Table 4 Frequency (%) and validity of clinical signs observed, referral decision and Kappa statistic for agreement between assessments by CHWs and physician gold standard
Newborn danger signs assessed | Number of children had the sign/symptoms (identified by physician) n (%) | Number of children did not have the sign/symptoms (identified by physician) n(%) | True negative | False negative | False positive | True positive | Sensitivity % (CI) | Specificity % (CI) | PPV % (CI) | NPV % (CI) | K | p-value |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Convulsion (N = 148) | 2 (1.4) | 146 (98.7) | 146 | 0 | 0 | 2 | 100.0 (15.8–100) | 100.0 (97.5–100) | 100.0 (15.8–100) | 100.0 (97.5–100) | 1.00 | 0.000 |
Hypothermia (N = 148) | 1 (0.7) | 147 (99.3) | 144 | 1 | 2 | 1 | 50.0 (1.3–98.7) | 98.6 (95.1–99.8) | 33.3 (0.8–90.6) | 99.3 (96.2–100) | 0.39 | 0.000 |
Hyperthermia (N = 148) | 1 (0.7) | 147 (99.3) | 146 | 0 | 1 | 1 | 100 (2.5–100) | 99.3 (96.3–100) | 50.0 (1.3–98.7) | 100 (97.5–100) | 0.66 | 0.000 |
SevereFechest in-drawing (N = 148) | 1 (0.7) | 147 (99.3) | 147 | 0 | 0 | 1 | 100 (2.5–100) | 100 (97.5–100) | 100 (2.5–100) | 100 (97.5–100) | 1.00 | 0.000 |
Tachypnea (N = 148) | 1 (0.7) | 147 (99.3) | 147 | 0 | 1 | 0 | (*) one-sided, 97.5% confidence interval | |||||
Baby has umbilical redness extending to abdominal skin (N = 148) | 1 (0.7) | 147 (99.3) | 147 | 0 | 0 | 1 | 100.0 (2.5–100) | 100.0 (97.5–100) | 100.0 (2.5–100) | 100.0 (97.5–100) | 1.00 | 0.000 |
Only moves when stimulated (N = 148) | 3 (2) | 145 (98) | 145 | 1 | 0 | 2 | 66.7 (9.4–99.2) | 100 (97.5–100) | 100 (15.8–100) | 99.3 (96.2–100) | 0.80 | 0.000 |
Newborn had no void (urine) in 24 h (N = 148) | 5 (3.4) | 143 (96.6) | 141 | 0 | 2 | 5 | 100.0 (47.8–100) | 98.6 (95.0–99.8) | 71.4 (29.0–96.3) | 100.0 (97.4–100) | 0.83 | 0.000 |
Newborn had yellow palm or soles of feet (N = 148) | 4 (2.7) | 144 (97.3) | 143 | 1 | 1 | 3 | 75.0 (19.4–99.4) | 99.3 (96.2–100) | 75.0 (19.4–99.4) | 99.3 (96.2–100) | 0.74 | 0.000 |
Baby having difficulty feeding (N = 148) | 4 (2.7) | 144 (97.3) | 144 | 1 | 0 | 3 | 75.0 (19.4–99.4) | 100 (97.5–100) | 75.0 (29.4–100) | 99.3 (96.2–100) | 0.85 | 0.000 |
CHW decision on assessment Baby has danger signs and need referral (N = 148) | 15 (10.1) | 133 (89.9) | 128 | 1 | 5 | 14 | 93.3 (68.1–99.8) | 96.2 (91.4–98.8) | 73.7 (48.8–90.9) | 99.2 (95.8–100) | 0.80 | 0.000 |