scholarly journals Evaluation of the diagnostic utility of case definitions to detect influenza virus infection in Vojvodina, Serbia

2020 ◽  
Vol 148 (1-2) ◽  
pp. 100-105
Author(s):  
Mioljub Ristic ◽  
Vladimir Petrovic
Keyword(s):  
Type A ◽  
Case Definition ◽  
World Health ◽  
Influenza Surveillance ◽  
Age Group ◽  
Type B ◽  
Case Definitions ◽  
Influenza Type ◽  
Epidemic Period ◽  
Definition Of

Introduction/Objective. A case definition recommended by the World Health Organization is commonly used for influenza surveillance worldwide. The aim of this study was to evaluate prognostic values of proposed case definitions of Influenza Like Illness (ILI), Severe Acute Respiratory Illness (SARI) and Acute Respiratory Distress Syndrome (ARDS) for laboratory confirmed-influenza and to compare the age distribution of influenza patients across virus types and subtypes in Vojvodina. Methods. We conducted a descriptive epidemiological study using surveillance reports and laboratory data from October 1, 2010 to May 20, 2017 (seven surveillance seasons). Results. We included 2,937 participants, 48.6% of whom were laboratory-confirmed influenza cases, and most of the confirmed cases (30.1%) were detected in February. In the 15?29 years age group, the type A influenza (H3N2) was more frequent among patients with ILI (54.9% vs. 34.2%, p = 0.040), and less frequent in patients with SARI (39.4% vs. 65.8%, p = 0.009) compared with influenza type B. In patients aged 30?64 years with ARDS, influenza type B was more common than influenza type A (H3N2) (13.4% vs. 6.2%, p = 0.032), but less common in compared to influenza type A (H1N1) pdm09 (13.4% vs. 25.7%, p = 0.017). The SARI case definition of influenza was associated with an increased likelihood of laboratoryconfirmed influenza for all age groups (p < 0.05). During the epidemic period, it was observed that the ILI case definition had the highest diagnostic value for influenza in the age group 5?14 (AUC = 0.733; 95% CI: 0.704?0.764), while the SARI and ARDS case definitions were the best predictors of influenza for patients 15?29 years of age (AUC = 0.565; 95% CI: 0.504?0.615 and AUC = 0.708; 95% CI: 0.489?0.708, respectively). The case definition of ARDS had the maximum sensitivity (100%) among patients 15?29 years of age. Conclusion. The proposed case definitions of influenza appeared to be good predictors of influenza and therefore can be useful for influenza surveillance, especially in the countries with limited laboratory capacities.

scholarly journals Evaluation of the diagnostic utility of the new clinical case definition of pertussis - experience from sentinel and hospital-based pertussis surveillance

2019 ◽  
Vol 147 (7-8) ◽  
pp. 443-449
Author(s):  
Mioljub Ristic ◽  
Vesna Stojanovic ◽  
Vladimir Petrovic ◽  
Ulrich Heininger
Keyword(s):  
Clinical Case ◽  
Age Groups ◽  
Positive Likelihood Ratio ◽  
Case Definition ◽  
Surveillance Systems ◽  
Age Group ◽  
Case Definitions ◽  
Pertussis Infection ◽  
Definition Of ◽  
Clinical Case Definition

Introduction/Objective. Global surveillance systems use different clinical case definitions of pertussis. The aim of this study was to identify sign and symptom combinations with best relation with laboratory confirmed pertussis. Methods. A one-year prospective observational study, proposed by the Global Pertussis Initiative (GPI) for three age groups (0?3 months, four months to nine years, and ? 10 years) was performed in Novi Sad to evaluate the performance of the clinical case definition of pertussis. Laboratory confirmation of B. pertussis infection was obtained using the DNA polymerase chain reaction (PCR) or ELISA serology tests. Results. From October 1, 2013 to September 30, 2014, 103 (32.3%) out of 319 participants with suspected pertussis had laboratory-confirmed pertussis. Combined whooping, post-tussive emesis, and worsening of symptoms at night was the best predictor of pertussis in outpatients aged four months to nine years (positive likelihood ratio (LR+) 11.6), while among inpatients of the same age group it was apnoea (LR+ 13.5). The LR+ in outpatients aged ?10 years for combinations of apnoea and post-tussive emesis, or a combination of whooping and sweating episodes between paroxysms and post-tussive emesis was 16.8, while among in-patients LR+ was < 2.3 for all combinations in the same age group. Conclusions. The GPI case definitions for pertussis are good predictors for laboratory-confirmed pertussis and are useful for the purpose of pertussis surveillance.

