Evidence map›Paper›PMID 39331273›Full record

SynthesisInfection2025

The relationship between group A streptococcus test positivity and clinical findings in tonsillopharyngitis in children: systematic review and meta-analysis.

Ayşe Eroğlu, Özge Karakaya Suzan, Tuğçe Kolukısa, Özge Kaya, Mehtap Metin Karaaslan, Yeliz Tanrıverdi Çaycı, Mustafa Altındiş, Murat Bektaş, Nursan Çınar

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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.

Ayşe EroğluDepartment of Nursing, Institute of Health Sciences, Sakarya University, Esentepe Campus, Serdivan, Sakarya, 54187, Turkey. ayseeroglu@sakarya.edu.tr.ORCID https://orcid.org/0000-0001-9515-1167
Özge Karakaya SuzanDepartment of Nursing, School of Health Sciences, Sakarya University, Sakarya, Turkey.ORCID https://orcid.org/0000-0003-4526-4619
Tuğçe KolukısaDepartment of Nursing, Institute of Health Sciences, Sakarya University, Esentepe Campus, Serdivan, Sakarya, 54187, Turkey.ORCID https://orcid.org/0000-0002-5114-9951
Özge KayaDepartment of Nursing, Institute of Health Sciences, Sakarya University, Esentepe Campus, Serdivan, Sakarya, 54187, Turkey.ORCID https://orcid.org/0000-0001-7127-6600
Mehtap Metin KaraaslanDepartment of Nursing, School of Health Sciences, Recep Tayyip Erdoğan University, Rize, Turkey.ORCID https://orcid.org/0000-0002-1575-3799
Yeliz Tanrıverdi ÇaycıDepartment of Basic Medical Sciences, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey.ORCID https://orcid.org/0000-0002-9251-1953
Mustafa AltındişDepartment of Basic Medical Sciences, School of Medicine, Sakarya University, Sakarya, Turkey.ORCID https://orcid.org/0000-0003-0411-9669
Murat BektaşDepartment of Nursing, School of Nursing, Dokuz Eylül University, Izmir, Turkey.ORCID https://orcid.org/0000-0003-3327-8204
Nursan ÇınarDepartment of Nursing, School of Health Sciences, Sakarya University, Sakarya, Turkey.ORCID https://orcid.org/0000-0003-3151-9975

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to present an evidence-based conclusion through a systematic meta-analysis to distinguish clinical signs and symptoms associated with the presence of group A beta-hemolytic streptococcus, as confirmed by throat culture or rapid test, from those in cases without culture confirmation.

methodsThe study protocol has been published in PROSPERO (CRD42023450854). Studies published between January 1, 2013 and August 15, 2023 were scanned in seven databases. The methodological quality of the articles was assessed using The Joanna Briggs Institution (JBI) Cross-Sectional Studies and Cohort Studies checklist. Effect size calculations were made using fixed effects and random effects models.

resultsA total of 22 articles were included in the systematic review, with 14 included in the meta-analysis. The prevalence of streptococcal pharyngitis in these studies ranged from 7.3 to 44.1%. According to the meta-analysis results, a significant association was observed between GAS test positivity and the presence of tonsillar exudate, palatal petechiae, tonsillar hypertrophy, dysphagia, fever, and cervical lymphadenopathy (p < 0.05). No significant relationship was found between GAS test positivity and symptoms such as headache, sore throat, cough, absence of cough, hoarseness, scarlatiniform rash, tonsillar erythema, vomiting, rhinorrhea, and abdominal pain (p > 0.05).

conclusionThe findings of the meta-analysis suggest that, in addition to the Centor criteria, palatal petechiae, dysphagia, and tonsillar hypertrophy are noteworthy indicators of GAS infection. Contrary to previous studies, our meta-analysis indicates that symptoms such as headache, sore throat, cough, absence of cough, hoarseness, scarlatiniform rash, tonsillar erythema, vomiting, rhinorrhea, and abdominal pain may not be associated with streptococcal infection. Further research is needed to elucidate these findings.

Indexed as

PharyngitisStreptococcal InfectionsStreptococcus pyogenesTonsillitisChildChild, PreschoolHumansPrevalenceChildrenClinical decision ruleStreptococcusTonsillopharyngitis

Identifiers

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Registered trials

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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.