Pakistan prevalence survey in acute pharyngitis

Objective: To study the prevalence of Group A beta haemolytic Streptococcus in patients with acute pharyngitis and correlation of Modified Centor Score and Rapid Antigen Detection Test. Methods: The multi-centre, prospective, cross-sectional study was conducted in 8 major cities of Pakistan between June 2012 and February 2013, and comprised patients presenting with acute pharyngitis. The subjects were above 3 years of age presenting to primary care physician with sore throat, temperature over 100.4°F, tonsillar exudates and/or cervical adenopathy (duration of symptoms 14 days). They were scored using Modified Centor Score and were tested with Rapid Antigen Detection Test for Group A beta haemolytic Streptococcus. SPSS 19 was used for statistical analysis. Results: Of the 5140 patients, 1299(25.3%) tested positive, for RADT Group A beta haemolytic Streptococcus in acute pharyngitis. There was no significant difference across different age groups (p 0.08). There was a strong correlation between Modified Centor Score and Rapid Antigen Detection Test results (p 0.001). Of the patients with positive result, 3(0.4%) had a Modified Centor Score 0; 23(1.8%) had score of 1; 152(11.7%) had score of 2; 511(39.3%) had score of 3; and 609(46.9%) had Centor score of 4. Conclusion: The prevalence of Group A beta haemolytic Streptococcus as a cause of acute pharyngitis was 25.3%. Modified Centor Score had a strong positive correlation with Rapid Antigen Detection Test in identifying Group A beta haemolytic Streptococcus as a cause of acute pharyngitis.