Table 6.
Comparison of current Kenyan IMCI referral criteria, revised WHO criteria and proposed criteria based on studies included in this review
| Current Kenyan IMCI referral criteria5 | Revised WHO IMCI referral criteria20 | Proposed referral criteria based on studies included in this review 4–13 |
|---|---|---|
| Not able to feed or breastfeed | Not feeding well | History of feeding difficulty |
| Convulsions or convulsing now | Convulsions | History of convulsions |
| Fast breathing (60 bpm or more) | Fast breathing (60 bpm or more) | Fast breathing (respiratory rate ≥60 bpm) |
| Severe chest indrawing | Severe chest indrawing | Severe chest indrawing |
| Fever (≥37.5°C* or feels hot) or low body temperature (<35.5°C* or feels cold) | Fever (≥37.5°C*) or low body temperature (<35.5°C*) | Temperature (axillary) ≥37.5°C or <35.5°C |
| No movements even when stimulated | Movement only when stimulated or no movement at all | Change in level of activity |
| Grunting or wheezing | – | Grunting |
| Central cyanosis | – | Cyanosis |
| Gasping | – | – |
| Not breathing at all even when stimulated | – | – |
| Respiratory rate less than 20 bpm | – | – |
| Nasal flaring | – | |
| Bulging fontanelle | – | – |
| Pus draining from the ear | – | – |
| Drowsy (lethargic) or unconscious | – | – |
*
Axillary temperature
bpm, breaths per minute.