American Journal of Pediatrics

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Prediction of Upper Limits of Normal Values of Anti Streptolysin ‘O’ Titres in Normal Healthy School Going Children of 6–16 Years

Received: Feb. 27, 2019    Accepted: Apr. 11, 2019    Published: Jun. 20, 2019
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Abstract

Antistreptolysin O test, an internationally gold standard test is widely used in detection of group A streptococcal infections and their sequelae at global level. An observational study was conducted at Bengaluru city during 2015-16. A total 454 children were randomly selected from the different schools in Bangalore city. As per the results, the sex ratio was 1:1(Male 230/454, Female 224/454) with mean age 12.58±2.63 years. The titre mean ASO value was 275.93±248.73 IU, median value was 202 IU. The average cut of ASO value was 256.53IU with good specificity (95.0%), sensitivity (88.05%), PPV (85.33%), NPV (68.93%); AUC was 0.93. The resulted findings was found to be statistically significant (P<0.01) and also this mean value will help for detection of streptococcal infections at population level (p<0.01). Majority of the cases were suffering from acute rheumatic fever (80%). Test algorithms was formulated by ROC analysis, the results showed that, the AUC of non-suppurative sequelae of Group-A streptococcal (GAS) infection of the throat (63.0%). The summing of the results concludes that, the ASO is a gold standard for the investigation of the disease progression at early stage (streptococcal and rheumatic fever). This present study will help to clinician’s for diagnose streptococcal infection at greater accuracy.

DOI 10.11648/j.ajp.20190502.17
Published in American Journal of Pediatrics ( Volume 5, Issue 2, June 2019 )
Page(s) 74-77
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

ASO, Children, ULN, streptococcal, ROC

References
[1] Special writing group of the committee on rheumatic fever, endocarditis and Kawasakidisease of the council on cardiovascular disease in the young of the American Heart Association: Guidelines for the diagnosis of rheumatic fever. Jones criteria, 1992 update. Jama 1992, 268: 2069-2073.
[2] Fauci AS, Brawnwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL eds. Harrison’s Principle of Internal Medicine. 14th edn. New York: McGraw-Hill; 2001; p 1340-1343.
[3] Pichichero ME, Marsocci SM, Murphy ML, Hoeger W, Green JL, Sorrento A. Incidence of streptococcal carriers in private practice. Arch Pediatr Adolesc Med 1999; l53: 624-628.
[4] Gooder H. Antistreptolysin O: Its interaction with streptolysin O, its titration and acomparison of some standard preparations. Bull WHO 1961; 25: 173-183.
[5] Dawson KP, Ameen AS, Nsanze H, Bin-oyhman S, Mustafa N. The prevalence of Group A streptococcal throat carriage in AL-Ain, United Arab Emirates. Ann Trop pediatrics1996; 16: 123-127.
[6] Klein GC, Baker CN and Jones WL. Upper limits of normal–antistreptolysin O and antideoxyribonuclease B titres. Applied Microbio 1971; 21: 999-1000.
[7] Stollerman GH, Lewis AT, Sehultz I, Taranta A. Relationship of immune response togroup A streptococci to the course of acute, chronic and recurrent rheumatic fever. Am JMet 1956; 20: 163-169.
[8] Report of the Adhoc committee to revise the Jones criteria (modified) of the council onrheumatic fever and congenital heart disease of the American Heart Association. Circulation 1965; 32: 664-668.
[9] Kaplan EL, Rothemel CD, Johnson DR. Antostreptolysin O and anti deoxyribonuclease B titres; normal values for children age 2 to 12 in the US. Int. Pediatrics 1998; 101; 86-88.
[10] Rajkumar S, Krishnamurthy R. Isolation of group A beta hemolytic streptococci in thetonsillopharynx of social children in Madras city and correlation with their clinical features. Jpn J Infect Dis 2001; 54: 137-139.
[11] Gharagozolo R, Gharamian P. The range of ASO titres among 3129 healthy individualin summer and winter in Tehran, Iran. J Pahlavi Med1976: 7; 323-333.
[12] Sethi S, Kaushik K, Kavya, et al., ASO titers innormal healthy school children of 5-15 years. J Indian Pediatrics 2003; 40: 1068-1071.
[13] Kotyal B Mahendrappa and Rajendra. Upper Limit of Normal Antistreptolysin-O Titer in Healthy School Children. J. Indian Pediatrics 2010; 47(17):1152-1156.
[14] Andrew C. Steer et al. Normal Ranges of Streptococcal Antibody Titers Are Similar Whether Streptococci Are Endemic to the Setting or Not. Accepted manuscript posted online 3 December 2008, doi: 10.1128/CVI.00291-08Clin Vaccine Immunol February 2009 vol. 16 no. 2 172-175.
[15] M G Karmakar, Vineetha Venugopal, Leela Joshi and Richea Kamboj. Evaluation and re evaluation of upper limits of , normal values of antistreotolysin O and antideoxyribonuclease B in Mumbai. Indian J Med Res 2004; 119: 26-28.
[16] Danchin M H, Carlin J B, Devenish W, Nolan T M, Carapetis J R. New normal range of Anti streptolysin O and anti deoxyribonuclease B titers for Australian children. J Paediatr Child Health. 2005 Nov; 41(11): 583-586.
[17] Edward L Kaplan, Constance D, Rothermel, D wight R Johnson. Anti streptolysin O and anti DNase B titers, normal values for children ages 2-12 years in United States. Int. Pediatrics 1998; 101:86-88.
[18] Zaman MM, Hassan MM, Ahmed J, Zareen S, Jalil M Q, Eshque N, Khanom R et al. Streptococcal antibodies among rural school children in Bangladesh. Bang. Med Res Counc Bull 2002 April; 28 (1): 1-6.
[19] Berriox X, Merbage S, Rodriguez C, Pierotic M, Morga W. Streptococcal antibodies in general population. Comparative study in two periods at a healthy service, Rev ChilPaediatr 1989 Nov-Dec; 60 (6); 333-337.
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    Chikkanarasa Reddy Parthihally Sanjeevaiah, Mohammedmusthaq Ahamed, Basavarajaiah Doddagangavadi Mariyappa. (2019). Prediction of Upper Limits of Normal Values of Anti Streptolysin ‘O’ Titres in Normal Healthy School Going Children of 6–16 Years. American Journal of Pediatrics, 5(2), 74-77. https://doi.org/10.11648/j.ajp.20190502.17

