Evidence map›Paper›PMID 40715696›Full record

ArticleCommunications medicine2025

Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) predicts mortality in patients with febrile illness in southern Mozambique.

Núria Balanza, Bàrbara Baro, Sara Ajanovic, Zumilda Boca, Justina Bramugy, Anelsio Cossa, Elizabeth Ja Fitchett, Heidi Hopkins, Suzanne H Keddie, Sham Lal and 11 more

Abstract read
In one paragraph

Article in Communications medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Núria BalanzaISGlobal, Barcelona, Spain.
Bàrbara BaroISGlobal, Barcelona, Spain.ORCID http://orcid.org/0000-0001-7780-1744
Sara AjanovicISGlobal, Barcelona, Spain.
Zumilda BocaCentro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
Justina BramugyFacultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain.
Anelsio CossaCentro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
Elizabeth Ja FitchettLondon School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-6767-6094
Heidi HopkinsLondon School of Hygiene and Tropical Medicine, London, UK.
Suzanne H KeddieLondon School of Hygiene and Tropical Medicine, London, UK.
Sham LalLondon School of Hygiene and Tropical Medicine, London, UK.
David C W MabeyLondon School of Hygiene and Tropical Medicine, London, UK.
Tegwen MarlaisLondon School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0003-0955-9807
Hridesh MishraSandra-Rotman Centre for Global Health, Toronto General Research Institute, University Health Network-Toronto General Hospital, Toronto, ON, Canada.ORCID http://orcid.org/0000-0002-8572-2736
Campos MucasseCentro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
Marta ValenteISGlobal, Barcelona, Spain.
Andrea M WeckmanSandra-Rotman Centre for Global Health, Toronto General Research Institute, University Health Network-Toronto General Hospital, Toronto, ON, Canada.
Julie K WrightSandra-Rotman Centre for Global Health, Toronto General Research Institute, University Health Network-Toronto General Hospital, Toronto, ON, Canada.
Shunmay YeungLondon School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-0997-0850
Kathleen ZhongSandra-Rotman Centre for Global Health, Toronto General Research Institute, University Health Network-Toronto General Hospital, Toronto, ON, Canada.
Kevin C KainSandra-Rotman Centre for Global Health, Toronto General Research Institute, University Health Network-Toronto General Hospital, Toronto, ON, Canada.ORCID http://orcid.org/0000-0001-6068-1272
Quique BassatISGlobal, Barcelona, Spain. quique.bassat@isglobal.org.ORCID http://orcid.org/0000-0003-0875-7596

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFever is a leading reason for seeking healthcare globally. Early in the course of febrile illness, it is challenging to identify patients at risk of severe and fatal infections. Quantifying biomarkers of immune and endothelial activation may facilitate patient triage.

methodsWe prospectively enrolled children ≥2 months and adults with fever visiting two Mozambican hospitals from December 2018 to February 2021. Standard clinical and laboratory parameters, including lactate levels, were assessed at presentation. Plasma levels of Angpt-2, CHI3L1, CRP, IL-6, IL-8, PCT, sFlt-1, sTNFR1, sTREM-1, and suPAR at presentation were retrospectively quantified. Clinical outcomes were evaluated up to 28 days. We assessed the prognostic performance of biomarkers for 28-day mortality and explored their association with other adverse outcomes.

resultsThis study includes 1955 participants, with 93 deaths occurring within 28 days. We show that all biomarker levels are elevated in inpatients compared to outpatients and are associated with 28-day mortality (all p < 0.001). sTREM-1 is the best biomarker predicting 28-day mortality with an AUROC of 0.82 (95% CI: 0.78-0.86), superior to that of PCT (p < 0.001), CRP (p < 0.001), and lactate (p = 0.0033). Its prognostic performance is consistent across age and sex, but is reduced in HIV-positive individuals (AUROC = 0.73, 95% CI: 0.66-0.80). Adding sTREM-1 improves the discrimination of clinical severity scores for 28-day mortality. Among discharged inpatients, sTREM-1 is positively correlated with duration of hospitalisation (p < 0.001). Among outpatients, sTREM-1 levels are higher in those seeking further care (p = 0.0022) or subsequently hospitalised (p = 0.012).

conclusionssTREM-1 is a promising biomarker for risk stratification of all-age, all-cause febrile illnesses in resource-limited settings.

Identifiers

PMID40715696
PMCPMC12297511

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.