Early Warning Infectivity Score for Acute Bacterial Diarrhea

 

Patient selection: acute diarrhea in community with high prevalence of infectious bacterial diarrhea (Salmonella, Shigella, etc).

 

Parameters:

(1) dietary hygiene

(2) abdominal pain

(3) body temperature in °C

(4) leukocytes in stool (fecal smear examination)

 

Parameter	Finding	Points
dietary hygiene	good	0
	poor	1
abdominal pain	no	0
	yes	1
body temperature	<= 37.3°C	0
	>=37.4°C	3
leukocytes in stool	no	0
	yes	4

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 9

• A score >= 5 was associated with bacterial diarrhea.

 

Performance:

• The sensitivity was 97% and specificity 90%.

• The AUC under the ROC was 0.975 (although seems high for 90% specificity).

• The authors describe a population with a high pre-test probability for infectivity. The score may not perform as well in a country with better hygiene.