TABLE 4.

Categories and definitions of severe febrile illness emerging from included publications (Definitions of severity in treatment seeking studies of febrile illness in children in low and middle income countries: a scoping review, Switzerland, 2021).

Category	Code for SFI definition	Description	Example
Biomedical definitions	Clinical management or diagnosis	The febrile condition requires a specific kind of clinical management unique to severe disease	Tinuade et al. [53]
		The child is diagnosed with severe disease by a clinician (no signs and symptoms specified)	Children with “life-threatening events that required emergency care such as resuscitation, rehydration, blood transfusion, respiratory supports etc.”
	Guidelines	Based on a clinical guideline, the febrile condition is classified as severe	Ellis et al. [18]
			“An illness was labelled as ‘severe febrile illness’ if it met the Integrated Management of Childhood Illness (IMCI) classifications of severe malaria.”
	Disease outcome	Based on the disease outcome, the febrile condition is classified as severe	Kassam et al. [45]
			“(…) the child’s condition progressing from mild to severe, resulting in negative outcomes such as irreversible disability or death.”
	Clinical signs and symptoms	Specific clinical signs and symptoms are considered an indicator of severe disease	Warsame et al. [55]
			“(…) children were admitted to the Regional Hospital with a diagnosis of severe malaria (altered consciousness, coma, convulsions, hypoglycaemia, difficulty in breathing, severe anaemia, prostration).”
Caregiver definitions	Local illness concepts	Local and/or traditional understandings of health conditions perceived to be severe	Beiersmann et al. [34]
			“The local concept of kono is very close to the biomedical definition of cerebral malaria. (…) It is considered a very serious illness which has often fatal outcomes.”
	Perceived severity	Caregivers perceive child’s condition as severe. The perceived severity is not (reported to be) associated to specific symptoms, outcomes or other illness factors	Tsukahara et al. [54]
			“The explanatory variables are (…) severity of the illness as perceived by the caretaker”.
	Perceived treatment failure	Caregivers perceive child’s condition to be severe if treatment fails	Kamat et al. [43]
			“(…) changes in perception of severity (…) based on the failure of home-based treatment”.
	Recognized signs and symptoms	Caregivers perceive specific symptoms or signs of illness to be a sign of severe disease	Chibwana et al. [35]
			“Caregivers had their own way of categorizing fever into mild and severe. (…) febrile children who could not play were considered as having severe fever.”