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Evaluating the diagnostic accuracy of the WHO Severe Acute Respiratory Infection (SARI) criteria in Middle Eastern children under two years over three respiratory seasons.
Klink, Thomas; Rankin, Danielle A; Piya, Bhinnata; Spieker, Andrew J; Faouri, Samir; Shehabi, Asem; Williams, John V; Khuri-Bulos, Najwa; Halasa, Natasha B.
  • Klink T; Medicine and Pediatric Residency Program, University of Minnesota, Minneapolis, Minnesota, United States of America.
  • Rankin DA; Vanderbilt Epidemiology PhD Program, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee, United States of America.
  • Piya B; Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, United States of America.
  • Spieker AJ; Vanderbilt Institute for Clinical and Translational Research, Nashville, Tennessee, United States of America.
  • Faouri S; Department of Biostatistics, Vanderbilt University, Nashville, Tennessee, United States of America.
  • Shehabi A; Department of Pediatrics, Al Bashir Hospital, Amman, Jordan.
  • Williams JV; Department of Pediatrics, Jordan University, Amman, Jordan.
  • Khuri-Bulos N; Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America.
  • Halasa NB; Department of Pediatrics, Jordan University, Amman, Jordan.
PLoS One ; 15(4): e0232188, 2020.
Article in English | MEDLINE | ID: covidwho-659620
ABSTRACT

OBJECTIVE:

The World Health Organization created the Severe Acute Respiratory Infection (SARI) criteria in 2011 to monitor influenza (flu)-related hospitalization. Many studies have since used the SARI case definition as inclusion criteria for surveillance studies. We sought to determine the sensitivity, specificity, positive predictive value, and negative predictive value of the SARI criteria for detecting ten different respiratory viruses in a Middle Eastern pediatric cohort. MATERIALS AND

METHODS:

The data for this study comes from a prospective acute respiratory surveillance study of hospitalized children <2 years in Amman, Jordan from March 16, 2010 to March 31, 2013. Participants were recruited if they had a fever and/or respiratory symptoms. Nasal and throat swabs were obtained and tested by real-time RT-PCR for eleven viruses. Subjects meeting SARI criteria were determined post-hoc. Sensitivity, specificity, positive predictive value, and negative predictive value of the SARI case definition for detecting ten different viruses were calculated and results were stratified by age.

RESULTS:

Of the 3,175 patients enrolled, 3,164 were eligible for this study, with a median age of 3.5 months, 60.4% male, and 82% virus-positive (44% RSV and 3.8% flu). The sensitivity and specificity of the SARI criteria for detecting virus-positive patients were 44% and 77.9%, respectively. Sensitivity of SARI criteria for any virus was lowest in children <3 months at 22.4%. Removing fever as a criterion improved the sensitivity by 65.3% for detecting RSV in children <3 months; whereas when cough was removed, the sensitivity improved by 45.5% for detecting flu in same age group.

CONCLUSIONS:

The SARI criteria have poor sensitivity for detecting RSV, flu, and other respiratory viruses-particularly in children <3 months. Researchers and policy makers should use caution if using the criteria to estimate burden of disease in children.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Syncytial Virus Infections Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Infant / Male Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0232188

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Syncytial Virus Infections Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Infant / Male Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0232188