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Seasonal influenza among children diagnosed by their guardians: a small pilot study in Japan
Hiroki Maita1,2, Tadashi Kobayashi3, Hiroshi Osawa3
1Development of Community Healthcare, Hirosaki University Graduate School of Medicine, Hirosaki-shi, Japan.
Insights
Guardian self-diagnosis of pediatric influenza can be a useful tool. An 80% cut-off accurately identifies influenza, while a 50% cut-off helps exclude cases, aiding timely management.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Seasonal influenza poses a significant public health challenge, particularly in pediatric populations.
- Influenza epidemics in children lead to socio-economic disruptions, including school closures and parental work absences.
- Accurate and timely identification of pediatric influenza is crucial for disease control and mitigation.
Purpose of the Study:
- To evaluate the accuracy of guardian self-diagnosis for pediatric influenza.
- To determine the optimal cut-off point for guardian-based influenza diagnosis.
- To compare guardian diagnosis with rapid influenza diagnostic test (RIDT) results.
Main Methods:
- A cross-sectional observational study was conducted in a rural Japanese clinic over three winter seasons (2013-2016).
- Retrospective data extraction from medical records and pre-examination checklists of 24 children under 12 years old.
- Analysis included guardian-reported symptoms, self-diagnosis accuracy, and comparison with RIDT results.
Main Results:
- An 80% cut-off for guardian self-diagnosis demonstrated optimal accuracy, with a specificity of 92.3%.
- A 50% cut-off showed high sensitivity (90.9%) for case identification but lower specificity (53.8%).
- Guardians' assessment of 'not feeling severely sick' was a useful indicator for excluding pediatric influenza.
Conclusions:
- Guardian self-diagnosis of pediatric influenza can be a valuable tool for both confirming and excluding the illness.
- An 80% threshold in guardian diagnosis aids in confirming influenza, while a 50% threshold assists in exclusion.
- This approach supports early assessment and management, contributing to societal and economic well-being by reducing influenza spread.
Aim:
We aimed to elucidate the accuracy and optimal cut-off point of the self-diagnosis of influenza and the associated clinical symptoms of children by their guardians, compared with those of the rapid influenza diagnostic test (RIDT).
Background:
Seasonal influenza is a common outpatient problem during the winter season. A paediatric influenza epidemic has socio-economic impacts like temporary school closure, school event cancellations, and unscheduled work absences among parents. Hence, early identification and assessment of influenza to prevent its spread is important from a societal perspective.
Method:
We performed a cross-sectional observational study in a rural clinic in Japan every winter season from December 2013 to March 2016. We retrospectively extracted information from the medical records and pre-examination checklists of 24 patients aged <12 years (mean age, 5.4 years; men, 54.2%). The data extracted from the medical records and pre-examination checklist included the baseline characteristics (age, sex and past medical history of influenza), clinical signs and symptoms, diagnosis by guardians (%) and RIDT results.
Findings:
The optimal cut-off point of the self-diagnosis of influenza by guardians was 80%, with a sensitivity and specificity of 63.6% (95% confidence interval: 30.8-89.1) and 92.3% (64.0-99.8). At a 50% cut-off point, the sensitivity and specificity were 90.9% (58.7-99.8) and 53.8% (25.1-80.8). The accuracy of feeling severely sick, as estimated by the guardians showed a sensitivity and specificity of 90.9% (58.7-99.8) and 69.2% (38.6-90.9). Our study indicates that the diagnosis of seasonal influenza by guardians to their children would be useful in the establishment of both confirmatory diagnoses when it has high probability above the optimal cut-off point (80%), and exclusion diagnosis when it has low probability (50%). Not feeling severely sick, estimated by the guardians might be a useful indicator for the exclusion of paediatric influenza.
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