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Table 4 Sensitivity, specificity, PPV and NPV of signs, symptoms and case definitions

From: Evaluation of case definitions to detect respiratory syncytial virus infection in hospitalized children below 5 years in Rural Western Kenya, 2009–2013

Age group Case definition RSV positive n = 470 RSV negative n = 3340 Sensitivity %(95 % CI) Specificity %(95 % CI) PPV %(95 % CI) NPV %(95 % CI)
All under 5   n % n %     
  Cough 453 96.4 3023 90.5 96.4(94.7,98.1) 9.5(8.5,10.5) 13.0(11.9,14.2) 94.9(92.6,97.3)
  Difficulty breathing 291 61.9 1715 51.3 61.9(57.5,66.3) 48.7(47.0,50.4) 14.5(13.0,16.1) 90.1(88.7,91.5)
  Night sweats 337 71.7 2224 66.6 71.7(67.6,75.8) 33.4(31.8,35.0) 13.2(11.9,14.5) 89.4(87.6,91.1)
  Tachypnea 288 61.3 1948 58.3 61.3(56.9,65.7) 41.7(40.0,43.4) 12.9(11.5,14.3) 88.4(86.9,90.0)
  Hypoxia 121 25.9 507 15.2 25.9(21.9,29.8) 84.8(83.5,86.0) 19.3(16.2,22.4) 89.1(88.0,90.1)
  Wheeze 125 26.6 569 17.0 26.6(22.6,30.6) 83.0(81.7,84.2) 18.0(15.2,20.9) 88.9(87.8,90.0)
  Stridor 36 7.7 142 4.3 7.7(5.3,10.1) 95.8(95.1,96.4) 20.2(14.3,26.1) 88.1(87.0,89.1)
  Nasal flaring 146 31.1 739 22.1 31.1(26.9,35.3) 77.9(76.5,79.3) 16.5(14.1,18.9) 88.9(87.8,90.1)
  Chest In-drawing 145 30.9 699 20.9 30.9(26.7,35.0) 79.1(77.7,80.5) 17.2(14.6,19.7) 89.0(87.9,90.2)
  SARI 389 82.8 2579 77.2 82.8(79.4,86.2) 22.8(21.4,24.2) 13.1(11.9,14.3) 90.4(88.4,92.4)
  hILI 112 23.8 678 20.3 23.8(20.0,27.7) 79.7(78.3,81.1) 14.2(11.7,16.6) 88.2(87.0,89.3)
  IMCI Non-severe pneumonia 95 20.2 777 23.3 20.2(16.6,23.8) 76.7(75.3,78.2) 10.9(8.8,13.0) 87.2(86.0,88.4)
  IMCI severe pneumonia 71 15.1 310 9.3 15.1(11.9,18.3) 90.7(89.7,91.7) 18.6(14.7,22.6) 88.4(87.3,89.4)
  IMCI very severe pneumonia 236 50.2 1719 51.5 50.2(45.7,54.7) 48.5(46.8,50.2) 12.1(10.6,13.5) 87.4(85.9,88.9)
  Cough or difficulty breathing plus hypoxia, chest in-drawing or wheeze 257 54.7 1316 39.4 54.7(50.2,59.2) 60.1(58.9,62.3) 16.3(14.5,18.2) 90.5(89.3,91.7)
Children < 1 years n 238   1518      
  Cough 232 97.5 1373 90.4 97.5(95.5,99.5) 9.6(8.1,11.0) 14.5(12.7,16.2) 96.0(92.9,99.1)
  Difficulty breathing 166 69.8 863 56.8 69.8(63.9,75.6)a 43.2(40.7,45.6)a 16.1(13.9,18.4) 90.1(87.9,92.3)
  SARI 189 79.4 1175 77.4 79.4(74.3,84.6) 22.6(20.5,24.7) 13.9(12.0,15.7) 87.5(84.2,90.8)
  hILI 52 21.9 307 20.2 21.9(16.6,27.1) 79.8(77.8,81.8) 14.5(10.8,18.1) 86.7(84.9,89.5)
  IMCI Non-severe pneumonia 34 14.3 312 20.6 14.3(9.8,18.7)a 79.5(77.4,81.5)a 9.8(6.7,13.0) 85.5(83.7,87.4)
  IMCI severe pneumonia 46 19.3 175 11.5 19.3(14.3,24.3)a 88.5(86.9,90.1)a 20.8(15.5,26.2) 87.5(85.8,89.2)
  IMCI very severe pneumonia 117 49.2 726 47.8 49.2(42.8,55.5) 52.2(49.7,54.7) 13.9(11.6,16.2) 86.8(84.6,89.0)
  Cough or difficulty breathing plus hypoxia, chest in-drawing or wheeze 157 66.0 698 46.0 66.0(60.0,72.0)a 54.0(51.5,56.5)a 18.4(15.8,21.0) 91.0(89.1,92.9)
Children 1- < 5 years n 232   1822      
  Cough 221 95.3 1650 90.6 95.3(92.5,98.0) 9.4(8.1,10.8) 11.8(10.4,13.3) 94.0(90.6,97.4)
  Difficulty breathing 125 53.9 852 46.8 53.9(47.5,60.3)a 53.2(51.0,55.5)a 12.8(10.7,14.9) 90.0(88.3,91.9)
  SARI 200 86.2 1404 77.1 86.2(81.8,90.6) 22.9(21.0,24.9) 12.5(10.9,14.1) 92.9(90.5,95.3)
  hILI 60 25.9 371 20.4 25.9(20.2,31.5) 79.6(77.8,81.5) 13.9(10.7,17.2) 89.4(87.9,90.9)
  IMCI Non-severe pneumonia 61 26.3 465 25.5 26.3(20.6,32.0)a 74.5(72.5,76.5)a 11.6(8.9,14.3) 88.8(87.2,90.4)
  IMCI severe pneumonia 25 10.8 135 7.4 10.8(6.8,14.8)a 92.6(91.4,93.8)a 15.6(10.0,21.3) 89.1(87.7,90.5)
  IMCI very severe pneumonia 119 51.3 993 54.5 51.3(44.9,57.7) 45.5(43.2,47.8) 10.7(8.9,12.5) 88.0(85.9,90.1)
  Cough or difficulty breathing plus hypoxia, chest in-drawing or wheeze 100 43.1 618 33.9 43.1(36.7,495)a 66.1(63.9,68.3)a 13.9(11.4,16.5) 90.1(88.5,91.7)
  1. aSensitivity and specificity significantly different between the two age groups