scholarly journals 1644. Performance of Symptom-Based Case Definitions to Identify Influenza Virus Infection among Pregnant Women in Middle-Income Countries: Findings from the Pregnancy and Influenza Multinational Epidemiologic (PRIME) Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S600-S600
Author(s):  
Meredith G Wesley ◽  
Yeny Tinoco ◽  
Archana Patel ◽  
Piyarat Suntarattiwong ◽  
Danielle R Hunt ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Sensitivity And Specificity ◽  
Univariate Analysis ◽  
Influenza Virus Infection ◽  
Case Definition ◽  
World Health ◽  
Influenza Surveillance ◽  
Multivariable Model ◽  
Case Definitions ◽  
Runny Nose

Abstract Background The World Health Organization (WHO) recommends case definitions for influenza surveillance that are also used in public health research, though their performance has not been assessed in many risk groups, including pregnant women in whom influenza may manifest differently. Â We evaluated the performance of symptom-based case definitions to detect influenza in a cohort of pregnant women in India, Peru, and Thailand. Methods In 2017, we contacted 4774 pregnant women twice a week during the influenza season to identify illnesses with new or worsened cough, runny nose, sore throat, difficulty breathing or myalgia, and collected data on other symptoms and nasal swabs for influenza rRT–PCR testing. To identify symptom predictors of influenza, we used multivariable logistic regression with forward selection of symptoms significant in univariate analysis after controlling for country, chronic conditions, influenza vaccination, and time from symptom onset to swab collection. We calculated sensitivity and specificity of each symptom, WHO respiratory illness case definitions and a case definition based on significant predictors from the multivariable model. Results Of 2431 eligible illness episodes among 1,716 participants, 142 (5.8%) were positive for influenza. Among individual symptoms, runny nose was most sensitive and measured fever ≥ 38° Celsius was most specific (Figure 1). In a multivariable model, measured fever ≥ 38° Celsius [adjusted odds ratio = 3.8, 95% confidence interval [CI] = 2.0–7.2], cough [2.7, CI 1.6–4.7], chills [2.2, CI 1.2–3.8], and myalgia [1.2, CI 2.2, 5.3] were independently associated with influenza illness. A case definition based on these four (measured fever, cough, chills or myalgia), was 91%-sensitive and 37% specific. Sensitivity and specificity of case definitions varied (Figure 2). Conclusion While a case definition based on one or more of fever, chills, cough or myalgia is highly-sensitive and moderately specific among pregnant women, case definitions requiring measured or subjective fever may miss many influenza cases making them sub-optimal for studies of burden or vaccine efficacy. The intended use of case definitions should be considered when evaluating the tradeoff between sensitivity and specificity. Disclosures All authors: No reported disclosures.

scholarly journals Performance of influenza case definitions for influenza community surveillance: based on the French influenza surveillance network GROG, 2009-2014

2017 ◽  
Vol 22 (14) ◽  
Author(s):  
Jean-Sebastien Casalegno ◽  
Daniel Eibach ◽  
Martine Valette ◽  
Vincent Enouf ◽  
Isabelle Daviaud ◽  
...  
Keyword(s):  
Influenza Infection ◽  
Age Groups ◽  
Case Definition ◽  
World Health ◽  
Influenza Surveillance ◽  
Case Definitions ◽  
Surveillance Network ◽  
Increased Risk ◽  
Influenza Case ◽  
Health Organization

International case definitions recommended by the Centers for Disease Control and Prevention (CDC), the European Centre for Disease Prevention and Control (ECDC), and the World Health Organization (WHO) are commonly used for influenza surveillance. We evaluated clinical factors associated with the laboratory-confirmed diagnosis of influenza and the performance of these influenza case definitions by using a complete dataset of 14,994 patients with acute respiratory infection (ARI) from whom a specimen was collected between August 2009 and April 2014 by the Groupes Régionaux d’Observation de la Grippe (GROG), a French national influenza surveillance network. Cough and fever ≥ 39 °C most accurately predicted an influenza infection in all age groups. Several other symptoms were associated with an increased risk of influenza (headache, weakness, myalgia, coryza) or decreased risk (adenopathy, pharyngitis, shortness of breath, otitis/otalgia, bronchitis/ bronchiolitis), but not throughout all age groups. The WHO case definition for influenza-like illness (ILI) had the highest specificity with 21.4%, while the ECDC ILI case definition had the highest sensitivity with 96.1%. The diagnosis among children younger than 5 years remains challenging. The study compared the performance of clinical influenza definitions based on outpatient surveillance and will contribute to improving the comparability of data shared at international level.

scholarly journals Performance of symptom-based case definitions to identify influenza virus infection among pregnant women in middle-income countries: findings from the Pregnancy and Influenza Multinational Epidemiologic (PRIME) Study

