| Reason for Referrala | Times Cited | Prevalence % (95% CI) | Sensitivity % (95% CI) | Specificity % (95% CI) | LR+ | LR- |
| Fever or felt hot | 82 | 41.2 (34.3–48.4) | 15.0 (3.2–37.9) | 55.9 (48.3–63.3) | 0.3 | 1.5 |
| Had cough | 80 | 40.4 (33.5–47.6) | 25.0 (8.7–49.1) | 57.9 (50.3–65.2) | 0.6 | 1.3 |
| Diarrhea | 15 | 7.6 (4.3–12.2) | 0.0 (0.0–16.1) | 91.6 (86.5–95.2) | 0.0 | 1.1 |
| Refusing to feed | 24 | 12.1 (7.9–17.4) | 45.0 (23.1–68.5) | 91.6 (86.6–95.2) | 5.4 | 0.6 |
| Sleepy or difficult to arouse | 8 | 4.0 (1.8–7.8) | 20.0 (5.7–43.7) | 97.8 (94.3–99.4) | 9.1 | 0.8 |
| Floppy or poor muscle tone | 18 | 9.1 (5.5–14.0) | 25.0 (8.7–49.1) | 92.7 (87.8–96.1) | 3.4 | 0.8 |
| Not making urine | 22 | 31.9 (21.2–44.2) | 57.1 (18.4–90.1) | 71.0 (58.1–81.8) | 2.0 | 0.6 |
| Convulsions, fits, or seizures | 8 | 4.1 (1.8–7.8) | 15.0 (3.2–37.9) | 97.2 (93.5–99.1) | 5.4 | 0.9 |
| Difficulty breathing | 52 | 26.4 (20.4–33.1) | 65.0 (40.8–84.6) | 78 (71.1–83.8) | 3.0 | 0.4 |
| Rapid breathing | 5 | 2.5 (0.8–5.8) | 10.0 (1.2–31.7) | 98.3 (95.1–99.6) | 5.9 | 0.9 |
| Chest wall in-drawing | 1 | 0.5 (0.0–2.8) | 0.0 (0.0–16.1) | 99.4 (96.9–100.0) | 0.0 | 1.0 |
| Skin pustules or red rash | 6 | 3.0 (1.1–6.5) | 0.0 (0.0–39.0) | 96.6 (92.8–98.7) | 0.0 | 1.0 |
| Infected umbilicus | 3 | 1.5 (0.3–4.4) | 5.0 (0.1–24.9) | 98.9 (96–99.9) | 4.5 | 1.0 |
| Bulging fontanel | 5 | 2.5 (0.8–5.8) | 10.0 (1.2–31.7) | 98.3 (95.1–99.6) | 5.9 | 0.9 |
| TBA thought baby appeared ill | 164 | 82.8 (76.8–87.8) | 95.0 (75.1–99.9) | 18.5 (13.1–25.0) | 1.2 | 0.3 |
| Mother thought baby appeared ill | 160 | 80.8 (74.6–86.0) | 80.0 (56.3–94.3) | 19.1 (13.6–25.7) | 1.0 | 1.0 |
| Otherb | 62 | NA | NA | NA | NA | NA |
| No reason cited | 8 | NA | NA | NA | NA | NA |
Abbreviations: CI, confidence interval; LR+ and LR−, positive and negative likelihood ratios (clinically relevant LR+ and LR− values are in bold); NA, not applicable.
↵a TBAs were free to specify more than 1 reason for a given referral, so the total number of reasons for referral exceeds the number of neonates who were referred (208).
↵b Among the “other” reasons cited, those cited more than once included 12 citations for abdominal complaints (not making stool, swollen or tender belly, or diarrhea); 8 citations for inconsolable crying; 6 because the baby had been resuscitated at birth (all of which occurred during the first follow-up visit during week 1); 6 for skin rashes or sores; 4 for congenital defects or prematurity; 3 for respiratory complaints; and 3 for eye infections or discharge.