Clinical Indicators for @entity2348 in Ghanaian XXXX with @entity3964 Infection.

@entity1 @entity2756 @entity2700 @entity417 @entity391 @entity2348 @entity281 @entity381 @entity5895 @entity3964 @entity311 @entity2259 @entity491
UNASSIGNED: Differentiation of infectious causes in severely ill @entity1 is essential but challenging in sub- Saharan Africa. The aim of the study was to determine clinical indicators that are able to identify @entity2348 in @entity3964 infected @entity1 in rural Ghana. In total, 1,915 severely ill @entity1 below the age of 15 years were recruited at Agogo Presbyterian Hospital in Ghana between May 2007 and February 2011. In 771 (40%) of the @entity1 @entity311 parasites were detected. This group was analyzed for indicators of @entity2348 using bivariate and multivariate regression analyses with 24 socio-economic variables, 16 terms describing medical history and anthropometrical information and 68 variables describing clinical symptoms. The variables were tested for sensitivity, specificity, positive predictive value and negative predictive value. In 46 (6.0%) of the @entity1 with @entity281 , @entity2348 was detected. The most frequent pathogens were non-typhoid salmonellae (45.7%), followed by Streptococcus spp. (13.0%). Coughing, @entity2700 , @entity381 , severe @entity417 and @entity491 were positively associated with @entity2259 . Domestic hygiene and exclusive breastfeeding is negatively associated with @entity2259 . In cases of high @entity5895 (>10,000/ l), a significant association with @entity2259 was found for @entity381 (OR 8.8; CI 1.6-48.9), @entity2700 (OR 18.2; CI 2.0-166.0) and coughing (OR 9.0; CI 0.7-118.6). In @entity1 with low @entity5895 , associations with @entity2259 were found for @entity391 (OR 4.7; CI 1.4-15.8), severe @entity417 (OR 3.3; CI 1.0-11.1) and @entity491 (OR 6.8 CI 1.9-24.2). Clinical signs of impaired microcirculation were negatively associated with @entity2259 . @entity2756 achieved best coverage of isolated pathogens. The results demonstrate the limitation of clinical symptoms to determine @entity2348 in @entity3964 infected @entity1 . Best clinical indicators are dependent on the @entity5895 level. Even with a moderate sensitivity of >60%, only low positive predictive values can be obtained due to low prevalence of @entity2259 . Rapid testing for distinguishing @entity5895 and @entity2259 is essential.
