ArticleBulletin of the World Health Organization2012
Performance of case definitions used for influenza surveillance among hospitalized patients in a rural area of India.
Article in Bulletin of the World Health Organization, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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26 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
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- Evaluation of COVID-19 and Influenza-like Illness Surveillance Case Definitions in a Prospective Cohort of Healthcare Personnel in Peru.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Seasonality of Influenza and Optimizing Timing of Vaccination: Systematic Review and Meta-Analysis.Cureus · 2025Review
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- [Epidemiological, clinical, and virological profile of influenza in the Democratic Republic of the Congo, from 2009 to 2018].The Pan African medical journal · 2025Article
- In-hospital mortality risk stratification in children aged under 5 years with pneumonia with or without pulse oximetry: A secondary analysis of the Pneumonia REsearch Partnership to Assess WHO REcommendations (PREPARE) dataset.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023Article
- A prospective observational study of community acquired pneumonia in Kenya: the role of viral pathogens.BMC infectious diseases · 2021Observational
- Performance of case definitions and clinical predictors for influenza surveillance among patients followed in a rural cohort in Senegal.BMC infectious diseases · 2021Article
- Reducing Antibiotic Use in Ambulatory Care Through Influenza Vaccination.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Article
- Profile: Vadu Health and Demographic Surveillance System Pune, India.Journal of global health · 2019Article
- Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Article
- Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection.Bulletin of the World Health Organization · 2018Article
- Burden of Influenza in 4 Ecologically Distinct Regions of Peru: Household Active Surveillance of a Community Cohort, 2009-2015.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- Comparison of severe acute respiratory illness (sari) and clinical pneumonia case definitions for the detection of influenza virus infections among hospitalized patients, western Kenya, 2009-2013.Influenza and other respiratory viruses · 2016Article
- Influenza-like illness in an urban community of Salvador, Brazil: incidence, seasonality and risk factors.BMC infectious diseases · 2016Article
- Impact of influenza vaccination on respiratory illness rates in children attending private boarding schools in England, 2013-2014: a cohort study.Epidemiology and infection · 2015Observational
- The case for ILI surveillance.Vaccine · 2015Article
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo assess case definitions for influenza in a rural community in India.
methodsResidents of the study area who were hospitalized for any acute medical condition for at least one night between May 2009 and April 2011 were enrolled. Respiratory specimens were collected and tested for influenza viruses in a reverse-transcription polymerase chain reaction (PCR). The PCR results were taken as the "gold standard" in evaluating the performance of several case definitions.
findingsOf the 3179 patients included in the final analysis, 21% (665) were PCR-positive for influenza virus, 96% reported fever and 4% reported shortness of breath. The World Health Organization (WHO) case definition for severe acute respiratory illness had a sensitivity of 11% among patients aged < 5 years and of 3% among older patients. When shortness of breath was excluded from the definition, sensitivities increased (to 69% and 70%, respectively) and corresponding specificities of 43% and 53% were recorded. Among patients aged ≥ 5 years, WHO's definition of a case of influenza-like illness had a sensitivity of 70% and a specificity of 53%. The addition of "cough and reported or measured fever" increased sensitivity to 80% but decreased specificity to 42%.
conclusionThe inclusion of shortness of breath in WHO's case definition for severe acute respiratory illness may grossly underestimate the burden posed by influenza in hospitals. The exclusion of shortness of breath from this definition or, alternatively, the inclusion of "cough and measured or reported fever" may improve estimates of the burden.
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