Prevalence of Positive Rapid Antigen Detection Test for Group A Streptococcus Among Patients With Respiratory Symptoms in Eastern Province, Kingdom of Saudi Arabia.

Background During the COVID-19 pandemic, there was a dramatic upsurge in the prevalence of respiratory symptoms, which may have altered the usual pattern of bacterial infections and relevant decision-making. Objectives This study aimed to investigate the prevalence of rapid antigen detection test (RADT) positivity for group A Streptococcus (GAS) in patients with respiratory symptoms and signs during the COVID-19 pandemic. In addition, we evaluated the association between a positive test and the modified Centor criteria in a population of children and adults with upper respiratory tract infections (URTIs). Methods A prospective study was conducted in primary health care centres (PHCCs) and the paediatric emergency department (ED) of the Maternity and Children Hospital in Dammam City, Kingdom of Saudi Arabia (KSA). Trained physicians collected data from patients aged three years and older or their guardian(s) regarding URTI symptoms. The modified Centor score was calculated, and RADT was performed for all patients. Results Data were collected from 469 patients. The prevalence of positive RADT was 19 (4.1%), and the setting was associated with RADT positivity, as 14% of ED visitors tested positive compared with 0.6% of PHCC visitors. The RADT results had an area under the curve of 0.856 (95% confidence interval (CI)=0.774-0.939), with Centor scores of 2 and 3 having a sensitivity of 89.5%/78.9% and specificity of 70.6%/80.8%, respectively. Individuals with a score of 5 had the highest rate of positive RADT (33.3%, P<0.001); a score less than 0 excluded the possibility of GAS infection. Conclusion The Centor score can improve effective antibiotic prescribing; however, Centor scores ≥2 should be supplemented with an additional confirmatory test. The high specificity of RADT makes it a useful tool in preventing the prescription of unneeded antibiotics.

High levels of back disability, not back pain, are associated with reduced physical activity across key activity domains.

BACKGROUND: Although remaining physically active is the cornerstone of management for low back pain, our understanding of the physical activity performed by those with back pain is limited. OBJECTIVES: To examine the physical activity reported by individuals with different levels of low back pain and disability across key activity domains. DESIGN: Community-based, cross-sectional study. METHODS: 542 women were recruited from a research database formed from an electoral roll and completed validated, self-report questionnaires. The amount and intensity of physical activity was reported using the International Physical Activity Questionnaire. Low back pain and disability were examined using the Graded Chronic Pain Scale. Participants were categorised into no, low or high pain and disability groups. RESULTS: Individuals who reported high disability performed 55% of the physical activity of those without disability (MET(hours/week):median(95%CI) = 27.1(13.2-41.0); 48.8(37.8-59.9),p = 0.01), including less moderate (18.0(10.4-25.6); 31.0(24.0-38.1),p = 0.007), and domestic and gardening activity (14.7(7.2-22.3); 25.7(19.8-31.7),p = 0.001). Fewer women with high disability performed vigorous (OR(95%CI) = 0.29(0.13-0.65),p = 0.002) and leisure activities (0.17(0.04-0.75),p = 0.02) compared to those with no disability. Those with low disability reported less leisure activity ((0.55(0.35-0.88),p = 0.01), but more work-related activities and active transport than individuals without disability (1.65(1.01-2.7),p = 0.04; 1.6(1.04-2.6),p = 0.03). There were no differences in activity between pain groups, with the exception of those with low intensity pain performing less leisure activity (0.51(0.30-0.88),p = 0.01). CONCLUSIONS: Individuals who reported high back disability, not back pain, were found to perform reduced physical activity, including less total, moderate, vigorous, and discretionary activity. These findings highlight the altered activity levels of people with back disability and the need to examine its impact on their health and wellbeing.

Negative beliefs about back pain are associated with persistent, high levels of low back disability in community-based women.

OBJECTIVES: Although pessimistic beliefs about back pain are associated with low back pain and disability, our understanding of their role in the natural history of the condition is limited. This study examined the association between beliefs about back pain and the development and progression of low back pain and disability over a 2-year period in community-dwelling women. METHODS: A total of 506 women were recruited at baseline to participate in a 2-year cohort study. Beliefs about back pain were measured at baseline using the Back Beliefs Questionnaire, and low back pain and disability were assessed at baseline and 2 years using the Chronic Pain Grade Questionnaire (CPG). Participants were categorized into the following groups based on their CPG scores: no, developing, resolving, and persistent high-intensity pain and disability. RESULTS: Of the 442 (87.4%) women who participated in the 2-year follow up study, 108 (24.4%) and 69 (15.6%) reported high levels of low back pain and disability, respectively. Negative beliefs about low back pain were associated with persistent, high levels of low back disability (M(SE) = 26.1(1.4) vs 31.3(0.31), P = 0.002), but not persistent, high-intensity pain (M(SE) = 28.9(1.02) vs 31.2(0.33), P = 0.2), after adjusting for confounders. Women with persistent high-intensity pain and disability had more negative responses to belief statements about the future consequences of the condition compared with those with no, resolving, or developing pain and disability (P < 0.001-0.03). CONCLUSIONS: This study found that pessimistic beliefs about back pain were associated with persistent high levels of low back disability, suggesting that strategies aimed at improving negative beliefs may reduce the chronicity associated with this condition.