Diagnostic Accuracy of Severe Acute Respiratory Infection Definitions in Hospitalized Children: A Systematic Review and Meta-Analysis.
World Health Organization 2014 severe acute respiratory infection definition has low specificity for detecting influenza in hospitalized children
Diagnostic Accuracy of Severe Acute Respiratory Infection Definitions in Hospitalized Children: A Systematic Review and Meta-Analysis.
IMPORTANCE: Following the 2009 H1N1 influenza pandemic, the World Health Organization (World Health Organization) established a new case definition for severe acute respiratory infection (severe acute respiratory infection) for viral surveillance.
To evaluate the diagnostic accuracy of severe acute respiratory infection case definitions in detecting microbiologically confirmed viral respiratory tract infections among hospitalized children.
Definition wrongly flagged many non-influenza cases as severe acute respiratory infection.
Included studies represent surveillance data from 65 inpatient sites across 8 countries, using data from 2007 to 2023.
The most common definition was the 2014 World Health Organization severe acute respiratory infection (9 studies).
Viral pathogens included influenza (10 studies) and respiratory syncytial virus (RSV; 6 studies).
In younger subgroups, sensitivity appeared to decrease while specificity appeared to increase for both influenza and RSV.
In this systematic review and meta-analysis of 13 studies, the World Health Organization 2014 severe acute respiratory infection definition demonstrated reduced sensitivity and increased specificity in younger pediatric cohorts, suggesting that surveillance systems that rely on severe acute respiratory infection case definitions may potentially underestimate disease burden in children.