Preliminary fast diagnosis of severe fever with thrombocytopenia syndrome with clinical and epidemiological parameters.

Abstract

To identify specific clinical and epidemiological parameters for clinical diagnosis of SFTSV infection with relatively higher accuracy. 231 suspected cases of SFTS were reported by various medical institutions from 2011 to 2013 in Jiangsu Province, China. They were followed with SFTSV diagnosis tests and interview-administered questionnaires about demographic characteristics, clinical symptoms and epidemiological exposure factors. Univariate and multivariable logistic regression analysis were used to examine the diagnostic value of these parameters. SFTSV infection occurred only from April to October annually and usually in hilly areas of specific regions. Three prediction models of SFTSV infection were constructed. Model 3 with clinical and epidemiological parameters combined the benefits of both Model 1and Model 2, which was optimal and had an overall accuracy of 80.2%. Independent indicators for clinical diagnosis of SFTSV infection in Model 3 were as follows: lymphadenopathy (P = 0.01), leucopenia (P<0.01), age >50 years (P = 0.01), tick bites (P<0.01), raising domestic animals in the residential areas (P<0.01) and farming (P = 0.03). Our results show that using a combination of clinical and epidemiological parameters may be a feasible strategy to provide preliminary fast diagnosis as differentiating SFTSV infection from SFTS-like diseases, thus reducing the risk of misdiagnosis.