Table 2. Overall sensitivity and specificity and agreement with paediatrician diagnosis for IMCI algorithm used by nurses to assess and classify childhood skin problems in two clinics in Fiji.

Variable	No. of cases identified by paediatricians (%)	No. of cases identified by nurses		Sensitivity, in % (95% CI)	Specificity, in % (95% CI)	Agreement, in %		Kappa statistic
Detection of skin problem	157 (63.3)	163		98.7 (95.5–99.9)	91.2 (83.4–96.1)	96		0.91
Itch	97 (39.1)	88		87.1 (78.6–93.2)	88.7 (78.1–95.3)	87.7		0.75
Skin pain	41 (16.5)	45		80.5 (65.1–91.2)	89.5 (82.3–94.4)	87.1		0.68
Extensive redness or swelling	3 (1.2)	3		33.3 (0.8–90.6)	98.7 (95.3–99.8)	97.4		0.32
Eye swelling or redness	5 (2)	5		60 (14.7–94.7)	98.7 (95.2–99.8)	90.3		0.65
Localized swelling or redness	21 (8.5)	30		85.1 (63.7–97)	91 (84.9–95.3)	97.4		0.59
Lesion with crusts or pus	92 (37.1)	94		91.3 (83.6–96.2)	84.1 (72.7–92.1)	88.4		0.76
Papules	90 (36.3)	75		76.7 (66.6–84.9)	90.8 (81–96.5)	82.6		0.65
Patches	12 (4.8)	10		58.3 (27.7–84.8)	97.9 (94–99.6)	94.8		0.61
Severe skin infection	1 (0.4)	1		100 (2.5–100)	100 (97.6–100)	100		1
Periorbital cellulitis	3 (1.2)	4		75 (29.2–100)	99.3 (96.4–100)	99.4		0.85
Abscess or cellulitis	20 (8.1)	24		95 (75.1–99.9)	96.3 (91.6–98.8)	96.1		0.84
Impetigo	50 (20.2)	52		70 (55.4–82.1)	83.8 (75.4–90.3)	79.4		0.53
Infected scabies	55 (22.2)	61		89.1 (77.8–95.9)	88 (78–93.6)	88.4		0.75
Scabies	24 (9.7)	22		58.3 (36.6–77.9)	93.9 (88.3–97.3)	88.4		0.54
Fungal infection	13 (5.2)	11		69.2 (38.6–90.9)	98.6 (95–99.8)	96.1		0.73
Other	28 (11.3)	36		75 (55.1–93.2)	88.2 (81.3–93.2)	85.8		0.57

CI, confidence interval; IMCI, Integrated Management of Childhood Illness.