Evaluating the diagnostic accuracy of the WHO Severe Acute Respiratory Infection (SARI) criteria in Middle Eastern children under two years over three respiratory seasons

Abstract

ObjectiveThe World Health Organization created the Severe Acute Respiratory Infection (SARI) criteria in 2011 to monitor influenza (flu)-related hospitalization. Many studies have since used the SARI case definition as inclusion criteria for surveillance studies. We sought to determine the sensitivity, specificity, positive predictive value, and negative predictive value of the SARI criteria for detecting ten different respiratory viruses in a Middle Eastern pediatric cohort. . Participants were recruited if they had a fever and/or respiratory symptoms. Nasal and throat swabs were obtained and tested by real-time RT-PCR for eleven viruses. Subjects meeting SARI criteria were determined post-hoc. Sensitivity, specificity, positive predictive value, and negative predictive value of the SARI case definition for detecting ten different viruses were calculated and results were stratified by age. ResultsOf the 3,175 patients enrolled, 3,164 were eligible for this study, with a median age of 3.5 months, 60.4% male, and 82% virus-positive (44% RSV and 3.8% flu). The sensitivity and PLOS ONE PLOS ONE | https://doi.org/10.1371/journal.pone.0232188 April 30, 2020 1 / 15 OPEN ACCESS Citation: Klink T, Rankin DA, Piya B, Spieker AJ, Faouri S, Shehabi A, et al. (2020) Evaluating the diagnostic accuracy of the WHO Severe Acute Respiratory Infection (SARI) criteria in Middle Eastern children under two years over three respiratory seasons. PLoS ONE 15(4): e0232188.

Assessing the epidemiology and seasonality of influenza among children under two hospitalized in Amman, Jordan, 2010‐2013

“…During the study period, Al‐Bashir Hospital had a total of 185 pediatric beds (120 pediatric and 65 neonatal intensive care unit) and 11 230 hospitalizations among children <2 years. 7,9‐11 Al‐Bashir is one of three major government run hospitals that services the population of Amman (capital and largest city in Jordan [>2 million persons]), with over 60% of the pediatric care occurring at this hospital 7,9‐11 . As part of the government policy, all Jordanian children under 6 years are provided no‐cost medical care, regardless of insurance status, at Al‐Bashir Hospital 7,9‐11 …”

“…After obtaining informed consent, trained research personnel collected nasal and throat swabs from all enrolled children 7,9‐11 . Parents/guardians were interviewed to obtain the child's demographic characteristics and medical and social histories using a standardized questionnaire 7,9‐11 . All interviews were conducted in Arabic using a standardized case report form and transcribed into English 7,9‐11 .…”

“…Parents/guardians were interviewed to obtain the child's demographic characteristics and medical and social histories using a standardized questionnaire 7,9‐11 . All interviews were conducted in Arabic using a standardized case report form and transcribed into English 7,9‐11 . After children were discharged, medical records were abstracted for the following: oxygen use, intensive care unit (ICU) stay, mechanical ventilation, length of stay in the hospital, and discharge status 10 .…”

“…All interviews were conducted in Arabic using a standardized case report form and transcribed into English 7,9‐11 . After children were discharged, medical records were abstracted for the following: oxygen use, intensive care unit (ICU) stay, mechanical ventilation, length of stay in the hospital, and discharge status 10 . Complete details on the methods of data collection are explained in a previous publication 10 …”

Explore study: Retrospective Cohort study to show the start of SARS-CoV-2 in patients with severe respiratory illness by real-time PCR

“…The 2019-20 coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). [1] The outbreak was rst noted in Wuhan, Hubei province, China, in December 2019. The World Health Organization (WHO) declared the outbreak to be a Public Health Emergency of International Concern on 30 January 2020 and recognized it as a pandemic on 11 March 2020.…”