Study assesses tools to predict respiratory infection-related death in children in Kenya

Findings could support better risk assessment for severe childhood respiratory infections in low-resource settings.

Doctor checking a young child patient who is sitting on a person's knee

A new study published in The Journal of Infectious Diseases has assessed the real-world performance of six commonly usedexisting paediatric risk scores in predicting death among children hospitalised with severe respiratory infections in Kenya.

The study was led by Usher's Ting Shi’s team in collaboration with colleagues from Kenya and South Africa. The team retrospectively analysed clinical data from children admitted to Kilifi County Referral Hospital with severe acute lower respiratory tract infections (ALRIs), including pneumonia and bronchiolitis.

Their goal was to evaluate how well each of the risk scores performed in this context, where accurate triage and treatment decisions are essential but healthcare resources may be limited. Of the six scores tested, the RISC-Malawi (MUAC) score – which uses mid-upper arm circumference to assess malnutrition – demonstrated the highest ability to distinguish between children who survived and those who did not. The remaining scores also showed acceptable predictive accuracy.

Any advances in severe respiratory infection triage or treatment in low- and middle-income countries are critical to address for children unable to reach care in a timely manner, who present later with greater disease severity and preventable mortality.

Dr Ting Shi Senior Lecturer (Associate Professor), Usher Institute

The authors emphasise the importance of validating existing tools in local contexts and recommend that future studies focus on refining risk scores to support frontline clinical decision-making in low-resource settings.

Cite as

Gordon B, Nyiro JU, Nair H, Sheikh Z, Katama E, Agoti CN, Pei R, Zar H, Shi T. External validation of paediatric pneumonia and bronchiolitis risk scores to predict mortality in children hospitalised in Kenya: a retrospective cohort study. J Infect Dis. 2025 Jul 22:jiaf377. doi: 10.1093/infdis/jiaf377. Epub ahead of print. PMID: 40692486.

Further information

Read the full paper published in The Journal of Infectious Diseases

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