Usefulness of clinical definitions of influenza for public health surveillance purposes

This study investigated the performance of various case definitions and influenza symptoms in a primary healthcare sentinel surveillance system. A retrospective study of the clinical and epidemiological characteristics of the cases reported by a primary healthcare sentinel surveillance network for e...

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Detalhes bibliográficos
Autores: Domínguez, Ángela|||0000-0003-0219-1907, Soldevila, Núria|||0000-0002-1353-5325, Torner, Núria, Martínez, Ana, Godoy, Pere|||0000-0002-2896-7286, Rius i Gibert, Maria Cristina|||0000-0001-5189-6503, Jané i Checa, Mireia|||0000-0002-1302-6723
Tipo de documento: artigo
Data de publicação:2020
País:España
Recursos:Universitat Autònoma de Barcelona
Repositório:Dipòsit Digital de Documents de la UAB
Idioma:inglês
OAI Identifier:oai:ddd.uab.cat:283571
Acesso em linha:https://ddd.uab.cat/record/283571
https://dx.doi.org/urn:doi:10.3390/v12010095
Access Level:Acceso aberto
Palavra-chave:Case definition
Influenza
Performance assessment
Primary healthcare physician
Sentinel surveillance system
Symptoms
Descrição
Resumo:This study investigated the performance of various case definitions and influenza symptoms in a primary healthcare sentinel surveillance system. A retrospective study of the clinical and epidemiological characteristics of the cases reported by a primary healthcare sentinel surveillance network for eleven years in Catalonia was conducted. Crude and adjusted diagnostic odds ratios (aDORs) and 95% confidence intervals (CIs) of the case definitions and symptoms for all weeks and epidemic weeks were estimated. The most predictive case definition for laboratory-confirmed influenza was the World Health Organization (WHO) case definition for ILI in all weeks (aDOR 2.69; 95% CI 2.42-2.99) and epidemic weeks (aDOR 2.20; 95% CI 1.90-2.54). The symptoms that were significant positive predictors for confirmed influenza were fever, cough, myalgia, headache, malaise, and sudden onset. Fever had the highest aDOR in all weeks (4.03; 95% CI 3.38-4.80) and epidemic weeks (2.78; 95% CI 2.21-3.50). All of the case definitions assessed performed better in patients with comorbidities than in those without. The performance of symptoms varied by age groups, with fever being of high value in older people, and cough being of high value in children. In patients with comorbidities, the performance of fever was the highest (aDOR 5.45; 95% CI 3.43-8.66). No differences in the performance of the case definition or symptoms in influenza cases according to virus type were found.