Evaluation of the WHO clinical decision rule for streptococcal pharyngitis (CROSBI ID 127800)
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Rimoin, A.W. ; Hamza, H.S. ; Vince, Adriana ; Kumar, R. ; Walker, C.F. ; Chitale, R.A. ; da Cunha, A.L. ; Qazi, S. ; Steinhoff, M.C.
engleski
Evaluation of the WHO clinical decision rule for streptococcal pharyngitis
Aims: To prospectively assess the WHO clinical decision rule (CDR) for group A beta haemolytic streptococcal (GABHS) pharyngitis in three countries. Methods: A prospective, observational cohort study in urban outpatient clinics in Rio de Janeiro, Cairo, and Zagreb. There were 2225 children aged 2-12 years with cough, rhinorrhoea, red or sore throat ; 1810 of these with sore throat were included in the analysis. Results: The proportion of children presenting with sore throat and found to have GABHS pharyngitis ranged from 24.6% (Brazil) to 42.0% (Croatia). WHO CDR sensitivity was low for all sites in both age groups. In children age 5 or older, sensitivity ranged from 3.8% in Egypt to 10.8% in Brazil. In children under 5, sensitivity was low (0.0-4.6%) Specificity was high in both age groups in all countries (93.8-97.4%). Conclusions: In these populations, the current WHO CDR has high specificity, but low sensitivity ; it did not detect up to 96.0% of children who have laboratory confirmed GABHS pharyngitis. A CDR with higher sensitivity should be developed for use in regions where rheumatic fever and rheumatic heart disease are still major health problems.
WHO; streptococcal pharyngitis; treatment
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