Working towards a simple case definition for influenza surveillance
Working towards a simple case definition for influenza surveillance
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DOI：
10.1016/s1386-6532(02)00172-5
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发表时间：
2003-07-01
影响因子：
8.8
通讯作者：
Kelly, H
中科院分区：
文献类型：
--
作者：
Thursky, K;Cordova, SP;Kelly, H
背景资料：澳大利亚流感大流行计划委员会建议在澳大利亚全国范围内对流感监测系统采用单一的流感样疾病（ILI）定义。目的：检查临床症状的组合，并确定哪种组合最有可能预测实验室确诊的成人ILI患者的流感。研究设计：1998年和1999年，西澳大利亚州和维多利亚州的哨兵一般做法。单变量分析和逐步逻辑回归用于确定成人流感的重要独立临床预测因子。计算各种症状复合物的敏感性、特异性和阳性预测值（PPV）。结果如下：咳嗽、发热和疲劳的组合具有敏感性（43.5-75.1%）和特异性（46.6-80.3%），在两个州的监测数据集中，PPV范围为23.3 - 59.7%。咳嗽、发热和疲劳的综合症状比那些年实际使用的三种不同监测病例定义更有可能预测实验室确诊的流感。结论：我们建议在流感监测中将咳嗽、发热和疲劳的综合症状作为ILI的简单病例定义。流感活动的准确鉴定仍然需要至少在一部分病例中进行实验室确认。(C)2002 Elsevier Science B. V.保留所有权利。
Background: A single definition of influenza-like illness (ILI) has been recommended by the Australian Influenza Pandemic planning committee for influenza surveillance systems throughout Australia. Objectives: To examine combinations of clinical symptoms and determine which combination was most likely to predict laboratory-confirmed influenza in adult patients with ILI. Study design: Sentinel general-practices in Western Australia and Victoria, 1998 and 1999. Univariate analysis and stepwise logistic regression were used to determine significant independent clinical predictors of influenza in adults. Sensitivity, specificity and positive predictive value (PPV) were calculated for various symptom complexes. Results: The combination of cough, fever and fatigue was both sensitive (43.5-75.1%) and specific (46.6-80.3%) with PPVs ranging from 23.3 to 59.7% in the surveillance data sets from both states. The symptom complex of cough, fever and fatigue was more likely to predict laboratory-confirmed influenza than the three different surveillance case definitions actually used in those years. Conclusions: We recommend the symptom complex of cough, fever and fatigue as a simple case definition for ILI in influenza surveillance. Accurate identification of influenza activity still requires laboratory confirmation in at least a proportion of cases. (C) 2002 Elsevier Science B.V. All rights reserved.