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Aim: to assess the management of children with acute tonsillopharyngitis according to practice guidelines and the importance of rapid strep test.Patients and Methods: prospective non-interventional study was performed to analyze whether management strategy for children with pharyngeal deposits matches practice guidelines. Pediatricians were provided an opportunity to perform rapid strep test in children with pharyngeal deposits using Streptatest. Children older than 1 year who visited pediatrician or emergency unit or were admitted to hospital for pharyngeal deposits were enrolled in the study. Inclusion criteria was the possibility to follow-up a child till completing case of disease.Results: initial examination using rapid strep test was performed in 215 children. All children were diagnosed with moderate acute tonsillo-pharyngitis. The children were subdivided in two groups by age according to the management algorithm for children with pharyngeal deposits addressed in Federal practice guidelines of the Union of Pediatricians of Russia, i.e., 2.3±0.7 years (n=45, 20.9%) and 8.5±4.1 years (n=170, 79.1%). Streptococcal etiology was verified in 31 of 215 children (14.4%). In 8.9% of children under 3 years of age, acute tonsillopharyngitis was caused by group A β-hemolytic streptococcus (group A strep). No pathognomonic signs of acute tonsillopharyngitis caused by group A strep were revealed. The use of Streptatest at early stages of etiological diagnostics reduced unreasonable prescription of antibiotics by 74%. Prevented economic damage associated with rapid strep test use to diagnose acute tonsillopharyngitis was estimated at 55,791 RUB. As a result, the costs of the treatment for one case of acute tonsillopharyngitis were reduced by 410 RUB.Conclusion: Streptatest reduces the percentage of unreasonable prescription of antibiotics for acute tonsillopharyngitis in children and pre-vents economic damage.Keywords: acute tonsillopharyngitis, group A β-hemolytic streptococcus, antibiotic, antibacterial therapy, resistance, Streptatest, rapid strep test, immunoassay.For citation: Tsar’kova S.A., Sokolova A.S., Vavilova V.P. The importance of rapid strep test for acute tonsillopharyngitis in children with pharyngeal deposits. Russian Journal of Woman and Child Health. 2020;3(2):112–118. DOI: 10.32364/2618-8430-2020-3-2-112-118.

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Morbidity parameters in children aged 0–17 years have been analyzed based on results of prophylactic medical examinations conducted in Ekaterinburg between 2013 and 2019. The prophylactic medical examination coverage of pediatric population, distribution among the health status groups and frequency of regular medical check-ups have been studied. In 2019 versus 2013, children aged 0–17 years demonstrated a 1.6-fold increase in overall morbidity, and 2.3-fold increase in primary-care morbidity. In 2013–2017, a higher level of overall morbidity was found in children aged 15–17 years compared to children 0–4 years of age, owing to the emergence of newly diagnosed diseases. It was noted than the most frequently diagnosed diseases included diseases of the musculoskeletal system and connective tissue, diseases of the eye and eye appendages, diseases of nervous system, digestive system, endocrine system, nutritional disorders and metabolic disorders. Each year, based on results of prophylactic medical examinations, the proportion of children for whom the outpatient examination has been recommended amounts to 9.5%, outpatient treatment to 35.0%, and outpatient medical rehabilitation to 9.3%. The fraction of healthy children as of 2019 was 23.1% of all examined children. In 2019 the coverage for medical check-ups at the health facilities was 605.6 per 1000 children, that is 1.8 times higher than that in 2013 (334,0 per 1000 children).

Background. The issue of acute respiratory infections in children remains one of the most urgent. Therefore, in the pandemic due to the new coronavirus SARS-CoV-2, the search for effective treatment regimens for this disease is necessary. Aim. To compare the change of clinical symptoms, terms of virus elimination and disease-related economic cost as well as utilization of outpatient healthcare services in children with new coronavirus infection using the herbal medicine Tonsilgon N, oral solution, added to standard therapy. Materials and methods. A prospective open comparative cohort study of the effectiveness of coronavirus infection treatment in children using the standard of care alone and the standard of care with Tonsilgon N was conducted. Group 1 children (n=720) received the standard therapy for COVID-19 and Tonsilgon N oral solution for 10 days, and group 2 patients (n=670) only received the standard therapy for COVID-19. Treatment efficacy was evaluated according to the change of clinical symptoms in the observed patients, the results of SARS-CoV-2 coronavirus RNA detection in nasopharyngeal smears by polymerase chain reaction, the utilization of healthcare services, temporary disability of parents, the economic cost of the disease. Results. Studied patients of both groups had a typical clinical presentation of mild to moderate severity new coronavirus infection. Fatigue (96.599.7%) and sore throat (93.893.9%) were the most frequent symptoms. Posterior pharynx hyperemia was noted slightly less frequently. Low-grade fever was noted in 85.786.6% of the patients, equally often in patients of both groups. The significant therapeutic effect of the herbal medicine containing extract of marshmallow root, chamomile flowers, horsetail herb, walnut leaf, yarrow herb, oak bark, and dandelion herb includes reducing the time of sore throat relief in 93.2% of main group patients. After 10 days of treatment, sore throat persisted only in 6.8% of group 1 and 68.1% of group 2 patients (p=0.0001). These results indicate that Tonsilgon combined with standard of care is a promising way to improve the quality of life of children with the new coronavirus infection. The addition of Tonsilgon in therapy for new coronavirus infection in children shortens the time of acute inflammation resolution and reduces the duration of inflammatory intoxication. The therapy of new coronavirus infection under the provisional guidelines leads to a reduction in the time for clinical recovery and virus elimination in children and adolescents (p=0.0001) and a decrease in the utilization of outpatient healthcare services are observed: 3/4 of Group 1 patients and 1/2 of Group 2 patients (p=0.0001) applied for medical help twice during the observation period, 14.6% of Group 1 patients and 29.1% of Group 2 parents applied for medical help more than 3 times (p=0.0001). Thus, the direct and indirect economic costs of the disease decreased. The lower economic cost for parents of children in Group 1 was due to less need for medication and a lower reduction in family income due to temporary disability compared to those for parents in Group 2 (p=0.0001). No treatment-related adverse events was reported. Conclusion. The above data indicate that Tonsilgon therapy is an affordable way to optimize the treatment of new coronavirus infection in children.