2020 ◽  
Author(s):  
Meredith G Wesley ◽  
Yeny Tinoco ◽  
Archana Patel ◽  
Piyarat Suntarratiwong ◽  
Danielle Hunt ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Predictive Value ◽  
De Novo ◽  
Influenza Virus Infection ◽  
Respiratory Illness ◽  
Risk Groups ◽  
Case Definition ◽  
World Health ◽  
Influenza Surveillance ◽  
Case Definitions

Abstract Background The World Health Organization (WHO) recommends case definitions for influenza surveillance that are also used in public health research, though their performance has not been assessed in many risk groups, including pregnant women in whom influenza may manifest differently. We evaluated the performance of symptom-based definitions to detect influenza in a cohort of pregnant women in India, Peru, and Thailand. Methods In 2017 and 2018, we contacted 11,277 pregnant women twice weekly during the influenza season to identify illnesses with new or worsened cough, runny nose, sore throat, difficulty breathing or myalgia, and collected data on other symptoms and nasal swabs for influenza rRT-PCR testing. We calculated sensitivity, specificity, positive predictive value and negative predictive value of each symptom-predictor, WHO respiratory illness case definitions and a de novo definition derived from results of multivariable modelling. Results Of 5,444 eligible illness episodes among 3,965 participants, 310 (6%) were positive for influenza. In a multivariable model, measured fever ≥38° Celsius (adjusted odds ratio = 4.6, 95% confidence interval [CI] = 3.1, 6.8), myalgia (3.0, 95% CI: 2.2, 4.0), cough (2.7, 95% CI: 1.9, 3.9), and chills (1.6, 95% CI: 1.1, 2.4) were independently associated with influenza illness. A definition based on these four (measured fever, cough, chills or myalgia), was 95% sensitive and 27% specific. The WHO influenza-like illness (ILI) definition was 16% sensitive and 98% specific. Conclusions The current WHO ILI case definition was highly specific but had low sensitivity. The intended use of case definitions should be considered when evaluating the tradeoff between sensitivity and specificity.

scholarly journals The Correlation of IFN <i>γ</i> to the Preferential Isolation of Influenza Type B over Type A Viruses in Madin Darby Canine Kidney Cells

2017 ◽  
Vol 07 (01) ◽  
pp. 12-28
Author(s):  
Timothy Byaruhanga ◽  
Bernard Bagaya ◽  
Joyce Namulondo ◽  
John Timothy Kayiwa ◽  
Barbara Namagambo ◽  
...  
Keyword(s):  
Type A ◽  
Kidney Cells ◽  
Type B ◽  
Madin Darby Canine Kidney ◽  
Influenza Type ◽  
Darby Canine Kidney ◽  
Canine Kidney

scholarly journals Existing comorbidities in people with osteoarthritis: a retrospective analysis of a population-based cohort in Alberta, Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033334 ◽  
Author(s):  
Deborah A Marshall ◽  
Xiaoxiao Liu ◽  
Cheryl Barnabe ◽  
Karen Yee ◽  
Peter D Faris ◽  
...  
Keyword(s):  
Cohort Analysis ◽  
Age Groups ◽  
Population Based ◽  
Case Definition ◽  
Chronic Obstructive ◽  
Age Group ◽  
Case Definitions ◽  
Obstructive Pulmonary Disease ◽  
Physician Visits ◽  
Significant Difference

ObjectivesThe purpose of this study is to estimate the prevalence of comorbidities among people with osteoarthritis (OA) using administrative health data.DesignRetrospective cohort analysis.SettingAll residents in the province of Alberta, Canada registered with the Alberta Health Care Insurance Plan population registry.Participants497 362 people with OA as defined by ‘having at least one OA-related hospitalization, or at least two OA-related physician visits or two ambulatory care visits within two years’.Primary outcome measuresWe selected eight comorbidities based on literature review, clinical consultation and the availability of validated case definitions to estimate their frequencies at the time of diagnosis of OA. Sex-stratified age-standardised prevalence rates per 1000 population of eight clinically relevant comorbidities were calculated using direct standardisation with 95% CIs. We applied χ2 tests of independence with a Bonferroni correction to compare the percentage of comorbid conditions in each age group.Results54.6% (n=2 71 794) of people meeting the OA case definition had at least one of the eight selected comorbidities. Females had a significantly higher rate of comorbidities compared with males (standardised rates ratio=1.26, 95% CI 1.25 to 1.28). Depression, chronic obstructive pulmonary disease (COPD) and hypertension were the most prevalent in both females and males after age-standardisation, with 40% of all cases having any combination of these comorbidities. We observed a significant difference in the percentage of comorbidities among age groups, illustrated by the youngest age group (<45 years) having the highest percentage of cases with depression (24.6%), compared with a frequency of 16.1% in those >65 years.ConclusionsOur findings highlight the high frequency of comorbidity in people with OA, with depression having the highest age-standardised prevalence rate. Comorbidities differentially affect females, and vary by age. These factors should inform healthcare programme and delivery.

