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Arch Dis Child ; 90(10): 1066-70, 2005 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-15941772

RESUMEN

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.


Asunto(s)
Toma de Decisiones , Faringitis/diagnóstico , Faringitis/microbiología , Infecciones Estreptocócicas/diagnóstico , Brasil , Niño , Preescolar , Croacia , Egipto , Humanos , Guías de Práctica Clínica como Asunto , Estudios Prospectivos , Curva ROC , Fiebre Reumática/prevención & control , Cardiopatía Reumática/prevención & control , Sensibilidad y Especificidad , Infecciones Estreptocócicas/microbiología , Organización Mundial de la Salud
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