Diagnosis of acute tonsillopharyngitis in primary care: a new approach for low-resource settings

Abstract

Background: Diagnosing GABHS (Group A-beta Hemolytic Streptococcus) tonsillopharyngitis by clinical scoring is a recommended approach in developed countries, but there is still much controversy for low resource settings.

Aim: We aimed to assess the impact of Centor criteria with the support of practical laboratory tests.

Methods: We prospectively included patients complaining sore throat (N = 282). We evaluated them in terms of Centor scoring and performed white blood cell count (WBC), C-reactive protein (CRP), rapid antigen detecting test, and throat culture.

Results: In GABHS cases (n = 32, 11·3%), two of the criteria were observed to be positive in more than half of the cases (n = 19, 59·3%), while 13 (40·7%) cases met three/four criteria. The specificity of having two criteria was found to be 65·5% and increased to 91·5% after including CRP and WBC.

Conclusion: Centor criteria could be safely used to reduce unnecessary antibiotic usage for tonsillopharyngitis in developing countries.

Keywords:

• Acute tonsillopharyngitis
• Centor scoring
• CRP
• Primary care
• Rapid antigen detecting test
• WBC

This work was supported by Uludağ University Scientific Research Projects Found. This manuscript was polished and got ready for submission by SPI (job no. 20110729221156).