not strongly related to death examined with respect to their association with the presence of a positive blood culture or CSF result. This measure was selected because it would allow infants to be included in the clinical prediction rule who might have negative cultures (e.g. those with low oxygen saturation and positive radiographs), but who still might benefit from treatment because they were at increased risk of bacterial infection.boolean-
Is_No_AbnormalityPrimary study outcome measure on an ordinal scale that summarized the presence or absence of disease, as well as its severity where first level of disease severity is no abnormalityboolean-
Is_Mild_HypoxemiaPrimary study outcome measure on an ordinal scale that summarized the presence or absence of disease, as well as its severity where second level of disease severity is mild hypoxemia (90% ≧ SaO2 < 95%) or radiologic pneumoniaboolean-
Is_Severe_HypoxemiaPrimary study outcome measure on an ordinal scale that summarized the presence or absence of disease, as well as its severity where third level of disease severity is severe hypoxemia (SaO2 < 90%) or bacteremia or meningitisboolean-
Is_Sleep_MoreSleeping more as a clinical signboolean-
Is_Sleep_LessSleeping less as a clinical signboolean-
Is_Wake_Less_EasyWakes less easy as a clinical signboolean-
Is_ConvulsionPresence or absence of convulsion as a clinical signboolean-
History_of_Abnormal_FeedingHistory of abnormal feeding where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
Is_Fast_BreathingFast breathing as a clinical signboolean-
Is_History_of_FeverHistory of fever as a clinical signboolean-
Is_History_of_Stop_BreathingHistory of stop breathing as a clinical signboolean-
Is_Less_ActivityLess activity as a clinical signboolean-
Is_More_CryMore crying as a clinical signboolean-
Is_Less_CryLess crying as a clinical signboolean-
Is_History_of_DiarrheaHistory of diarrhea as a clinical signboolean-
Is_Vomit_MoreVomitting more as a clinical signboolean-
Is_Birth_PretermBirth preterm as a clinical signboolean-
Is_Fever_at_DeliveryFever at delivery as a clinical signboolean-
Is_History_of_Child_DeathHistory of child death as a clinical signboolean-
Is_Engorged_BreastsEngorged breasts as a clinical signboolean-
Is_Water_BrokeWater breaking as a clinical signboolean-
Days_in_LabourDays in labournumberlevel : Ratio
Respiratory_DistressRespiratory distress, where 0=sign no present, 1=mild, 2=moderate, as clinical signstring-
State_Respiratory_1State of respiratory distress (1) where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
State_Respiratory_2State of respiratory distress (2) where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
Is_ApneaApnea as a clinical signboolean-
Lower_Chest_IndrawingLower chest indrawing where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
Nasal_FlareNasal flare where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
StridorStridor where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
GruntGrunt where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Is_Cough_HeardCough heard as a clinical signboolean-
Is_Central_CyanosisCentral cyanosis as a clinical signboolean-
Is_JaundiceJaundice as a clinical signboolean-
Drowsy_StateDrowsy state where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Is_Agitated_StateAgitated state as a clinical signboolean-
ArousalArousal where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Quality_of_CryingQuality of crying where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
ConsolabilityConsolability where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
AttentiveAttentive where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Amount_of_MovementAmount of movement where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Drinking_AbilityDrinking ability where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Sucking_AbilitySucking ability where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Skin_TurgorSkin turgor where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
DehydrateDehydration where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Digital_Capillary_RefillDigital capillary refill where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
