A review on the evolution of the defining criteria for possible serious bacterial infection in the young infant from IMCI to IMNCI. Why the change?

Abstract

Abstract: Introduction: IMCI (Integrated Management of Childhood Illness) was initiated in 1997 by World Health Organization (WHO) and the United Nations International Children’s Fund (UNICEF) to reduce child mortality and promote child health and development. It later evolved to Integrated Management of Childhood and Newborn Illness (IMNCI). The objective of this review is to inform, discuss and highlight the reasons which led to these improved strategies.
Method: A comprehensive literature review was conducted using electronic data bases, including Google scholar and PubMed,  in which guidelines, related updates; and related studies were searched and reviewed from 1995 to 2023.
Discussion: Initially, IMCI guidelines included young infants from 1 week of age to two months, and from two months to five  years. As there has been an appreciable decline in under five mortality rates, but the neonatal mortality rate is still high  especially in the first week of life; new strategies were introduced particularly in the first week of life to make IMNCI. Initially,  sixteen signs were used when classifying a young infant with possible serious bacterial infection (PSBI). With evidence, a reduced algorithm to seven signs was then used in young infants. Update in management of classified infection where referral  is not possible in 2015 have been a big step up in reducing child mortality. Ongoing studies will provide more insight  on new criteria and treatment regimens.
Conclusion: With this evolution, IMNCI has continued to be useful in clinical practice.