The "timeless" use of influenza-like illness criteria for influenza detection in the tropics
The "timeless" use of influenza-like illness criteria for influenza detection in the tropics
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DOI：
10.1016/j.ijid.2021.03.045
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发表时间：
2021-04-12
影响因子：
8.4
通讯作者：
Chow, Angela L. P.
中科院分区：
文献类型：
--
作者：
Aung, Aung H.;Lye, David C.;Chow, Angela L. P.
目的：我们评估了疾病控制和预防中心（CDC）、欧洲疾病控制和预防中心和世界卫生组织（WHO）在热带地区对流感样疾病（ILI）病例定义的表现，在热带地区，急性上呼吸道感染（AURTI）中呼吸道病毒的季节性模式定义不清。从2016-2018年在新加坡急诊科就诊的717例无并发症AURTI的连续患者中收集了呼吸道多重聚合酶链反应检测的临床数据和样本。结果：流感（20.6%），鼻病毒（14.4%）和冠状病毒（3.6%）是最常见的病毒病原体。发现流感全年活动的半年高峰。虽然在流感季节间观察到鼻病毒活动较高，但鼻病毒和冠状病毒全年传播，没有明显的季节模式。在流感高发月份，CDC和WHO ILI病例定义的中至高阳性似然比（LR+）分别为3.8-6.8和4.5-10.7，用于判定流感。他们在其他月份诊断流感的LR +为3.3-3.8和3.9-4.6。ILI病例定义对鼻病毒和冠状病毒具有较高的特异性（77.2%- 85.4%）。结论：CDC和WHO ILI病例定义可用于热带地区流感的临床诊断，不受季节限制。(c)2021年，任作家。由爱思唯尔有限公司代表国际传染病学会出版。这是一个在CC BY-NC-ND许可证下的开放获取文章（http：//creativecommons.org/licenses/by-ncnd/4.0/）。
Objective: We assessed the performance of influenza-like illness (ILI) case definitions by the Centers for Disease Control and Prevention (CDC), European Centers for Disease Control and Prevention and World Health Organization (WHO) in the tropics where seasonal patterns of respiratory viruses in acute upper respiratory tract infections (AURTIs) are ill-defined.Methods: Clinical data and samples for respiratory multiplex polymerase chain reaction test were collected from 717 consecutive patients attending an emergency department in Singapore for uncomplicated AURTI in 2016-2018. Results: Influenza (20.6%), rhinoviruses (14.4%), and coronaviruses (3.6%) were the most common viral pathogens identified. Biannual peaks with year-round activity were identified for influenza. Although higher rhinovirus activity was observed in inter-influenza seasonal periods, rhinoviruses and coronaviruses circulated year-round without distinct seasonal patterns. During high influenza activity months, the CDC and WHO ILI case definitions had moderate-to-high positive likelihood ratio (LR+) of 3.8-6.8 and 4.5-10.7, respectively, for ruling in influenza. They had moderately-high LR + of 3.3-3.8 and 3.9-4.6 for diagnosing influenza during other months. The ILI case definitions had high specificity (77.2%- 85.4%) for rhinoviruses and coronaviruses.Conclusion: The CDC and WHO ILI case definitions can be applied to clinically diagnose influenza in the tropics, regardless of the time of the year.(c) 2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-ncnd/4.0/).