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.

EVALUATION OF A CLINICAL CASE-DEFINITION OF ACQUIRED IMMUNODEFICIENCY SYNDROME IN AFRICA

The Lancet ◽  
1987 ◽  
Vol 329 (8531) ◽  
pp. 492-494 ◽  
Author(s):  
Robert Colebunders ◽  
Henry Francis ◽  
Lebughe Izaley ◽  
Kanyinda Kabasele ◽  
Nzila Nzilambi ◽  
...  
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
Clinical Case ◽  
Case Definition ◽  
Acquired Immunodeficiency ◽  
Definition Of ◽  
Immunodeficiency Syndrome ◽  
Clinical Case Definition

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.

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.

USEFULNESS OF A CLINICAL CASE-DEFINITION OF AIDS IN EAST AFRICA

The Lancet ◽  
1987 ◽  
Vol 330 (8558) ◽  
pp. 569 ◽  
Author(s):  
I.C. Bygbjerg ◽  
M. Schiødt ◽  
P.B. Bakilana ◽  
J.F. Rhaza ◽  
J.F. Shao ◽  
...  
Keyword(s):  
East Africa ◽  
Clinical Case ◽  
Case Definition ◽  
Definition Of ◽  
Clinical Case Definition

CLINICAL CASE DEFINITION OF AIDS IN AFRICAN ADULTS

The Lancet ◽  
1987 ◽  
Vol 330 (8565) ◽  
pp. 972 ◽  
Author(s):  
K.J. Pallangyo ◽  
I.M. Mbaga ◽  
F. Mugusi ◽  
E. Mbena ◽  
F.S. Mhalu ◽  
...  
Keyword(s):  
Clinical Case ◽  
Case Definition ◽  
Definition Of ◽  
Clinical Case Definition

scholarly journals Clinical case definition of COVID-19 and morbid obesity: Is it time to move on?

2021 ◽  
Author(s):  
Valente Marina ◽  
Ricco Matteo ◽  
Tartamella Francesco ◽  
Petracca Gabriele Luciano ◽  
Dalmonte Giorgio ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Clinical Case ◽  
Case Definition ◽  
Definition Of ◽  
Clinical Case Definition

scholarly journals Enhancing the predictive value of throat swabs in virological influenza surveillance

2002 ◽  
Vol 7 (12) ◽  
pp. 180-183 ◽  
Author(s):  
K Leitmeyer ◽  
U Buchholz ◽  
M. Kramer ◽  
B Schweiger
Keyword(s):  
National Survey ◽  
Predictive Value ◽  
Clinical Case ◽  
Disease Onset ◽  
Case Definition ◽  
Influenza Viruses ◽  
Influenza Surveillance ◽  
Definition Of ◽  
Virological Surveillance ◽  
Clinical Case Definition

According to a national survey in Germany, the influenza virological surveillance can be improved when sentinel practitioners take throat swabs specimens only from patients who consult early after the disease onset (ie, within 48 hours), and when they use the strict clinical case definition of influenza-like illness. PCR should be used for primary detection of influenza viruses.

scholarly journals MEASLES IN LARUT, MATANG AND SELAMA: ANALYSIS AND EVALUATION OF CLINICAL CASE DEFINITIONS FOR 2015-2019

2020 ◽  
Vol 20 (1) ◽  
pp. 130-140
Author(s):  
Asraf Ahmad Qamruddin ◽  
Afiq Malek ◽  
Asnita Rozali ◽  
Norsihimah Wahid
Keyword(s):  
Positive Predictive Value ◽  
Incidence Rate ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Clinical Case ◽  
Case Definition ◽  
Case Definitions ◽  
Cross Sectional ◽  
Sensitivity Specificity ◽  
Clinical Case Definition

An accurate system of identifying measles cases is critical for the measles surveillance system. The objectives were: 1) To determine the incidence rate of measles in Larut, Matang and Selama district in Perak from 2015 to 2019 2) To evaluate the measles clinical case definition by comparing the performance of the measles clinical case definition in predicting laboratory-confirmed measles case. A cross-sectional analysis was carried out looking at all suspected and laboratory-confirmed measles cases in Larut, Matang and Selama District registered on the online measles surveillance reporting system between 2015 to 2019. The sensitivity, specificity, positive predictive value and negative predictive value of the clinical case definition as confirmed by the laboratory result were calculated. The incidence rate for suspected measles showed an increasing trend from 3.96 per 100,000 population in 2015 to 28.82 per 100,000 population in 2019. For laboratory-confirmed measles cases, the incidence rate showed more variation with an increase to 36.11 per million population in 2017 from 5.67 per million population in 2015. The incidence rate later decreased to 10.99 per million population in 2018 and increased again to 24.47 per million population in 2019. The sensitivity of the clinical case definition in confirming measles was 86.67% (95% CI: 69.28%, 96.24%) , specificity 47.52% (95% CI: 41.56%, 53.52%), positive predictive value 14.95% (95% CI 12.81%, 17.36%)  and negative predictive value 97.10% (93.03%, 98.83%). Measles incidence is increasing in trend. The clinical case definition is an effective tool to rule out measles in cases that failed to meet the criteria due to the high negative predictive value of the definition. However, for cases that meet the clinical case definition, laboratory confirmation or epidemiological link to a confirmed case is needed.

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