Evidence map›Paper›PMID 34952887›Full record

ArticleBMJ open2021

Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018-2019.

Michael Trent Herdman, Rebecca Cordery, Basel Karo, Amrit Kaur Purba, Lipi Begum, Theresa Lamagni, Chuin Kee, Sooria Balasegaram, Shiranee Sriskandan

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Michael Trent HerdmanNational Infection Service, Public Health England (now UK Health Security Agency), London, UK.ORCID 0000-0002-4662-9352
Rebecca CorderySouth London Health Protection Team, Public Health England (now UK Health Security Agency), London, UK.
Basel KaroNational Infection Service, Public Health England (now UK Health Security Agency), London, UK.
Amrit Kaur PurbaSouth London Health Protection Team, Public Health England (now UK Health Security Agency), London, UK.
Lipi BegumSouth London Health Protection Team, Public Health England (now UK Health Security Agency), London, UK.
Theresa LamagniNational Infection Service, Public Health England (now UK Health Security Agency), London, UK.
Chuin KeeOak Lodge Medical Centre, Barnet, North Central London CCG, London, UK.
Sooria BalasegaramNational Infection Service, Public Health England (now UK Health Security Agency), London, UK.
Shiranee SriskandanDepartment of Infectious Disease, Imperial College London, London, UK s.sriskandan@imperial.ac.uk.ORCID 0000-0002-5214-4941
Public Health England · GBNIHR Imperial Biomedical Research Centre · GB

Funding

Medical Research Council MR/P022669/1
6 · The paper itself

Abstract

objectivesIn response to increasing incidence of scarlet fever and wider outbreaks of group A streptococcal infections in London, we aimed to characterise the epidemiology, symptoms, management and consequences of scarlet fever, and to identify factors associated with delayed diagnosis. DESIGN AND

settingCross-sectional community-based study of children with scarlet fever notified to London's three Health Protection Teams, 2018-2019.

participantsFrom 2575 directly invited notified cases plus invitations via parental networks at 410 schools/nurseries with notified outbreaks of confirmed/probable scarlet fever, we received 477 responses (19% of those directly invited), of which 412 met the case definition. Median age was 4 years (range <1 to 16), 48% were female, and 70% were of white ethnicity. OUTCOME MEASURES: Preplanned measures included quantitative description of case demographics, symptoms, care-seeking, and clinical, social, and economic impact on cases and households. After survey completion, secondary analyses of factors associated with delayed diagnosis (by logistic regression) and consequences of delayed diagnosis (by Cox's regression), and qualitative analysis of free text comments were added.

resultsRash was reported for 89% of cases, but followed onset of other symptoms for 71%, with a median 1-day delay. Pattern of onset varied with age: sore throat was more common at onset among children 5 years and older (OR3.1, 95% CI 1.9 to 5.0). At first consultation, for 28%, scarlet fever was not considered: in these cases, symptoms were frequently attributed to viral infection (60%, 64/106). Delay in diagnosis beyond first consultation occurred more frequently among children aged 5+ who presented with sore throat (OR 2.8 vs 5+without sore throat; 95% CI 1.3 to 5.8). Cases with delayed diagnosis took, on average, 1 day longer to return to baseline activities.

conclusionsScarlet fever may be initially overlooked, especially among older children presenting with sore throat. Raising awareness among carers and practitioners may aid identification and timely treatment.

Indexed as

PharyngitisScarlet FeverStreptococcal InfectionsAdolescentChildChild, PreschoolCross-Sectional StudiesFemaleHumansInfantLondonepidemiologymicrobiologyprimary care

Identifiers

PMID34952887
PMCPMC9066343
OpenAlexW4226276259

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.