Opiyo and English identified clinical signs indicative of severe illness in neonates and young infants less than 2 months of age. These can help a health working in a developing country decide which infants should be admitted to a hospital for evaluation. The authors are from KEMRI/Wellcome Trust Research Programme in Nairobi and University of Oxford.


Patient selection: age 0 to 59 days in a developing country


Clinical signs indicative severe illness - one or more of the following:

(1) history of feeding difficulty

(2) history of convulsions

(3) axillary temperature < 35.5°C or >= 37.5°C

(4) a change in the level of activity

(5) rapid breathing with respirations >= 60 breaths per minute

(6) severe chest indrawing

(7) grunting

(8) cyanosis (or hypoxemia on pulse oximetry)



• Change in level of activity might include restlessness, lethargy, not moving when stimulated or reduced consciousness.


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