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The World Health Organization clinical decision rule was specific but not sensitive for predicting group A β haemolytic streptococcus in children with pharyngitis

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 Q In children with complaints of sore throat, how accurate is the World Health Organization (WHO) clinical decision rule for predicting group A β haemolytic streptococcus (GABHS) on throat culture?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Infectious disease ★★★★★★☆ Paediatrics ★★★★☆☆☆


Embedded ImageDesign:

prospective cohort study to validate the previously developed WHO clinical decision rule for GABHS pharyngitis.

Embedded ImageSetting:

3 urban paediatric outpatient clinics in Rio de Janiero, Brazil; Cairo, Egypt; and Zagreb, Croatia.

Embedded ImagePatients:

1810 children aged 2–12 years (mean age 5 y, 57% boys) with complaints of sore throat (among 2255 with acute respiratory infections). Exclusion criteria were antibiotic use (oral within 3 d or intramuscular within 28 d), history of rheumatic fever or heart disease, or illness requiring hospital admission. …

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  • For correspondence: Dr A W Rimoin, UCLA School of Public Health, Los Angeles, CA, USA. arimoin{at}

  • Sources of funding: USAID and World Health Organization.