scholarly journals Influenza-associated morbidity and mortality in Tunisia

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Bouguerra ◽  
A Hechaichi ◽  
L Bouabid ◽  
R Yazidi ◽  
N Abdeddaiem ◽  
...  
Keyword(s):  
Descriptive Analysis ◽  
Data Entry ◽  
Public Health Problem ◽  
Type A ◽  
Risk Groups ◽  
Morbidity And Mortality ◽  
Influenza Surveillance ◽  
Case Definitions ◽  
Previous Season ◽  
Severe Acute Respiratory Infection

Abstract Background Influenza is a highly contagious viral infection representing a public health problem worldwide with more than 10% of the population affected each year. In addition, severe complications and deaths may occur especially among high-risk groups. Our objectives was to assess the severity of influenza in Tunisia from 2015 to 2017 and to identify the isolated circulating viruses. Methods Basedon the network of ILI (Influenza-like illness) and SARI (Severe acute respiratory infection) Sentinel Sites and the National Influenza Center, we conducted a descriptive analysis of all data collected from 2015 to 2017. The case definitions of ILI and SARI were those recommended by WHO. Data entry was using Epi-Data and data analysis using SPSS-20. Results The total number of SARI cases during 2016-17 season was 614. The hospitalization rate was 0.7% which was higher than the 2015-16 season (0.19%). The majority of these severe cases were males (60,3%) and the group aged more than 65 years was the most affected. Comorbidities were reported in 58,7% of the cases, especially cardiovascular diseases, obesity and asthma. In 2016-17, the viruses identified in SARI cases were type A(H3N2) (47,7%), type B (40,9%) and type A (H1N1) pmd09 (4%). The lethality rate was lower than in the previous season (0.32% vs 20%) with two deaths reported in February. These deaths were due to virus B and virus AH3N2, comparing to 77% of deaths due to virus A (H1N1) pmd09 the season before. Conclusions Influenza severity vary from a season to another. The 2016-17 season was marked by higher rates of hospitalization but a lower lethality rate. This may be due to a lower circulation of the type A (H1N1) pmd09 virus, which virulence is much discussed. Influenza surveillance remains essential to detect any emerging novel pathogen and to guide decision-makers for future strategies. Key messages Seasonal influenza epidemics continue to have significant morbidity and mortality. Epidemiological and virological surveillance are highly essential for an early detection of epidemics and novel strains.

Case Definitions for Paediatric AIDS: The Zambian Experience

1993 ◽  
Vol 4 (2) ◽  
pp. 83-85 ◽  
Author(s):  
C Chintu ◽  
A Malek ◽  
M Nyumbu ◽  
C Luo ◽  
J Masona ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Clinical Case ◽  
Case Definition ◽  
World Health ◽  
Who Criteria ◽  
Number Of Patients ◽  
Definition Of ◽  
Hiv 1 ◽  
Clinical Case Definition

For the purpose of surveillance of the acquired immunodeficiency syndrome (AIDS) in developing countries, the World Health Organization (WHO) has recommended criteria for the clinical case definition of AIDS in adults and children. In a preliminary examination of children in Zambia a number of patients with obvious AIDS did not fit the published WHO case definition for paediatric AIDS. Based on this the Zambia National AIDS Surveillance Committee designed local criteria for the clinical case definition of paediatric AIDS. We compared the Zambian criteria with the WHO criteria for the diagnosis of paediatric AIDS by studying 134 consecutively admitted children to one of the paediatric wards at the University Teaching Hospital in Lusaka. Twenty-nine of the patients were HIV-1 seropositive and 105 were HIV-1 seronegative. Among the 29 HIV-seropositive patients, the Zambian criteria identified 23, and the WHO criteria identified 20 children as having AIDS. The 105 HIV-seronegative children were classified as having AIDS in 9 cases by the Zambian criteria and in 38 cases by the WHO criteria. These results give the Zambian criteria for the diagnosis of AIDS a sensitivity of 79.3%, a specificity of 91.4% and a positive predictive value of 86.8% compared to a sensitivity of 69%, specificity of 64% and a positive predictive value of 38% for the WHO criteria. The current WHO criteria are inadequate for the diagnosis of paediatric AIDS. The need to refine the WHO criteria for the diagnosis of paediatric AIDS is discussed.

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