Validating a novel index (SWAT-Bp) to predict mortality risk of community-acquired pneumonia in Malawi.

Background: Community-acquired pneumonia is a major cause of mortality worldwide. Early assessment and initiation of management improves outcomes. In higher-income countries, scores assist in predicting mortality from pneumonia.

Increasing the volume of blood received in adult paired blood culture bottles at a regional public health laboratory: results of a quality improvement project to optimise the diagnosis of bacteraemia.

Background: Optimising the diagnosis of bacteraemia has clinical, infection control and antimicrobial stewardship benefits. It's well documented that volume of blood received in blood culture bottles affects test sensitivity. The ability of blood cultures to detect bacteraemia is proportional to the volume of blood cultured.

Severity assessment of lower respiratory tract infection in Malawi: derivation of a novel index (SWAT-Bp) which outperforms CRB-65.

Objective: To assess the validity of CRB-65 (Confusion, Respiratory rate >30 breaths/min, BP<90/60 mmHg, age >65 years) as a pneumonia severity index in a Malawian hospital population, and determine whether an alternative score has greater accuracy in this setting.

Design: Forty three variables were prospectively recorded during the first 48 hours of admission in all patients admitted to Queen Elizabeth Central Hospital, Malawi, for management of lower respiratory tract infection over a two month period (N = 240). Calculation of sensitivity and specificity for CRB-65 in predicting mortality was followed by multivariate modeling to create a score with superior performance in this population.