Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo

To improve the early recognition of danger signs in children with severe febrile illness in low resource settings, WHO promotes automated respiratory rate (RR) counting, but its performance is unknown in this population. Therefore, we prospectively evaluated the field performance of automated point-...

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Autores principales:	Bieke Tack, Daniel Vita, Thomas Nsema Mbaki, Octavie Lunguya, Jaan Toelen, Jan Jacobs
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	automated respiratory rate counting fast breathing point-of-care test low resource setting handheld pulse oximeter severe febrile illness Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/d57db317df914be0ab1e494b560594c8
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spelling	oai:doaj.org-article:d57db317df914be0ab1e494b560594c82021-11-25T17:21:27ZPerformance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo10.3390/diagnostics111120782075-4418https://doaj.org/article/d57db317df914be0ab1e494b560594c82021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2078https://doaj.org/toc/2075-4418To improve the early recognition of danger signs in children with severe febrile illness in low resource settings, WHO promotes automated respiratory rate (RR) counting, but its performance is unknown in this population. Therefore, we prospectively evaluated the field performance of automated point-of-care plethysmography-based RR counting in hospitalized children with severe febrile illness (<5 years) in DR Congo. A trained research nurse simultaneously counted the RR manually (comparative method) and automatically with the Masimo Rad G pulse oximeter. Valid paired RR measurements were obtained in 202 (83.1%) children, among whom 43.1% (87/202) had fast breathing according to WHO criteria based on manual counting. Automated counting frequently underestimated the RR (median difference of −1 breath/minute; p2.5–p97.5 limits of agreement: −34–6), particularly at higher RR. This resulted in a failure to detect fast breathing in 24.1% (21/87) of fast breathing children (positive percent agreement: 75.9%), which was not explained by clinical characteristics (<i>p</i> > 0.05). Children without fast breathing were mostly correctly classified (negative percent agreement: 98.3%). In conclusion, in the present setting the automated RR counter performed insufficiently to facilitate the early recognition of danger signs in children with severe febrile illness, given wide limits of agreement and a too low positive percent agreement.Bieke TackDaniel VitaThomas Nsema MbakiOctavie LunguyaJaan ToelenJan JacobsMDPI AGarticleautomated respiratory rate countingfast breathingpoint-of-care testlow resource settinghandheld pulse oximetersevere febrile illnessMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2078, p 2078 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	automated respiratory rate counting fast breathing point-of-care test low resource setting handheld pulse oximeter severe febrile illness Medicine (General) R5-920
spellingShingle	automated respiratory rate counting fast breathing point-of-care test low resource setting handheld pulse oximeter severe febrile illness Medicine (General) R5-920 Bieke Tack Daniel Vita Thomas Nsema Mbaki Octavie Lunguya Jaan Toelen Jan Jacobs Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo
description	To improve the early recognition of danger signs in children with severe febrile illness in low resource settings, WHO promotes automated respiratory rate (RR) counting, but its performance is unknown in this population. Therefore, we prospectively evaluated the field performance of automated point-of-care plethysmography-based RR counting in hospitalized children with severe febrile illness (<5 years) in DR Congo. A trained research nurse simultaneously counted the RR manually (comparative method) and automatically with the Masimo Rad G pulse oximeter. Valid paired RR measurements were obtained in 202 (83.1%) children, among whom 43.1% (87/202) had fast breathing according to WHO criteria based on manual counting. Automated counting frequently underestimated the RR (median difference of −1 breath/minute; p2.5–p97.5 limits of agreement: −34–6), particularly at higher RR. This resulted in a failure to detect fast breathing in 24.1% (21/87) of fast breathing children (positive percent agreement: 75.9%), which was not explained by clinical characteristics (<i>p</i> > 0.05). Children without fast breathing were mostly correctly classified (negative percent agreement: 98.3%). In conclusion, in the present setting the automated RR counter performed insufficiently to facilitate the early recognition of danger signs in children with severe febrile illness, given wide limits of agreement and a too low positive percent agreement.
format	article
author	Bieke Tack Daniel Vita Thomas Nsema Mbaki Octavie Lunguya Jaan Toelen Jan Jacobs
author_facet	Bieke Tack Daniel Vita Thomas Nsema Mbaki Octavie Lunguya Jaan Toelen Jan Jacobs
author_sort	Bieke Tack
title	Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo
title_short	Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo
title_full	Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo
title_fullStr	Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo
title_full_unstemmed	Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo
title_sort	performance of automated point-of-care respiratory rate counting versus manual counting in children under five admitted with severe febrile illness to kisantu hospital, dr congo
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/d57db317df914be0ab1e494b560594c8
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Performance of Automated Point-of-Care Respiratory Rate Counting versus Manual Counting in Children under Five Admitted with Severe Febrile Illness to Kisantu Hospital, DR Congo

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