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Background: Neonatal sepsis is a major cause of morbidity and mortality in developing countries. Blood culture which is the gold standard for confirmation of sepsis has a low yield and does not provide rapid diagnosis. In addition, it is relatively costly and requires skilled workers and laboratory equipments that are scarce and space in between low resource settings. Therefore, there is need for other rapid screening tests, so that prompt intervention can be instituted. There is therefore need for other rapid screening or diagnostic tests. This study was therefore carried out to determine the predictive value of micro-erythrocyte sedimentation rate (mini-ESR) in the diagnosis of neonatal sepsis.
Methods: A prospective study was carried out from July to December 2007. Blood was obtained from 406 neonates with suspicion of sepsis for the estimation of mini-ESR, blood culture, full blood count and blood film. Blood culture was used as gold standard for the diagnosis of neonatal sepsis.
Results: Two hundred and fifty one (61.8%) neonates had elevated mini-ESR while 169 (41.6%) had positive blood culture. The prevalence of neonatal sepsis was 33.1%. The sensitivity, specificity, positive and negative predictive values of mini-ESR using blood culture as gold standard were 75.7%, 48.1%, 51.0% and 73.5% respectively. Combination of mini-ESR with band forms had high sensitivity and negative predictive values of 95.9% and 94.2% respectively.
Conclusion: Mini-ESR can be combined with band forms as screening tools for neonatal sepsis.