Harrison L H, Moursi S, Guinena A H, Gadomski A M, el-Ansary K S, Khallaf N, Black R E
Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205, USA.
Int J Epidemiol. 1995 Oct;24(5):1058-63. doi: 10.1093/ije/24.5.1058.
Acute respiratory infection (ARI) is a major cause of childhood morbidity and mortality in developing countries. Community surveys are used to determine the proportion of children with ARI for whom care is sought by questioning mothers about the signs and symptoms of illness episodes. The validity of this approach has been studied infrequently.
We evaluated maternal reporting of signs and symptoms 2 and 4 weeks after diagnosis among 271 Egyptian children < 5 years old. Children with ARI were evaluated by physical examination, chest radiography, and pulse oximetry, and were alternately assigned for a maternal interview about the episode 14 or 28 days later.
For radiographically-defined acute lower respiratory infection (ALRI), the sensitivity of several symptoms for combined open- and close-ended questions was relatively high: nahagan (deep or rapid breathing) (80%), nafas sarie (fast breathing) (66%), and kharfasha (coarse breath sounds) (63%). The specificity of these terms was 50-68%. The specificity was inversely related to the follow-up time. No term provided both a sensitivity and specificity of > 50% at day 28 across the radiographically, clinically- and pulse oximetry-based definitions of ALRI. Spontaneously mentioned karshet nafas (difficult or rapid breathing) at 14 days had a specificity and sensitivity for radiographic ALRI of 87% and 41%, respectively, suggesting that this term is a good choice for community surveys.
Maternal reporting of ARI symptoms is non-specific 2 and 4 weeks after diagnosis but may be useful for monitoring trends in the proportion of children with pneumonia who receive medical care. To maximize specificity, ARI programmes should generally use a recall period of 2 weeks.
急性呼吸道感染（ARI）是发展中国家儿童发病和死亡的主要原因。社区调查通过询问母亲关于疾病发作的体征和症状来确定寻求治疗的ARI儿童比例。这种方法的有效性很少被研究。
我们评估了271名5岁以下埃及儿童在诊断后2周和4周时母亲对体征和症状的报告。对患有ARI的儿童进行体格检查、胸部X光检查和脉搏血氧饱和度测定，并在14天或28天后交替安排母亲就该疾病发作进行访谈。
对于影像学定义的急性下呼吸道感染（ALRI），几个症状对于开放式和封闭式问题组合的敏感性相对较高：nahagan（呼吸深或快）（80%）、nafas sarie（呼吸急促）（66%）和kharfasha（呼吸音粗糙）（63%）。这些术语的特异性为50%-68%。特异性与随访时间呈负相关。在基于影像学、临床和脉搏血氧饱和度测定的ALRI定义中，没有一个术语在第28天的敏感性和特异性均>50%。在14天时自发提到的karshet nafas（呼吸困难或急促）对影像学ALRI的特异性和敏感性分别为87%和41%，这表明该术语是社区调查的一个不错选择。
ARI症状的母亲报告在诊断后2周和4周时不具有特异性，但可能有助于监测接受医疗护理的肺炎儿童比例的趋势。为了最大限度地提高特异性，ARI项目通常应使用2周的回忆期。