CrepitationCrepitation where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Skin_RashSkin rash where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Is_Bulging_FontanelleBulging fontanelle as a clinical signboolean-
Is_Sunken_FontanelleSunken fontanelle as as clinical signboolean-
HypotoniaHypotonia where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
Is_WheezeWheeze as a clinical signboolean-
Is_Difficult_BreathingDifficulty breathing as a clinical signboolean-
Smile_Adjust_for_AgeSmile adjustability for age where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Is_Pustular_Skin_RashPustular skin rash as a clinical signboolean-
Abdominal_Distention_ScoreAbdominal distention score where 0=sign no present, 1=mild, 2=moderate, 3=severe, 4=very severe as clinical signstring-
Nutritional_Status_ScoreNutritional status score where 0=sign no present, 1=mild, 2=moderate, 3=severe as clinical signstring-
Otoscopy_ImpressionOtoscopy where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Severity_IllnessSeverity of illness where 0=sign no present, 1=mild, 2=moderate, 3=severe, 4=very severe as clinical signstring-
Is_Sclerema_or_HypertonicitySclerema or hypertonicity as a clinical signboolean-
Is_Positive_Lumbar_PuncturePositive lumbar puncture as a clinical signboolean-
Treatment_IndicatedTreatment indicated where 0=sign no present, 1=mild, 2=moderate as clinical signstring-
Sticker_NumberWeight_Criteria_MetLaboratory_Evaluation_Criteria_MetWhite_Blood_Cell_ResultLumbar_Puncture_Cell_CountNumber_Days_IllBirthweightHead_CircumferenceWeight_in_GramsLength_in_CentimetersTemperatureChronic_Inflammatory_Demyelinating_PolyneuropathyHeart_Rate_OximeterCountryAge_in_DaysAdjusted_Respiratory_RateChest_Radiograph_ProtocolMother_Report_Respiratory_ProblemsImplicationsArterial_Oxygen_SaturationPolymorphonuclear_Cell_RatioDays_to_Death_or_DischargeBlood_Culture_RankWeight_for_Age_ZscoreWeight_for_Age_Percent_MedianDeadIs_Omphalitis_PresentIs_Conjunctivitis_PresentIs_Disease_Present_or_AbsentTotal_Number_of_Xray_ReadingsPneumoniaNumber_of_Definite_PneumoniaNumber_NormalNumber_of_Probable_PneumoniaIs_Associated_with_DeathIs_Associated_with_Bacterial_InfectionIs_No_AbnormalityIs_Mild_HypoxemiaIs_Severe_HypoxemiaIs_Sleep_MoreIs_Sleep_LessIs_Wake_Less_EasyIs_ConvulsionHistory_of_Abnormal_FeedingIs_Fast_BreathingIs_History_of_FeverIs_History_of_Stop_BreathingIs_Less_ActivityIs_More_CryIs_Less_CryIs_History_of_DiarrheaIs_Vomit_MoreIs_Birth_PretermIs_Fever_at_DeliveryIs_History_of_Child_DeathIs_Engorged_BreastsIs_Water_BrokeDays_in_LabourRespiratory_DistressState_Respiratory_1State_Respiratory_2Is_ApneaLower_Chest_IndrawingNasal_FlareStridorGruntIs_Cough_HeardIs_Central_CyanosisIs_JaundiceDrowsy_StateIs_Agitated_StateArousalQuality_of_CryingConsolabilityAttentiveAmount_of_MovementDrinking_AbilitySucking_AbilitySkin_TurgorDehydrateDigital_Capillary_RefillCrepitationSkin_RashIs_Bulging_FontanelleIs_Sunken_FontanelleHypotoniaIs_WheezeIs_Difficult_BreathingSmile_Adjust_for_AgeIs_Pustular_Skin_RashAbdominal_Distention_ScoreNutritional_Status_ScoreOtoscopy_ImpressionSeverity_IllnessIs_Sclerema_or_HypertonicityIs_Positive_Lumbar_PunctureTreatment_Indicated
N0099Yes10220002718004037.8112Gambia230Very severe diseaseNo problemSepsis only>94%0-3.5753.9Yfalsefalsetruetruefalsefalsefalsefalsetruefalsetruefalsemildfalsefalsefalsetruefalsetruetruefalsetruefalsetruefalsetrue1moderatemildmildfalsemildsign not presentsign not presentsign not presentfalsetruetruemoderatefalsemildmoderatesign not presentmoderatemildmoderatemoderatemildmildmildmoderatesign not presentfalsefalseseverefalsefalsesign not presentfalsemoderatemoderatesign not presentvery severefalsefalsemoderate
A0386NoYes011890.723221204735112Ethiopia1940Very severe diseaseNo problemSepsis only00-2.8257.26Yfalsefalsetruetruetruetruetruetruetruefalsetruefalseseverefalsefalsetruetruefalsetruefalsefalsetruefalsefalsetruetrue1sign not presentmildmildtruesign not presentsign not presentsign not presentsign not presentfalsetruefalsemildfalsemildmildmildmildmoderatemoderatemoderatemildmildmildsign not presentsign not presentfalsetrueseverefalsefalsesign not presentfalsesign not presentmoderatesign not presentseverefalsefalsemoderate
