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27-09-2024 | Streptococci | Research

The relationship between group A streptococcus test positivity and clinical findings in tonsillopharyngitis in children: systematic review and meta-analysis

Authors: Ayşe Eroğlu, Özge Karakaya Suzan, Tuğçe Kolukısa, Özge Kaya, Mehtap Metin Karaaslan, Yeliz Tanrıverdi Çaycı, Mustafa Altındiş, Murat Bektaş, Nursan Çınar

Published in: Infection

Abstract

Purpose

This study aimed to present an evidence-based conclusion through a systematic meta-analysis to distinguish clinical signs and symptoms associated with the presence of group A beta-hemolytic streptococcus, as confirmed by throat culture or rapid test, from those in cases without culture confirmation.

Methods

The study protocol has been published in PROSPERO (CRD42023450854). Studies published between January 1, 2013 and August 15, 2023 were scanned in seven databases. The methodological quality of the articles was assessed using The Joanna Briggs Institution (JBI) Cross-Sectional Studies and Cohort Studies checklist. Effect size calculations were made using fixed effects and random effects models.

Results

A total of 22 articles were included in the systematic review, with 14 included in the meta-analysis. The prevalence of streptococcal pharyngitis in these studies ranged from 7.3 to 44.1%. According to the meta-analysis results, a significant association was observed between GAS test positivity and the presence of tonsillar exudate, palatal petechiae, tonsillar hypertrophy, dysphagia, fever, and cervical lymphadenopathy (p < 0.05). No significant relationship was found between GAS test positivity and symptoms such as headache, sore throat, cough, absence of cough, hoarseness, scarlatiniform rash, tonsillar erythema, vomiting, rhinorrhea, and abdominal pain (p > 0.05).

Conclusion

The findings of the meta-analysis suggest that, in addition to the Centor criteria, palatal petechiae, dysphagia, and tonsillar hypertrophy are noteworthy indicators of GAS infection. Contrary to previous studies, our meta-analysis indicates that symptoms such as headache, sore throat, cough, absence of cough, hoarseness, scarlatiniform rash, tonsillar erythema, vomiting, rhinorrhea, and abdominal pain may not be associated with streptococcal infection. Further research is needed to elucidate these findings.

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Title: The relationship between group A streptococcus test positivity and clinical findings in tonsillopharyngitis in children: systematic review and meta-analysis
Authors: Ayşe Eroğlu
Özge Karakaya Suzan
Tuğçe Kolukısa
Özge Kaya
Mehtap Metin Karaaslan
Yeliz Tanrıverdi Çaycı
Mustafa Altındiş
Murat Bektaş
Nursan Çınar
Publication date: 27-09-2024
Publisher: Springer Berlin Heidelberg
Keywords: Streptococci
Sore Throat
Petechiae
Pharyngitis
Pharyngitis
Cough
Cough
Cough
Lymphadenopathy
Dysphagia
Dysphagia
Dysphagia
Published in: Infection
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI: https://doi.org/10.1007/s15010-024-02395-7

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