Derivation and external validation of a clinical prognostic model identifying children at risk of death following presentation for diarrheal care

Bibliographic Data

ID19593777
AuthorsSharia M Ahmed (0000-0002-4060-5712, University of Utah, corresponding author), Ben J Brintz (0000-0003-4695-0290, University of Utah, corresponding author), Alison W Talbert (0000-0002-9328-6903, Kenya Medical Research Institute, corresponding author), Moses M Ngari (0000-0001-7149-5491, Kenya Medical Research Institute, corresponding author), Patricia B Pavlinac (0000-0002-0051-9131, University of Washington, corresponding author), James A Platts-Mills (0000-0002-4956-0418, University of Virginia, corresponding author), Adam C Levine (0000-0003-3982-3824, Brown University, corresponding author), Eric J Nelson (0000-0003-2649-2624, University of Florida, corresponding author), JL Walson (0000-0003-4836-720X, University of Washington, corresponding author), Judd L Walson, Karen L Kotloff (0000-0003-1808-6431, University of Maryland, Baltimore, corresponding author), James A Berkley (0000-0002-1236-849X, Kenya Medical Research Institute, corresponding author), Daniel T Leung (0000-0001-8401-0801, University of Utah, corresponding author)
EditorsCollins Otieno Asweto (0000-0003-3514-9836)
Year2023
Volume3
Issue6
Pagese0001937
Publication date2023-06-27
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0001937
PMID37368867
OpenAlexW4382344739
LanguageEN
Citations received3
References cited20

Diarrhea continues to be a leading cause of death for children under-five. Amongst children treated for acute diarrhea, mortality risk remains elevated during and after acute medical management. Identification of those at highest risk would enable better targeting of interventions, but available prognostic tools lack validation. We used clinical and demographic data from the Global Enteric Multicenter Study (GEMS) to build clinical prognostic models (CPMs) to predict death (in-treatment, after discharge, or either) in children aged ≤59 months presenting with moderate-to-severe diarrhea (MSD), in Africa and Asia. We screened variables using random forests, and assessed predictive performance with random forest regression and logistic regression using repeated cross-validation. We used data from the Kilifi Health and Demographic Surveillance System (KHDSS) and Kilifi County Hospital (KCH) in Kenya to externally validate our GEMS-derived CPM. Of 8060 MSD cases, 43 (0.5%) children died in treatment and 122 (1.5% of remaining) died after discharge. MUAC at presentation, respiratory rate, age, temperature, number of days with diarrhea at presentation, number of people living in household, number of children

Diarrhea · Intensive care medicine · Logistic regression · Psychological intervention · Child Nutrition and Water Access · Food Security and Health in Diverse Populations · Medicine · Viral gastroenteritis research and epidemiology · Emergency Medicine · Internal Medicine · Pediatrics · Surgery

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