Assessment of the performance of a definition of a suspected measles case: implications for measles surveillance Evaluación de la utilidad de una definición de "caso sospechado de sarampión": implicaciones para la vigilancia de la enfermedad
OBJECTIVE: To assess the performance, in Brazil, of the definition of a suspected measles case among patients with rash diseases that has been adopted in Brazil and many other countries. METHODS: From January 1994 to December 2003, patients with acute rash were seen at two large primary health care...
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ftdoajarticles:oai:doaj.org/article:2bdaa1202da8431d81e98c02c2136254 2023-05-15T15:18:59+02:00 Assessment of the performance of a definition of a suspected measles case: implications for measles surveillance Evaluación de la utilidad de una definición de "caso sospechado de sarampión": implicaciones para la vigilancia de la enfermedad Solange Artimos de Oliveira Luiz Antonio Bastos Camacho Antonio Carlos de Medeiros Pereira Sérgio Setúbal Rita Maria Ribeiro Nogueira Marilda Mendonça Siqueira 2006-04-01T00:00:00Z https://doaj.org/article/2bdaa1202da8431d81e98c02c2136254 EN ES PT eng spa por Pan American Health Organization http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892006000400002 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 https://doaj.org/article/2bdaa1202da8431d81e98c02c2136254 Revista Panamericana de Salud Pública, Vol 19, Iss 4, Pp 229-235 (2006) Sarampión exantema diagnóstico diferencial valor predictivo vigilancia Brasil Measles exanthema diagnosis differential predictive value of tests population surveillance Brazil Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2006 ftdoajarticles 2022-12-31T12:06:22Z OBJECTIVE: To assess the performance, in Brazil, of the definition of a suspected measles case among patients with rash diseases that has been adopted in Brazil and many other countries. METHODS: From January 1994 to December 2003, patients with acute rash were seen at two large primary health care units and a public general hospital in Niterói, a city in the metropolitan area of the city of Rio de Janeiro, Brazil. Data from clinical and serologic assessment were used to estimate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the definition of a suspected measles case that has been adopted in Brazil, as well as other combinations of signs and symptoms; serologic status was taken as the reference. Using enzyme immunoassay, serum samples were tested for immunoglobulin M (IgM) antibodies against measles virus. RESULTS: A total of 1 221 patients with an illness characterized by different combinations of rash with other signs and symptoms were studied. The suspected case definition that has been adopted in Brazil (rash, fever, and at least one of the following: cough, coryza, or conjunctivitis) had an overall sensitivity of 100%, and a specificity of 58.7%. Confirmed measles cases were 2.4 times as likely as were other rash diseases to have that combination of signs/symptoms. The suspected case definition adopted in Brazil had a 6% PPV and 100% NPV. The combination of all five signs and symptoms had the highest specificity, PPV, and likelihood ratio, for both children (< 15 years old) and adults (> 15 years). That was achieved at the expense of sensitivity, which dropped to 89%, but the NPV was still very high. CONCLUSIONS: Our results show that the suspected measles case definition adopted in Brazil is extremely sensitive for measles surveillance among patients with rash diseases. However, the high false-positive rates that were found may result in a substantial number of other rash diseases being misclassified as measles, leading to the misdirection of ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
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English Spanish Portuguese |
topic |
Sarampión exantema diagnóstico diferencial valor predictivo vigilancia Brasil Measles exanthema diagnosis differential predictive value of tests population surveillance Brazil Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Sarampión exantema diagnóstico diferencial valor predictivo vigilancia Brasil Measles exanthema diagnosis differential predictive value of tests population surveillance Brazil Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Solange Artimos de Oliveira Luiz Antonio Bastos Camacho Antonio Carlos de Medeiros Pereira Sérgio Setúbal Rita Maria Ribeiro Nogueira Marilda Mendonça Siqueira Assessment of the performance of a definition of a suspected measles case: implications for measles surveillance Evaluación de la utilidad de una definición de "caso sospechado de sarampión": implicaciones para la vigilancia de la enfermedad |