R0155NoYes1550014212004.6128.1250046.536.4S164Manila3541Very severe diseaseHyrespir/chestPneumonia only<90%0360-2.6161.07Pfalsefalsetrue34210truetruetruetruetruefalsetruetruefalsemoderatetruetruetruetruetruefalsefalsetruefalsefalsetruefalsetrue1moderatemildmildfalseseveremildmoderatesign not presenttruetruefalsemildfalsemildmoderatemildmildmoderatemoderatemoderatesign not presentsign not presentmildmoderatesign not presenttruetruemoderatefalsetruesign not presentfalsemoderatemoderatesign not presentseverefalsefalsemoderate
Q0576NoYes940072766.3638.5478056.836.3Yes136PapuaNewGuinea7954Very severe diseaseHyrespir/chestPneumonia only<90%0.73150-0.9784.23Pfalsefalsetrue4400falsefalsefalsefalsefalsetruefalsetruefalsemildfalsetruefalsetruetruefalsefalsefalsefalsefalsefalsetruetrue1moderatemoderateseverefalsemoderatemildsign not presentmoderatetruetruefalsemildfalsemildmildmildmildsign not presentmildmildmildmildsign not presentmoderatemildfalsefalsemoderatefalsetruemoderatetruesign not presentsign not presentsign not presentseverefalsefalsemoderate
A0661NoYes23800071785.453225005237140Ethiopia8264Very severe diseaseHyrespir/chestSepsis only<90%0.0960-3.748.15Yfalsefalsetrue31030falsefalsefalsefalsefalsetruefalsetruefalsemoderatetruefalsetruetruetruefalsetruefalsefalsefalsefalsefalsetrue1moderatesevereseverefalsemildmildsign not presentmildfalsefalsefalsesign not presentfalsemildmildmildmildmildmoderatemoderatemoderatemildmoderatesign not presentsign not presentfalsefalsesign not presentfalsetruemoderatefalsesign not presentseveresign not presentseverefalsefalsemoderate
R0746NoYes70003230031.525004036.5S125Manila3450Very severe diseaseHyrespir/chestPneumonia and Sepsis<90%0200-2.6856.79Nfalsetruetrue34210truetruetruetruetruefalsefalsefalsefalseseverefalsefalsefalsetruefalsetruetruefalsefalsefalsefalsefalsetrue1moderatemildmildfalsemoderatemildsign not presentsign not presentfalsefalsefalsemildfalsemildmildmoderatemildmildmoderatemoderatemoderatemildsign not presentmoderatesign not presentfalsefalsemoderatefalsetruesign not presentfalsemoderateseveresign not presentmoderatefalsefalsemoderate
P0023NoYes630012282507.063724455738.5148Manila1665Very severe diseaseNo problemSepsis only<90%000-2.4263.98Yfalsefalsetrue25200truetruetruetruetruetruefalsetruefalsemoderatetruetruefalsetruefalsetruetruefalsefalsefalsefalsefalsetrue1mildmildmildfalsemoderatesign not presentsign not presentsign not presentfalsefalsefalsemildfalsemildmildsign not presentmoderatemildmildmildmoderatemoderatemoderatesign not presentsign not presentfalsetruemoderatefalsefalsesign not presentfalseseveremoderatesign not presentseverefalsefalsemoderate
A0130NoYes152002326003631004835Yes157Ethiopia3645Very severe diseaseHyrespir/chestPneumonia only>94%1.360-1.6675.28Nfalsefalsetrue21020truetruetruetruetruefalsetruefalsefalsesign not presenttruefalsefalsetruefalsetruefalsefalsetruefalsefalsetruetrue1moderatemildmildfalsemoderatemildsign not presentmildfalsetruefalsemildfalsemildmildmoderatemildmildmoderatemoderatesign not presentsign not presentmoderatemildsign not presentfalsefalsemildfalsetruesign not presentfalsesign not presentmoderatesign not presentseverefalsefalsemoderate
A0411NoYes158000330003221505238116Ethiopia8148Very severe diseaseNo problemSepsis only<90%0.33290-4.1641.59Yfalsefalsetrue31030falsefalsefalsefalsefalsefalsetruefalsefalsemoderatefalsefalsefalsetruefalsetruetruetruefalsefalsefalsefalsetrue1sign not presentmildmildfalsemildmildsign not presentsign not presentfalsefalsefalsemildfalsemildmildsign not presentmildmildmoderatemoderatemildmildmildsign not presentsign not presentfalsetruesign not presentfalsefalsemoderatefalsesign not presentseveresign not presentseverefalsefalsemoderate
R0726NoYes20200551888.9828190045.337.8143Manila1155Very severe diseaseNo problemMeningitis and Sepsis<90%070-3.3652.02Ntruefalsetrue31030truetruetruetruetruefalsetruefalsefalseseverefalsefalsefalsetruetruefalsetruefalsefalsefalsefalsefalsetrue1mildmildmildfalsemildsign not presentsign not presentsign not presentfalsefalsetruemildfalsemildmildmildmildmildmoderatemoderatemoderatemoderatemildsign not presentsign not presentfalsetruemoderatefalsefalsesign not presentfalsesign not presentseveresign not presentmoderatefalsefalsemoderate