Paediatric Rapid Sepsis Trigger (PRST) Tool
PRST
Smart Triage: Triage and Management of Sepsis in Children Using the Point-of-care Paediatric Rapid Sepsis Trigger (PRST) Tool
1 other identifier
interventional
18,693
2 countries
3
Brief Summary
Sepsis is the leading cause of death and disability in children, every hour of delay in treatment is associated with greater organ damage and ultimately death. The challenges, especially in poor countries, are the delays in diagnosis and the inability to identify children in urgent need of treatment.To circumvent these challenges, we propose the development and clinical evaluation of a trigger tool that will reduce the time to diagnosis and prompt the timely initiation of life-saving treatment. The key innovations are 1) a data-driven approach to rapid diagnosis of sepsis severity and 2) a low- cost digital tagging system to track the time to treatment. The tool will require minimal cost, clinical expertise and training or time to use. The tool will identify high risk children and reduce time to treatment. The digital platform (mobile device and dashboard) will create a low-cost, highly scalable solution for children with sepsis.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable sepsis
Started Apr 2020
Longer than P75 for not_applicable sepsis
3 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
March 3, 2020
CompletedFirst Posted
Study publicly available on registry
March 11, 2020
CompletedStudy Start
First participant enrolled
April 27, 2020
CompletedPrimary Completion
Last participant's last visit for primary outcome
July 1, 2023
CompletedStudy Completion
Last participant's last visit for all outcomes
July 1, 2023
CompletedResults Posted
Study results publicly available
May 13, 2025
CompletedMay 13, 2025
April 1, 2025
3.2 years
March 3, 2020
February 7, 2024
April 29, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Time to Administration of an Appropriate Antimicrobial
Time in minutes to administer an appropriate antimicrobial, which includes at least one antibiotic or antimalarial (treatment determined and administered by hospital staff). The time is measured from when the child arrives at the facility (time of the first registration) until the antimicrobial administration is started.
1 day
Other Outcomes (5)
Readmission
7 days
Mortality
7 days
Admission
12 hours
- +2 more other outcomes
Study Arms (7)
Kenya intervention baseline
ACTIVE COMPARATORHospital nurses will triage participants using the Emergency Triage and Treatment (ETAT) guidelines, the triage policy that is currently in place at the study hospital sites.
Kenya intervention implementation
EXPERIMENTALHospital nurses will triage participants using the digital triage tool (mhealth intervention).
Kenya control baseline
ACTIVE COMPARATORHospital nurses will triage participants using the Emergency Triage and Treatment (ETAT) guidelines, the triage policy that is currently in place at the study hospital sites.
Kenya control implementation
ACTIVE COMPARATORHospital nurses will triage participants using the Emergency Triage and Treatment (ETAT) guidelines, the triage policy that is currently in place at the study hospital sites.
Uganda intervention baseline
ACTIVE COMPARATORHospital nurses will triage participants using the Emergency Triage and Treatment (ETAT) guidelines, the triage policy that is currently in place at the study hospital sites.
Uganda intervention implementation
EXPERIMENTALHospital nurses will triage participants using the digital triage tool (mhealth intervention)
Uganda control implementation
ACTIVE COMPARATORHospital nurses will triage participants using the Emergency Triage and Treatment (ETAT) guidelines, the triage policy that is currently in place at the study hospital sites.
Interventions
The digital platform consists of a mobile application integrating a pulse oximetry sensor attached to this device, with embedded smart algorithms that predict a critically ill state, or level of risk (below) in a child presenting at the hospital. The platform also includes an interactive dashboard located in strategic locations (e.g., laboratory, consultation rooms), which connects to the mobile application through a secure local network and displays the triage data to provide real-time monitoring for the physicians who manage the patients.
These are the triage guidelines currently applied in the study hospital sites. This will be the comparator group.
Eligibility Criteria
You may qualify if:
- All paediatric outpatients presenting to the study hospitals for medical treatment. The lower age limit will include children aged from 0 days, and the upper age limit will be in accordance to respective hospitals' practice for paediatric admissions (this may be 12, 15 or 19 years).
- Informed parental/guardian consent provided.
- Assent from children older than 13 years in addition to parental/guardian consent provided.
