Role of epidemiological risk factors in improving the clinical diagnosis of streptococcal sore throat in pediatric clinical practice.
Child
environment
epidemiology
pharyngitis
smoking
streptococcus
Journal
Journal of family medicine and primary care
ISSN: 2249-4863
Titre abrégé: J Family Med Prim Care
Pays: India
ID NLM: 101610082
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
24
06
2019
revised:
22
08
2019
accepted:
03
09
2019
entrez:
20
11
2019
pubmed:
20
11
2019
medline:
20
11
2019
Statut:
epublish
Résumé
Antibiotics are frequently prescribed for sore throat in developing countries, that in turn leads to huge healthcare expenditure and their irrational use may lead to antimicrobial resistance in the community. The aim of this study is to investigate the effect of environmental factors on the frequency of occurrence of group A beta hemolytic streptococcus (GABHS) sore throat and to work out enhancing effect on the sensitivity and specificity and positive predictive value of the signs and symptoms of GABHS sore throat for facilitation of rational antibiotic use. This was a prospective, cross sectional study conducted over period of one year in Pediatric Outpatient Department (OPD) of a Tertiary care teaching hospital. All the children between the age of 5 years and 15 years of age presenting in OPD with the signs and symptoms of sore throat were included in the study. Statistical analysis was carried out by using Statistical Package for Social Sciences software and statistical tests of Pearson's Coefficient, Chi-square Test, Fischer's Test, Likelihood Ratio, Odds Ratio, and ROC Curve were applied. Out of 225 children of the study group, 153 (68%) of the children were in the 5-10 years' age group. Positive throat swab culture was found to be positively associated with high grade fever, pain in throat while swallowing, severely enlarged tonsils, tender lymphadenopathy, poor housing condition, fuel used for cooking, and presence of smoker in house. The study stresses on the need of carefully evaluating children presenting with the symptoms of sore throat as majority of the cases may be viral and thus, self-limiting. Poor housing conditions and indoor pollution contribute to the increased prevalence of sore throat.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Antibiotics are frequently prescribed for sore throat in developing countries, that in turn leads to huge healthcare expenditure and their irrational use may lead to antimicrobial resistance in the community. The aim of this study is to investigate the effect of environmental factors on the frequency of occurrence of group A beta hemolytic streptococcus (GABHS) sore throat and to work out enhancing effect on the sensitivity and specificity and positive predictive value of the signs and symptoms of GABHS sore throat for facilitation of rational antibiotic use.
SETTINGS AND DESIGN
METHODS
This was a prospective, cross sectional study conducted over period of one year in Pediatric Outpatient Department (OPD) of a Tertiary care teaching hospital.
METHODS
METHODS
All the children between the age of 5 years and 15 years of age presenting in OPD with the signs and symptoms of sore throat were included in the study.
STATISTICAL ANALYSIS USED
METHODS
Statistical analysis was carried out by using Statistical Package for Social Sciences software and statistical tests of Pearson's Coefficient, Chi-square Test, Fischer's Test, Likelihood Ratio, Odds Ratio, and ROC Curve were applied.
RESULTS
RESULTS
Out of 225 children of the study group, 153 (68%) of the children were in the 5-10 years' age group. Positive throat swab culture was found to be positively associated with high grade fever, pain in throat while swallowing, severely enlarged tonsils, tender lymphadenopathy, poor housing condition, fuel used for cooking, and presence of smoker in house.
CONCLUSIONS
CONCLUSIONS
The study stresses on the need of carefully evaluating children presenting with the symptoms of sore throat as majority of the cases may be viral and thus, self-limiting. Poor housing conditions and indoor pollution contribute to the increased prevalence of sore throat.
Identifiants
pubmed: 31742131
doi: 10.4103/jfmpc.jfmpc_495_19
pii: JFMPC-8-3130
pmc: PMC6857377
doi:
Types de publication
Journal Article
Langues
eng
Pagination
3130-3135Informations de copyright
Copyright: © 2019 Journal of Family Medicine and Primary Care.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
J Pediatr (Rio J). 2005 Jan-Feb;81(1):23-8
pubmed: 15742082
Am J Dis Child. 1977 May;131(5):514-7
pubmed: 855837
Adv Data. 2001 Jun 25;(320):1-34
pubmed: 12666256
Arch Intern Med. 1975 Nov;135(11):1493-7
pubmed: 1103766
Fam Pract. 1996 Jun;13(3):317-21
pubmed: 8671142
Pediatr Emerg Care. 1998 Apr;14(2):109-11
pubmed: 9583390
Bull World Health Organ. 2001;79(6):528-33
pubmed: 11436474
J Pediatr. 2019 Mar;206:268-273.e1
pubmed: 30528760
CMAJ. 1998 Jan 13;158(1):75-83
pubmed: 9475915
Med J Aust. 1996 Oct 21;165(8):420-3
pubmed: 8913242
Hong Kong Med J. 2002 Apr;8(2):92-8
pubmed: 11937663
Med Decis Making. 1981;1(3):239-46
pubmed: 6763125
Indian J Pediatr. 2002 Jun;69(6):471-5
pubmed: 12139130
BMC Pediatr. 2019 Jan 16;19(1):24
pubmed: 30651115
Pediatr Clin North Am. 2007 Feb;54(1):103-20, ix
pubmed: 17306686
J Chronic Dis. 1969 Feb;21(9):645-54
pubmed: 5770431
Arch Pediatr Adolesc Med. 2001 Jun;155(6):687-91
pubmed: 11386959
Pediatr Clin North Am. 2005 Jun;52(3):729-47, vi
pubmed: 15925660
Lancet. 1997 Sep 27;350(9082):918-21
pubmed: 9314870
CMAJ. 2004 Jul 20;171(2):139-45
pubmed: 15262882
Am Fam Physician. 1994 Apr;49(5):1147-54
pubmed: 8154403
Indian Pediatr. 2019 Jan 15;56(1):49-52
pubmed: 30806362
Clin Infect Dis. 1997 Sep;25(3):574-83
pubmed: 9314443
Singapore Med J. 1992 Dec;33(6):597-9
pubmed: 1488669
Am Fam Physician. 2009 Mar 1;79(5):383-90
pubmed: 19275067
N Z Med J. 1993 Sep 8;106(963):381-3
pubmed: 8367095