Standard determination of clinical case of measles in conditions of its elimination

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Abstract

Objective. To develop a standard determination of a clinical case of measles in conditions of its elimination.

Materials and methods. The study included 28 patients with measles (main group) and 30 with infectious mononucleosis (comparison group). By means of correlation analysis, among clinicolaboratory indicators there was determined a list of clinical signs, which statistically significantly were more often identified in patients with measles compared to patients with infectious mononucleosis. The mathematical model was developed using the method of logistic regression, which helped to single out the most qualitative binary classifiers directly connected with diagnostic probability of measles. Sensitivity and specificity of the obtained model were calculated. For statistical processing IBM SPSS Statistics 26 was used.

Results. To carry out a standard determination of a clinical case of measles with the presence of combined clinicolaboratory symptoms, the mathematical model was developed, described by the following equation: р=1/(1+е-z) · 100, where z=71,7+36,8 · Х dry cough +53,5 · Х maculo-papular rash +17,6 · Х damages of eyes in the form of conjunctivitis and/or sclerite. Taking into account the regression coefficient values, such clinicolaboratory symptoms as maculo-papular rash, damages of eyes in the form of conjunctivitis and/or sclerite were directly connected with diagnostic probability of the diagnosis “Measles”. The determination coefficient of the obtained model was R2 = 0,97, p < 0,001. The sensitivity of the model was 96.4 %, specificity – 100 %, efficiency – 98 %.

Conclusions. In conditions of measles elimination, the combination of maculo-papular rash, damages of eyes in the form of conjunctivitis and/or sclerite allows confirming the clinical diagnosis of measles with the probability of 98 %.

About the authors

V. V. Semerikov

E.A. Vagner Perm State Medical University

Email: Nina40000@yandex.ru

MD, PhD, Professor, Department of Epidemiology and Hygiene

Russian Federation, Perm

N. N. Vorobyova

E.A. Vagner Perm State Medical University

Author for correspondence.
Email: Nina40000@yandex.ru

MD, PhD, Professor, Head of Department of Infectious Diseases

Russian Federation, Perm

N. O. Postanogova

E.A. Vagner Perm State Medical University

Email: Nina40000@yandex.ru

Assistant, Department of Pediatrics with Course of Polyclinic Pediatrics

Russian Federation, Perm

M. A. Okishev

E.A. Vagner Perm State Medical University

Email: Nina40000@yandex.ru

Candidate of Medical Sciences, Associate Professor, Department of Infectious Diseases

Russian Federation, Perm

E. Yu. Uvarova

Perm Regional Clinical Hospital of Infectious Diseases

Email: Nina40000@yandex.ru

Head of Children’s Hospital

Russian Federation, Perm

A. P. Nebolsina

Perm Regional Clinical Hospital of Infectious Diseases

Email: Nina40000@yandex.ru

Deputy Head Physician

Russian Federation, Perm

N. A. Metelkina

Perm Regional Clinical Hospital of Infectious Diseases

Email: Nina40000@yandex.ru

hospital epidemiologist

Russian Federation, Perm

L. V. Sofronova

E.A. Vagner Perm State Medical University

Email: Nina40000@yandex.ru

MD, PhD, Professor, Department of Pediatrics with Course of Polyclinic Pediatrics

Russian Federation, Perm

A. V. Nikolaev

E.A. Vagner Perm State Medical University

Email: Nina40000@yandex.ru

resident, Department of Infectious Diseases

Russian Federation, Perm

References

  1. Pokazatel' smertnosti ot kori vo vsem mire, available at: https://www.who.int/ru/news/item/12-11-2020-worldwide-measles-deaths-climb-50-from-2016-to-2019-claiming-over-207-500-lives-in-2019
  2. VOZ / Evropa. Kor' i krasnukha, available at: https://www.euro.who.int/en/health-topics/communicable-diseases/measles-and-rubella/measles-and-rubella
  3. National action Plan for the implementation of the program "Elimination of measles and rubella, achieving sporadic incidence of mumps in the Russian Federation" (2021–2025), approved by the Head of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare and the Minister of Health of the Russian Federation. Moscow 2021 (in Russian).
  4. On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2019: State report. Moscow: Federal service for supervision of consumer rights protection and human welfare 2020; 299 (in Russian).
  5. On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2020: State report. Moscow: Federal service for supervision of consumer rights protection and human welfare 2021; 256 (in Russian).
  6. Platonova T.A., Golubkova A.A., Smirnova S.S. To the question of the causes of the intensification of the epidemic process of measles at the stage of elimination of infection and the forecast of the development of the situation in the near and long term. Detskie infekcii 2021; 20 (1): 51–55 (in Russian).
  7. Fletcher R., Fletcher S., Wagner E. Clinical epidemiology. The essentials. Moscow: Media Sphera 1998; 352 (in Russian).

Supplementary files

Supplementary Files
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2. Fig. 1. Frequency of occurrence of the main clinical symptoms in patients with measles infection and infectious mononucleosis, %

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3. Fig. 2. Frequency of occurrence of major laboratory abnormalities in patients, %

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Copyright (c) 2022 Semerikov V.V., Vorobyova N.N., Postanogova N.O., Okishev M.A., Uvarova E.Y., Nebolsina A.P., Metelkina N.A., Sofronova L.V., Nikolaev A.V.

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