Sensitivity and specificity of the World Health Organization pertussis clinical case definition

Ghanaie, Roxana Mansour; Karimi, Abdollah; Sadeghi, H; Esteghamti, Abdolreza; Falah, Fateme; Armin, Shahnaz; Fahimzad, Alireza; Shamshiri, Ahmad Reza; Kahbazi, Manige; Shiva, Faride

doi:10.1016/j.ijid.2010.07.005

Cited by 47 publications

(37 citation statements)

References 10 publications

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“…Three studies reported the accuracy of the CDC criteria, with summary estimates of accuracy at 90% sensitivity, only 16% specificity, LRϩ of 1.1, and LRϪ of 0.66. 19,25,27 Summary ROC Curves Summary ROC curves for key signs and symptoms are shown in Figure 2A (Figure 2A) shows good consistency and a fairly narrow confidence interval around the summary estimate of accuracy. As noted earlier, whooping cough ( Figure 2B) and posttussive vomiting ( Figure 2C) were both more sensitive in children than in adults.…”

Section: Accuracy Of Signs and Symptomsmentioning

confidence: 89%

Clinical Diagnosis of Bordetella Pertussis Infection: A Systematic Review

2017

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Background: Bordetella pertussis (BP) is a common cause of prolonged cough. Our objective was to perform an updated systematic review of the clinical diagnosis of BP without restriction by patient age.Methods: We identified prospective cohort studies of patients with cough or suspected pertussis and assessed study quality using QUADAS-2. We performed bivariate meta-analysis to calculate summary estimates of accuracy and created summary receiver operating characteristic curves to explore heterogeneity by vaccination status and age.Results

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Section: Accuracy Of Signs and Symptomsmentioning

confidence: 89%

Clinical Diagnosis of Bordetella Pertussis Infection: A Systematic Review

2017

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“…Clinical case definitions of pertussis have limited specificity (162)(163)(164). Therefore, in the following, for assessment of the sensitivities of serodiagnosis methods, we used studies, as much as possible, in which clinical suspicion of pertussis was confirmed by positivity of culture and/or PCR for B. pertussis.…”

Section: Serodiagnosis Of Pertussismentioning

confidence: 99%

Laboratory Diagnosis of Pertussis

2015

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SUMMARYThe introduction of vaccination in the 1950s significantly reduced the morbidity and mortality of pertussis. However, since the 1990s, a resurgence of pertussis has been observed in vaccinated populations, and a number of causes have been proposed for this phenomenon, including improved diagnostics, increased awareness, waning immunity, and pathogen adaptation. The resurgence of pertussis highlights the importance of standardized, sensitive, and specific laboratory diagnoses, the lack of which is responsible for the large differences in pertussis notifications between countries. Accurate laboratory diagnosis is also important for distinguishing between the several etiologic agents of pertussis-like diseases, which involve both viruses and bacteria. If pertussis is diagnosed in a timely manner, antibiotic treatment of the patient can mitigate the symptoms and prevent transmission. During an outbreak, timely diagnosis of pertussis allows prophylactic treatment of infants too young to be (fully) vaccinated, for whom pertussis is a severe, sometimes fatal disease. Finally, reliable diagnosis of pertussis is required to reveal trends in the (age-specific) disease incidence, which may point to changes in vaccine efficacy, waning immunity, and the emergence of vaccine-adapted strains. Here we review current approaches to the diagnosis of pertussis and discuss their limitations and strengths. In particular, we emphasize that the optimal diagnostic procedure depends on the stage of the disease, the age of the patient, and the vaccination status of the patient.

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“…Paroxysm was the most common symptom 34 . In another study, from Iran, detected pertussis by culture and PCR in school-age children with persistent cough, the frequencies of these symptoms were 59.1%, 55.5% and 22.3%, respectively; 85% of the children had at least one symptom of paroxysmal cough, whooping, or post-tussive emesis 35 . In our study, 55% of PCR-confirmed cases had only a prolonged cough without any of classic findings of pertussis.…”

Section: Discussionmentioning

confidence: 97%

High frequency of pertussis in older children and adolescents with prolonged cough in Turkey

et al. 2016

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Nasopharyngeal specimens were collected from 7-18 year old children, presenting with prolonged cough of two to four weeks' duration. Specimens were examined for B. pertussis by PCR.Of 101 children with prolonged cough, 20 (19.8%) had a positive PCR testing for B. pertussis. Children who were vaccinated ≥5 years previously had a 6.13-fold higher risk of PCR-confirmed pertussis than those who were vaccinated <5 years before. The classic symptoms of pertussis (paroxysmal cough, whooping and post-tussive vomiting) were seen in 30%, 15% and 25% of the patients with positive PCR, respectively; 55% of them had only a prolonged cough without any classic symptoms. Pertussis is common among Turkish children with prolonged cough, even after implementation of a fifth dose of pertussis vaccination and despite high vaccination coverage.

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Sensitivity and specificity of the World Health Organization pertussis clinical case definition

Abstract: Pertussis remains one of the etiologies of prolonged cough, even in communities with high immunization in children. The specificity of the WHO criteria is low in diagnosing pertussis compared with PCR.

Cited by 47 publications

References 10 publications

Clinical Diagnosis of Bordetella Pertussis Infection: A Systematic Review

Clinical Diagnosis of Bordetella Pertussis Infection: A Systematic Review

Laboratory Diagnosis of Pertussis

High frequency of pertussis in older children and adolescents with prolonged cough in Turkey

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