Influenza-like illness criteria were poorly related to laboratory-confirmed influenza in a sentinel surveillance study
Influenza-like illness criteria were poorly related to laboratory-confirmed influenza in a sentinel surveillance study
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DOI：
10.1016/j.jclinepi.2004.08.014
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发表时间：
2005-03-01
影响因子：
7.2
通讯作者：
Rosa-Fraile, M
中科院分区：
文献类型：
--
作者：
Navarro-Marí, JM;Pérez-Ruiz, M;Rosa-Fraile, M
目的：分析流感最相关的临床数据和流感样疾病标准作为3年流感哨点监测中采样的临床阈值的效用。方法：哨点医师收集急性呼吸道感染（持续时间小于或等于72小时）门诊患者的咽喉标本和资料。将实验室确诊的流感感染与独立症状和世界家庭医生组织分类委员会定义的流感样疾病标准进行比较。结果：1934例患者中流感病毒阳性359例（18.56%）。只有199例（55.4%）实验室确诊病例符合流感样疾病的临床标准：阳性预测值（PPV）和阴性预测值（NPV）分别为0.36和0.88。发烧、咳嗽和鼻流分别与流感感染相关（PPV分别为0.30、0.20和0.20；NPV分别为0.92、0.87和0.85）。多因素分析显示，流感感染与发烧和咳嗽的相关性与流感感染与流感样疾病标准的相关性相似（优势比分别为2.24比2.71）。结论：流感样疾病标准与实验室确诊流感相关性较差。为了在监测系统中早期发现流感病毒，也许应该遵循一项限制性较低的临床标准（特别是急性呼吸道感染）。(C) 2005爱思唯尔公司版权所有。
Objective: To analyze the most related clinical data for influenza and the utility of influenza-like illness criteria as the clinical threshold for sampling in an influenza sentinel surveillance over a 3-year period.Methods: Sentinel physicians collected throat specimens and data from outpatients with acute respiratory infection (less than or equal to72 hours duration). Laboratory-confirmed influenza infection was compared with independent symptoms and the influenza-like illness criteria, as defined by the Classification Committee of the World Organization of Family Doctors.Results: From 1934 patients, 359 (18.56%) yielded positive results for influenza viruses. Only 199 (55.4%) of laboratory-confirmed cases fulfilled clinical criteria of influenza-like illness: positive and negative predictive value (PPV and NPV) of 0.36 and 0.88, respectively. Fever, cough, and rhinorrhea individually correlated with influenza infections (PPV: 0.30, 0.20, and 0.20, respectively; NPV: 0.92, 0.87, and 0.85, respectively). Multivariate analysis demonstrated that the correlation of influenza infection with the presence of fever and cough was similar to the correlation between influenza infection and influenza-like illness criteria (odds ratio 2.24 vs. 2.71, respectively).Conclusion: Influenza-like illness criteria are poorly related to laboratory-confirmed influenza. For early detection of influenza viruses in surveillance systems, a less restrictive clinical criterion (specifically, acute respiratory infection) perhaps should be followed. (C) 2005 Elsevier Inc. All rights reserved.