title: Validation of IMNCI algorithm for young infants (0-2 months) in India.
abstract: OBJECTIVE
  To check the validity of Integrated Management of Neonatal and Childhood Illness (IMNCI) algorithm for young infants (0-2 months).
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  The outpatient department and emergency room of a medical college attached hospital.
  
  
  METHODS
  419 infants (176 between 0-7 days, 243 between 7 days to 2 months) underwent a detailed diagnostic assessment and treatment as per the standard protocol of treating unit. These infants also underwent assessment, classification and identification of treatment as per IMNCI algorithm. The diagnostic and therapeutic agreement between standard protocol and IMNCI was computed to assess the validity of IMNCI algorithm.
  
  
  RESULTS
  The IMNCI algorithm performed well in identifying sick young infants with  sensitivity of 97%, 94%  and 95%, and specificity of 85%, 87% and 87%  in 0-7 days, 7 days to 2 months and 0-2 months age groups, respectively.  The algorithm covered majority (80%) of recorded diagnoses, and could identify bacterial infection with 88.5% sensitivity and 57.4% specificity. Complete diagnostic agreement with gold standard was seen in 50%; overdiagnosis and under diagnosis was seen in 13% and 19%, respectively.  Low birthweight and upper respiratory infection were the main reasons for overdiagnosis whereas surgical conditions resulted in under diagnoses in majority.
  
  
  CONCLUSIONS
  IMNCI algorithm for evaluation and management of young infants has good sensitivity and specificity for referring cases with severe illness.
authors.affiliation: Department of Pediatrics, Kalawati Saran Childrens Hospital and Lady Hardinge Medical College, New Delhi, India.
authors.forename: Satnam
authors.initials: S
authors.lastname: Kaur
authors.forename: V
authors.initials: V
authors.lastname: Singh
authors.forename: A K
authors.initials: AK
authors.lastname: Dutta
authors.forename: J
authors.initials: J
authors.lastname: Chandra
mesh_terms: D000465:Algorithms; D019090:Case Management; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis*; D011446:Prospective Studies; D015203:Reproducibility of Results