Baby Check is a systematic way of grading the severity of illness in infants. We studied its usefulness for assessing 53 infants presenting to a clinic in a West African village. Their ages ranged from 2 weeks to 7 months. The Baby Check scores ranged from 0 to 30. Forty-four infants were considered by the doctors to be well or mildly ill, 41 of these had scores below 9. The three infants with higher scores had symptoms and signs suggesting they were more than mildly ill. Nine infants were considered to be moderately ill. Their scores ranged from 4 to 30. The babies with the low scores had few symptoms and diagnoses suggesting they were only mildly ill. The babies with the highest scores all had diagnoses requiring medical attention. This pilot study of Baby Check in a developing country suggests that its use by health workers could increase the accuracy with which babies are referred for a medical opinion, and be a valuable tool for the identification of such infants in a busy clinic.

The objective was to assess whether Baby Check could be used in a different cultural setting to where it was developed. Babies were scored using Baby Check and then assessed by a physician who had no knowledge of the score. Out-patient clinics were held at the Child In Need Institute, Calcutta, India. The subjects were 100 babies aged between 0 and 12 months. Ninety-five babies were successfully scored and independently graded by a doctor. The total scores ranged 0 to 53 with a median of 11. Physicians graded two babies as seriously ill that required urgent admission; eight required admission for observation and/or treatment; 51 were thought to require careful observation and treatment at home; and 34 were considered to be mildly ill or well. There were several difficulties using Baby Check in Calcutta. Baby Check is designed to assess the severity of acute systemic illness in babies. Many babies seen had chronic conditions such as malnutrition, as well as an acute illness. There were difficulties translating some of the checks. In the study design there is no 'gold standard' against which to test physicians' grading of illness or the Baby Check score. Despite these problems Baby Check detected the majority of ill babies in the study: with a total score cut-off of 12-13 Baby Check had a positive predictive value of 86 per cent for detecting babies that required medical attention. Of the babies scoring less than 8, 97 per cent did not need admission to hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

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