You may not qualify if:
- Patients presenting to the outpatient department for elective cases (e.g. elective surgery or change of dressing) or for clinical review appointment.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- University of British Columbialead
- Kenya Medical Research Institutecollaborator
- Wellcome Trustcollaborator
Study Sites (3)
Kiambu County Referral Hospital
Nairobi, Kenya
Mbagathi County Hospital
Nairobi, Kenya
Jinja Regional Referral Hospital
Jinja, Uganda
Related Publications (4)
Ansermino JM, Pillay Y, Tagoola A, Zhang C, Dunsmuir D, Kamau S, Kigo J, Agaba C, Aye IA, Hwang B, Novakowski SK, Huxford C, Wiens MO, Kimutai D, Ouma M, Ahmed I, Mwaniki P, Oyella F, Tenywa E, Nambuya H, Toliva BO, Kenya-Mugisha N, Kissoon N, Akech S; Pediatric Sepsis CoLab. Implementation of Smart Triage combined with a quality improvement program for children presenting to facilities in Kenya and Uganda: An interrupted time series analysis. PLOS Digit Health. 2025 Mar 10;4(3):e0000466. doi: 10.1371/journal.pdig.0000466. eCollection 2025 Mar.
PMID: 40063663RESULTLi ECK, Tagoola A, Komugisha C, Nabweteme AM, Pillay Y, Ansermino JM, Khowaja AR. Cost-effectiveness analysis of Smart Triage, a data-driven pediatric sepsis triage platform in Eastern Uganda. BMC Health Serv Res. 2023 Aug 31;23(1):932. doi: 10.1186/s12913-023-09977-5.
PMID: 37653477DERIVEDLi ECK, Grays S, Tagoola A, Komugisha C, Nabweteme AM, Ansermino JM, Mitton C, Kissoon N, Khowaja AR. Cost-effectiveness analysis protocol of the Smart Triage program: A point-of-care digital triage platform for pediatric sepsis in Eastern Uganda. PLoS One. 2021 Nov 17;16(11):e0260044. doi: 10.1371/journal.pone.0260044. eCollection 2021.
PMID: 34788338DERIVEDMawji A, Li E, Komugisha C, Akech S, Dunsmuir D, Wiens MO, Kissoon N, Kenya-Mugisha N, Tagoola A, Kimutai D, Bone JN, Dumont G, Ansermino JM. Smart triage: triage and management of sepsis in children using the point-of-care Pediatric Rapid Sepsis Trigger (PRST) tool. BMC Health Serv Res. 2020 Jun 3;20(1):493. doi: 10.1186/s12913-020-05344-w.
PMID: 32493319DERIVED
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Limitations and Caveats
Simultaneous recruitment across countries disrupted by COVID-19 pandemic.
Results Point of Contact
- Title
- J Mark Ansermino
- Organization
- The University of British Columbia
Study Officials
- PRINCIPAL INVESTIGATOR
John M Ansermino
The University of British Columbia
Publication Agreements
- PI is Sponsor Employee
- No
- Restrictive Agreement
- No
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- NON RANDOMIZED
- Masking
- NONE
- Masking Details
- Due to the clinical pre-post intervention design, masking will not be possible.
- Purpose
- PREVENTION
- Intervention Model
- SEQUENTIAL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Principal Investigator
Study Record Dates
First Submitted
March 3, 2020
First Posted
March 11, 2020
Study Start
April 27, 2020
Primary Completion
July 1, 2023
Study Completion
July 1, 2023
Last Updated
May 13, 2025
Results First Posted
May 13, 2025
Record last verified: 2025-04
Data Sharing
- IPD Sharing
- Will share
- Time Frame
- Data will be made available within 12 months following completion of the study.
- Access Criteria
- Sharing and access will be managed and subject to institutional agreements (Kenya Medical Research Institute, The University of British Columbia, Makerere University School of Public Health) that will set terms for how requests and access will be managed. We will ensure that a rigorous data governance structure is used by the data hosting service. The distribution will only occur with agreement from Principal Investigators and the investigators at all of the study sites.
After the study period, a de-identified copy of the data will be prepared for deposition in a repository with open access with proper governance mechanisms. We will make every effort to prevent re-identification of subjects by coding data that has the potential of being identifiable. The de-identified study data will be made publicly available using the Harvard Dataverse (https://dataverse.harvard.edu/), which is the data repository for KWTRP, and a URL will be made accessible. To enhance visibility, sharing and collating datasets with other collaborating sites for increased usability/re-use, de-identified will also be shared availed to reputable data hosting service such as the INDEPTH Data Repository (http://www.indepth-ishare.org/index.php/home), or through the newly established Pediatric Sepsis CoLab (sponsored by the World Federation of Pediatric Critical and Intensive care Societies).