topic_facet |
Sarampión exantema diagnóstico diferencial valor predictivo vigilancia Brasil Measles exanthema diagnosis differential predictive value of tests population surveillance Brazil Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
OBJECTIVE: To assess the performance, in Brazil, of the definition of a suspected measles case among patients with rash diseases that has been adopted in Brazil and many other countries. METHODS: From January 1994 to December 2003, patients with acute rash were seen at two large primary health care units and a public general hospital in Niterói, a city in the metropolitan area of the city of Rio de Janeiro, Brazil. Data from clinical and serologic assessment were used to estimate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the definition of a suspected measles case that has been adopted in Brazil, as well as other combinations of signs and symptoms; serologic status was taken as the reference. Using enzyme immunoassay, serum samples were tested for immunoglobulin M (IgM) antibodies against measles virus. RESULTS: A total of 1 221 patients with an illness characterized by different combinations of rash with other signs and symptoms were studied. The suspected case definition that has been adopted in Brazil (rash, fever, and at least one of the following: cough, coryza, or conjunctivitis) had an overall sensitivity of 100%, and a specificity of 58.7%. Confirmed measles cases were 2.4 times as likely as were other rash diseases to have that combination of signs/symptoms. The suspected case definition adopted in Brazil had a 6% PPV and 100% NPV. The combination of all five signs and symptoms had the highest specificity, PPV, and likelihood ratio, for both children (< 15 years old) and adults (> 15 years). That was achieved at the expense of sensitivity, which dropped to 89%, but the NPV was still very high. CONCLUSIONS: Our results show that the suspected measles case definition adopted in Brazil is extremely sensitive for measles surveillance among patients with rash diseases. However, the high false-positive rates that were found may result in a substantial number of other rash diseases being misclassified as measles, leading to the misdirection of ... |
format |
Article in Journal/Newspaper |
author |
Solange Artimos de Oliveira Luiz Antonio Bastos Camacho Antonio Carlos de Medeiros Pereira Sérgio Setúbal Rita Maria Ribeiro Nogueira Marilda Mendonça Siqueira |
author_facet |
Solange Artimos de Oliveira Luiz Antonio Bastos Camacho Antonio Carlos de Medeiros Pereira Sérgio Setúbal Rita Maria Ribeiro Nogueira Marilda Mendonça Siqueira |
author_sort |
Solange Artimos de Oliveira |
title |
Assessment of the performance of a definition of a suspected measles case: implications for measles surveillance Evaluación de la utilidad de una definición de "caso sospechado de sarampión": implicaciones para la vigilancia de la enfermedad |
title_short |
Assessment of the performance of a definition of a suspected measles case: implications for measles surveillance Evaluación de la utilidad de una definición de "caso sospechado de sarampión": implicaciones para la vigilancia de la enfermedad |
title_full |
Assessment of the performance of a definition of a suspected measles case: implications for measles surveillance Evaluación de la utilidad de una definición de "caso sospechado de sarampión": implicaciones para la vigilancia de la enfermedad |
title_fullStr |
Assessment of the performance of a definition of a suspected measles case: implications for measles surveillance Evaluación de la utilidad de una definición de "caso sospechado de sarampión": implicaciones para la vigilancia de la enfermedad |
title_full_unstemmed |
Assessment of the performance of a definition of a suspected measles case: implications for measles surveillance Evaluación de la utilidad de una definición de "caso sospechado de sarampión": implicaciones para la vigilancia de la enfermedad |
title_sort |
assessment of the performance of a definition of a suspected measles case: implications for measles surveillance evaluación de la utilidad de una definición de "caso sospechado de sarampión": implicaciones para la vigilancia de la enfermedad |
publisher |
Pan American Health Organization |
publishDate |
2006 |
url |
https://doaj.org/article/2bdaa1202da8431d81e98c02c2136254 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista Panamericana de Salud Pública, Vol 19, Iss 4, Pp 229-235 (2006) |
op_relation |
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892006000400002 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 https://doaj.org/article/2bdaa1202da8431d81e98c02c2136254 |
_version_ |
1766349153124745216 |