The utility of rapid antigen detection testing for the diagnosis of streptococcal pharyngitis in low-resource settings

Rimoin, Anne W.; Walker, Christa L. Fischer; Hamza, Hala; Elminawi, Nevine; Ghafar, Hadeer Abdel; Vince, Adriana; Cunha, Antonia L. A. da; Qazi, Shamim; Gardovska, Dace; Steinhoff, Mark C.

doi:10.1016/j.ijid.2010.02.2269

Cited by 47 publications

(46 citation statements)

References 37 publications

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“…In a study conducted by Rimoin et al (16), there was a statistically significant difference in the frequency of signs: cervical lymphadenopathy, exudate, fever, absence of cough with GAS pharyngitis in various four countries, however, cervical lymphadenopathy was the only sign that was consistently and statistically associated with positive GAS culture at all different sites (17). This finding is consistent with our study.…”

supporting

confidence: 92%

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Comparison of Clinical Findings and Rapid Streptococcal Antigen Detection Test in the Diagnosis of Group A Streptococcal (GAS) Pharyngitis

Ehsanipour

Mirghorbani

Asl

et al. 2016

Arch Clin Infect Dis

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confidence: 92%

“…The positive predictive value ranged from 67.9% to 88.6% and negative predictive value ranged from 88.1% to 95.7% (16).…”

mentioning

confidence: 95%

Comparison of Clinical Findings and Rapid Streptococcal Antigen Detection Test in the Diagnosis of Group A Streptococcal (GAS) Pharyngitis

Ehsanipour

Mirghorbani

Asl

et al. 2016

Arch Clin Infect Dis

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“…Where the multiple sensitivity and specificity pairs were estimated from different samples of patients, each pair is treated in our analysis as if it came from a separate study. 6,[17][18][19][20] Where a different RADT was tested in the same sample of patients, we included each sensitivity and specificity pair in the subgroup analysis for the respective RADT. [21][22][23][24][25] Where multiple sensitivity and specificity pairs were estimated from the same patients in a study, only 1 pair of sensitivity and specificity was included in our analysis.…”

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confidence: 99%

“…5 This delay is especially problematic in low-resource settings, as it may not be feasible for patients to return for further follow-up visits and appropriate treatment. 6 Rapid antigen diagnostic tests (RADTs) are a potentially more feasible alternative because of their quick turnaround time, so that the clinician can make a decision regarding treatment at the point of care. 7 Since their inception in the early 1980s, there have been several generations of RADTs that have used different methodologies.…”

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confidence: 99%

Rapid Diagnostic Tests for Group A Streptococcal Pharyngitis: A Meta-analysis

et al. 2014

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BACKGROUND AND OBJECTIVE: Effective management of group A streptococcal (GAS) pharyngitis is hindered by impracticality of the gold standard diagnostic test: throat culture. Rapid antigen diagnostic tests (RADTs) are a promising alternative, although concerns about their sensitivity and specificity, and variation between test methodologies, have limited their clinical use. The objective of this study was to perform a systematic review with meta-analysis of the diagnostic accuracy of RADTs for GAS pharyngitis. METHODS:Medline and Embase from 1996 to 2013 were used as data sources. Of 159 identified studies, 48 studies of diagnostic accuracy of GAS RADTs using throat culture on blood agar as a reference standard were selected. Bivariate random-effects regression was used to estimate sensitivity and specificity with 95% confidence intervals (CIs). Additional meta-analyses were performed for pediatric data. RESULTS:A total of 60 pairs of sensitivity and specificity from 48 studies were included. Overall summary estimates for sensitivity and specificity of RADTs were 0.86 (95% CI 0.83 to 0.88) and 0.96 (95% CI 0.94 to 0.97), respectively, and estimates for pediatric data were similar. Molecular-based RADTs had the best diagnostic accuracy. Considerable variability exists in methodology between studies. There were insufficient studies to allow meta-regression/subgroup analysis within each test type.CONCLUSIONS: RADTs can be used for accurate diagnosis of GAS pharyngitis to streamline management of sore throat in primary care. RADTs may not require culture backup for negative tests in most low-incidence rheumatic fever settings. Newer molecular tests have the highest sensitivity, but are not true point-of-care tests. ABBREVIATIONS CI-confidence interval ELISA-enzyme-linked immunosorbent assay FISH-fluorescence in situ hybridization GAS-group A b-hemolytic streptococcus OIA-optical immunoassay PCR-polymerase chain reaction QUADAS-Quality Assessment of Diagnostic Accuracy Studies RADT-rapid antigen diagnostic test ROC-receiver operating characteristics S-ROC-summary receiver operating characteristics Dr. Lean collected data for the study and drafted the initial manuscript; Dr Arnup carried out the statistical analyses and reviewed and revised the manuscript; Drs Danchin and Steer conceptualized the study, supervised data collection, and critically reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

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“…Oleh karena itu beberapa metode dikembangkan untuk mengidentifikasi faringitis akut yang disebabkan oleh GABHS. Metode yang disarankan untuk manajemen faringitis akut yang disebabkan oleh GABHS, adalah menggunakan centor criteria atau menggunakan RADT (Rapid Antigen Detection Testing) (Rimoin et al, 2010).…”

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Pola Peresepan Antibiotik Pada Manajemen Faringitis Akut Dewasa Di Puskemas

2017

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Acute pharyngitis is one of the most common diseases in primary health ABSTRAKFaringitis akut merupakan salah satu kondisi penyakit yang sering dialami oleh pasien di puskesmas. Namun belum diketahui manajemen terbaik untuk menekan penggunaan antibiotika pada kasus faringitis akut dewasa di Puskesmas Kabupaten X, Bali. Penelitian ini bertujuan untuk mengetahui manajemen terbaik dalam menekan jumlah peresepan antibotika pada kasus faringitis akut dewasa di Puskesmas Kabupaten X, Bali. Studi prospektif kohort ini melibatkan 93 pasien berumur 12-45 tahun yang telah didiagnosa faringitis akut oleh dokter. Pengukuran dilakukan pada distribusi jumlah obat yang diresepkan tiap resep, frekuensi antibiotika, jumlah antibiotika serta DDD antibiotika yang diresepkan pada pasien faringitis akut. Hasil yang didapatkan yaitu Manajemen centor criteria dan RADT dapat menekan jumlah antibiotika yang diresepkan dibandingkan manajemen empiris di Puskesmas. Penekanan terjadi pada distribusi jumlah obat yang diresepkan tiap resep, frekuensi antibiotika, jumlah antibiotika serta DDD antibiotika. pola peresepan antibiotika pada pasien faringitis akut paling efektif dengan menggunakan manajemen centor criteria dan RADT di Puskesmas Kabupaten X, Bali.

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The utility of rapid antigen detection testing for the diagnosis of streptococcal pharyngitis in low-resource settings

Abstract: In limited-resource regions where microbiological diagnosis is not feasible or practical, RADTs should be considered an option that can be performed in a clinic and provide timely results.

Cited by 47 publications

References 37 publications

Comparison of Clinical Findings and Rapid Streptococcal Antigen Detection Test in the Diagnosis of Group A Streptococcal (GAS) Pharyngitis

Comparison of Clinical Findings and Rapid Streptococcal Antigen Detection Test in the Diagnosis of Group A Streptococcal (GAS) Pharyngitis

Rapid Diagnostic Tests for Group A Streptococcal Pharyngitis: A Meta-analysis

Pola Peresepan Antibiotik Pada Manajemen Faringitis Akut Dewasa Di Puskemas

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