■A组链球菌(GAS)感染,比如咽炎和脓疱疮,可导致风湿热和风湿性心脏病(RHD)。澳大利亚原住民和托雷斯海峡岛民的RHD和GAS皮肤感染发生率很高,然而,GAS咽炎的发生率尚不清楚。有趣的是,咽炎的临床表现,包括扁桃体肥大和喉咙痛,不常见。这项研究旨在开发一套标准化的扁桃体照片,并确定城市儿科人群的扁桃体大小分布。
■在珀斯的“发现日”和“Telethon周末”(2017年10月)公共活动中招募了3-15岁的前瞻性儿童队列,西澳大利亚,澳大利亚。扁桃体照片,症状学,收集GAS快速抗原检测试验(RADT)。扁桃体大小由两名独立的临床医生使用扁桃体肥大的Brodsky分级量表(Brodsky)从照片中分级。并计算了评估者间的可靠性。咽炎症状和GASRADT相关,并立即提供结果。
■四百二十六个健康儿童参加了为期三天的研究。中位年龄为7岁[四分位距(IQR)5.9-9.7岁]。收集了92%的参与者的扁桃体照片,其中62%的照片被评为质量良好,79%的照片被认为质量足够,可供两位临床医生评估。当两名独立的临床医生打分时,57%的人获得了相同的品级。平均Brodsky评分(临床医生之间)为11%,35%,28%,分别为0、1、2、3和4级的22%和5%。在使用照片评分方面有适度的共识,对感染迹象的共识微乎其微。在394名参与者中,8%报告喉咙痛。在执行的334个GASRADT中,<1%为阳性。
■我们报告了首次标准化使用儿科扁桃体照片来评估城市生活的澳大利亚儿童的扁桃体大小。这提供了来自城市生活队列的概念证明,可以与其他环境中的儿童进行比较,这些儿童患有GAS咽炎或风湿热的风险很高,例如偏远生活的澳大利亚土著居民。
UNASSIGNED: Group A streptococcus (GAS) infections, such as pharyngitis and impetigo, can lead to rheumatic fever and rheumatic heart disease (RHD). Australian Aboriginal and Torres Strait Islander populations experience high rates of RHD and GAS skin infection, yet rates of GAS pharyngitis are unclear. Anecdotally, clinical presentations of pharyngitis, including tonsillar hypertrophy and sore throat, are uncommon. This study aimed to develop a standardised set of tonsil photographs and determine tonsil size distribution from an urban paediatric population.
UNASSIGNED: A prospective cohort of children aged 3-15 years were recruited at the public events \"Discover Day\" and \"Telethon Weekend\" (October 2017) in Perth, Western Australia, Australia. Tonsil photographs, symptomatology, and GAS rapid antigen detection tests (RADT) were collected. Tonsil size was graded from the photographs using the Brodsky Grading Scale of tonsillar hypertrophy (Brodsky) by two independent clinicians, and inter-rater reliability calculated. Pharyngitis symptoms and GAS RADT were correlated, and immediate results provided.
UNASSIGNED: Four hundred and twenty-six healthy children participated in the study over three days. The median age was seven years [interquartile range (IQR) 5.9-9.7 years]. Tonsil photographs were collected for 92% of participants, of which 62% were rated as good-quality photographs and 79% were deemed of adequate quality for assessment by both clinicians. When scored by two independent clinicians, 57% received the same grade. Average Brodsky grades (between clinicians) were 11%, 35%, 28%, 22% and 5% of grades 0,1,2,3 and 4, respectively. There was moderate agreement in grading using photographs, and minimal to weak agreement for signs of infection. Of 394 participants, 8% reported a sore throat. Of 334 GAS RADT performed, <1% were positive.
UNASSIGNED: We report the first standardised use of paediatric tonsil photographs to assess tonsil size in urban-living Australian children. This provides a proof of concept from an urban-living cohort that could be compared with children in other settings with high risk of GAS pharyngitis or rheumatic fever such as remote-living Australian Indigenous populations.