Validation of a clinical algorithm to identify neonates with severe illness during routine household visits in rural Bangladesh

<h3>Background</h3> To validate a clinical algorithm for community health workers (CHWs) during routine household surveillance for neonatal illness in rural Bangladesh. <h3>Methods</h3> Surveillance was conducted in the intervention arm of a trial of newborn interventions. CHWs assessed 7587 neonates on postnatal days 0, 2, 5 and 8 and identified neonates with very severe disease (VSD) using an 11-sign algorithm. A nested prospective study was conducted to validate the algorithm (n=395). Physicians evaluated neonates to determine whether newborns with VSD needed referral. The authors calculated algorithm sensitivity and specificity in identifying (1) neonates needing referral and (2) mortality during the first 10 days of life. <h3>Results</h3> The 11-sign algorithm had sensitivity of 50.0% (95% CI 24.7% to 75.3%) and specificity of…