Clinical signs predictive of severe illness in young Pakistani infants

Shahira Shahid, Shiyam Sunder Tikmani, Kanwal Nayani, Ayesha Munir, Nick Brown, Anita K.M. Zaidi, Fyezah Jehan, Muhammad Imran Nisar

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Objective: Early detection of specific signs and symptoms to predict severe illness is essential to prevent infant mortality. As a continuation of the results from the multicenter Young Infants Clinical Signs and Symptoms (YICSS) study, we present here the performance of the seven-sign algorithm in 3 age categories (0–6 days, 7–27 days and 28–59 days) in Pakistani infants aged 0–59 days. Results: From September 2003 to November 2004, 2950 infants were enrolled (age group 0–6 days = 1633, 7–27 days = 817, 28–59 days = 500). The common reason for seeking care was umbilical redness or discharge (29.2%) in the 0–6 days group. Older age groups presented with cough (16.9%) in the 7–27 age group and (26.9%) infants in the 28–59 days group. Severe infection/sepsis was the most common primary diagnoses in infants requiring hospitalization across all age groups. The algorithm performed well in every age group, with a sensitivity of 85.9% and specificity of 71.6% in the 0–6 days age group and a sensitivity of 80.5% and specificity of 80.2% in the 28–59 days group; the sensitivity was slightly lower in the 7–27 age group (72.4%) but the specificity remained high (83.1%).

Original languageEnglish
Article number71
JournalBMC Research Notes
Issue number1
Publication statusPublished - Dec 2021


  • Clinical signs
  • Community
  • Pakistan
  • Severe illness requiring hospitalization
  • Young infants


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