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In South\u2010East Asia, C\u2010reactive protein (CRP) has been demonstrated to be highly sensitive and moderately specific in detecting bacterial infections and to safely reduce unnecessary antibacterial prescriptions in primary care. As evidence is scant in sub\u2010Saharan Africa, we assessed the sensitivity of CRP in identifying serious bacterial infections in Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Samples were obtained from inpatients and outpatients in a prospective febrile illness study at two hospitals in Moshi, Tanzania, 2011\u20132014. Bacterial bloodstream infections (BSI) were established by blood culture, and bacterial zoonotic infections were defined by \u22654\u00a0fold rise in antibody titre between acute and convalescent sera. The sensitivity of CRP in identifying bacterial infections was estimated using thresholds of 10, 20 and 40\u00a0mg\/l. Specificity was not assessed because determining false\u2010positive CRP results was limited by the lack of diagnostic testing to confirm non\u2010bacterial aetiologies and because ascertaining true\u2010negative cases was limited by the imperfect sensitivity of the diagnostic tests used to identify bacterial infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 235 febrile outpatients and 569 febrile inpatients evaluated, 31 (3.9%) had a bacterial BSI and 61 (7.6%) had a bacterial zoonosis. Median (interquartile range) CRP values were 173 (80\u2013315) mg\/l in bacterial BSI, and 108 (31\u2013208) mg\/l in bacterial zoonoses. The sensitivity (95% confidence intervals) of CRP was 97% (83%\u201399%), 94% (79%\u201398%) and 90% (74%\u201397%) for identifying bacterial BSI, and 87% (76%\u201393%), 82% (71%\u201390%) and 72% (60%\u201382%) for bacterial zoonoses, using thresholds of 10, 20 and 40\u00a0mg\/l, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>C\u2010reactive protein was moderately sensitive for bacterial zoonoses and highly sensitive for identifying BSIs. Based on these results, operational studies are warranted to assess the safety and clinical utility of CRP for the management of non\u2010malaria febrile illness at first\u2010level health facilities in sub\u2010Saharan Africa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.13358","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T05:11:05Z","timestamp":1575609065000},"page":"291-300","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Sensitivity of C\u2010reactive protein for the identification of patients with laboratory\u2010confirmed bacterial infections in northern Tanzania"],"prefix":"10.1111","volume":"25","author":[{"given":"Thomas","family":"Althaus","sequence":"first","affiliation":[{"name":"Mahidol\u2010Oxford Tropical Medicine Research Unit Mahidol University Bangkok Thailand"},{"name":"Centre for Tropical Medicine and Global Health University of Oxford 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