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    ACS Style

    Chikkanarasa Reddy Parthihally Sanjeevaiah; Mohammedmusthaq Ahamed; Basavarajaiah Doddagangavadi Mariyappa. Prediction of Upper Limits of Normal Values of Anti Streptolysin ‘O’ Titres in Normal Healthy School Going Children of 6–16 Years. Am. J. Pediatr. 2019, 5(2), 74-77. doi: 10.11648/j.ajp.20190502.17

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    AMA Style

    Chikkanarasa Reddy Parthihally Sanjeevaiah, Mohammedmusthaq Ahamed, Basavarajaiah Doddagangavadi Mariyappa. Prediction of Upper Limits of Normal Values of Anti Streptolysin ‘O’ Titres in Normal Healthy School Going Children of 6–16 Years. Am J Pediatr. 2019;5(2):74-77. doi: 10.11648/j.ajp.20190502.17

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  • @article{10.11648/j.ajp.20190502.17,
      author = {Chikkanarasa Reddy Parthihally Sanjeevaiah and Mohammedmusthaq Ahamed and Basavarajaiah Doddagangavadi Mariyappa},
      title = {Prediction of Upper Limits of Normal Values of Anti Streptolysin ‘O’ Titres in Normal Healthy School Going Children of 6–16 Years},
      journal = {American Journal of Pediatrics},
      volume = {5},
      number = {2},
      pages = {74-77},
      doi = {10.11648/j.ajp.20190502.17},
      url = {https://doi.org/10.11648/j.ajp.20190502.17},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajp.20190502.17},
      abstract = {Antistreptolysin O test, an internationally gold standard test is widely used in detection of group A streptococcal infections and their sequelae at global level. An observational study was conducted at Bengaluru city during 2015-16. A total 454 children were randomly selected from the different schools in Bangalore city. As per the results, the sex ratio was 1:1(Male 230/454, Female 224/454) with mean age 12.58±2.63 years. The titre mean ASO value was 275.93±248.73 IU, median value was 202 IU. The average cut of ASO value was 256.53IU with good specificity (95.0%), sensitivity (88.05%), PPV (85.33%), NPV (68.93%); AUC was 0.93. The resulted findings was found to be statistically significant (P<0.01) and also this mean value will help for detection of streptococcal infections at population level (p<0.01). Majority of the cases were suffering from acute rheumatic fever (80%). Test algorithms was formulated by ROC analysis, the results showed that, the AUC of non-suppurative sequelae of Group-A streptococcal (GAS) infection of the throat (63.0%). The summing of the results concludes that, the ASO is a gold standard for the investigation of the disease progression at early stage (streptococcal and rheumatic fever). This present study will help to clinician’s for diagnose streptococcal infection at greater accuracy.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Prediction of Upper Limits of Normal Values of Anti Streptolysin ‘O’ Titres in Normal Healthy School Going Children of 6–16 Years
    AU  - Chikkanarasa Reddy Parthihally Sanjeevaiah
    AU  - Mohammedmusthaq Ahamed
    AU  - Basavarajaiah Doddagangavadi Mariyappa
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    DO  - 10.11648/j.ajp.20190502.17
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20190502.17
    AB  - Antistreptolysin O test, an internationally gold standard test is widely used in detection of group A streptococcal infections and their sequelae at global level. An observational study was conducted at Bengaluru city during 2015-16. A total 454 children were randomly selected from the different schools in Bangalore city. As per the results, the sex ratio was 1:1(Male 230/454, Female 224/454) with mean age 12.58±2.63 years. The titre mean ASO value was 275.93±248.73 IU, median value was 202 IU. The average cut of ASO value was 256.53IU with good specificity (95.0%), sensitivity (88.05%), PPV (85.33%), NPV (68.93%); AUC was 0.93. The resulted findings was found to be statistically significant (P<0.01) and also this mean value will help for detection of streptococcal infections at population level (p<0.01). Majority of the cases were suffering from acute rheumatic fever (80%). Test algorithms was formulated by ROC analysis, the results showed that, the AUC of non-suppurative sequelae of Group-A streptococcal (GAS) infection of the throat (63.0%). The summing of the results concludes that, the ASO is a gold standard for the investigation of the disease progression at early stage (streptococcal and rheumatic fever). This present study will help to clinician’s for diagnose streptococcal infection at greater accuracy.
    VL  - 5
    IS  - 2
    ER  - 

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Author Information
  • Department of Paediatrics, Bengaluru Medical College and Research institute, Bengaluru, Republic of India

  • Department of Paediatrics, Bengaluru Medical College and Research institute, Bengaluru, Republic of India

  • Department of Statistics and Computer Science, Diary Science College, KVAFSU(B), Bengaluru, Republic of India

  • Section