Main Article Content
Abstract
RÉSUMÉ
Objectif. Le but de notre étude était d’évaluer la performance du « score for allergic rhinitis » dans le diagnostic de la rhinite allergique à Yaoundé. Patients et méthodes. Il s’agit d’une étude transversale menée d’avril à août 2019 (5 mois) dans cinq hôpitaux de Yaoundé. Cinquante-deux patients (7 à 51 ans) présentant de manière récurrente ou permanente au moins deux signes parmi rhinorrhée, éternuement et obstruction nasale ont été inclus dans l’étude. Ils ont été regroupés en rhinitique allergique et non rhinitique allergique selon leur réaction aux tests cutanés allergiques (gold-standard) à 9 allergènes. Un score variant de 0 à 16 leur a été attribué selon les réponses au questionnaire « Score for allergic rhinitis » qui porte sur 8 caractéristiques de la rhinite allergique. Un tableau de contingence à double entrée a été établi pour le calcul des indices de performance dudit score pour le diagnostic de rhinite allergique. Résultats. Quarante des 52 patients avaient une rhinite allergique. Les acariens étaient les allergènes les plus incriminés. Tous les patients inclus dans l’étude avaient un « score for allergic rhinitis » ≥ 7 et 43 patients (rhinite allergique n=33 et non rhinite allergique n= 10) un score compris entre 10 et 13. Un score de 12 constituait le seuil optimisant simultanément la sensibilité (52%), la spécificité (50%), la valeur prédictive positive (77,78%) et la valeur prédictive négative (24%) de ce test. En-deçà, le score était très sensible et peu spécifique et au-delà il était peu sensible et moyennement spécifique. Conclusion. La bonne sensibilité du « score for allergic rhintis » en fait un outil de triage important pour le rhinologiste dans le diagnostic de la rhinite allergique dans un contexte de non-disponibilité des tests cutanés allergiques en pratique courante.
ABSTRACT
Aim. To evaluate the performance of the "score for allergic rhinitis" for diagnosing allergic rhinitis in Yaounde. Patients and methods. This was a cross-sectional study that was conducted from April to August 2019 (5 months) in five hospitals of Yaounde. Fifty-two patients (7-51 years old, 35 women) suffering from at least two recurrent or permanent signs comprising rhinorrhea, sneezing and nasal obstruction, were included in the study. They were classified as allergic rhinitis and non-allergic rhinitis according to their reaction to 9 allergens on skin prick test (gold standard). A score ranging from 0 to 16 was assigned to them according to their answers to the "Score for allergic rhinitis" questionnaire which encompasses 8 characteristics of allergic rhinitis. A double entry contingency table was established to calculate the performance indices of the said score for diagnosing allergic rhinitis. Results. Forty patients (77%) had allergic rhinitis. House dust mites were the most common allergens. All patients included in the study had a "score for allergic rhinitis" ≥ 7 and 43 patients (allergic rhinitis n=33 and non-allergic rhinitis n= 10) a score between 10 and 13. A score of 12 constituted the threshold optimizing simultaneously the sensitivity (52%), specificity (50%), positive predictive value (77.78%) and negative predictive value (24%) of this tool. Below this threshold, the score was very sensitive and somewhat specific. Conclusion. The good sensitivity of the "score for allergic rhinitis" makes it an important triage tool for rhinologist in diagnosing allergic rhinitis in a context of poor-availability of allergic skin tests in daily practice.
Keywords
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
- Braun J J, Devillier P , Wallaert B, Rancé F, Jankowski R, Acquavita J-L, Beley G, Demoly P. Recommandations pour le diagnostic et la la prise en charge de la rhinite allergique (épidémiologie et physiopathologie exclues) - texte long Revue française d'allergologie. 2010;27:79-105.
- Skoner D. Allergic rhinitis: definition,epidemiology,pathophysiology, detection and diagnosis. Journal of Allergy and Clinical Immunology. 2001;108(1):2-8.
- Bousquet J, Van Cauwenberg P, Khaltaev N, ARIA workshop group, World Health Organization. Allergic rhinitis and its impact on asthma. The Journal of allergy and clinical immunology. 2001;108(5):147-334.
- Hamouda S, Scheinmann P, de Blic J. Diagnostic et fréquence de la rhinite allergique chez l'enfant asthmatique. Revue française d'allergologie. 2006;46:584-7.
- Sanli A, Aydin Sadate, Ates gunay, Eken Mehmet, Celebi özlem. Comparison of nasal smear eosinophilia with skin prick test positivity in patients with allergic rhinitis. 2006;16(2):60-3.
- Schwartz D A. Gene-environment interactions and airway disease in children. pediatrics. 2009;123(3):151-9.
- Annesi-Maesano I, Didier A , Klossek M, Chanal I, Moreau D, Bousquet J. Le Score For Allergic Rhinitis (SFAR) - version française. Revue Française d'allergologie et d'immunologie clinique. 2004;44:396-99.
- Pefura-Yone EW, Kengne AP, Balkissou AD, et al. Prevalence of asthma and allergic rhinitis among adults in Yaounde, Cameroon. PLoS One 2015;10:e0123099. 10.1371/journal.pone.0123099
- Alharethy S, Wedami MA, Syouri F, et al. Validation of the Arabic version of the score for allergic rhinitis tool. Ann Saudi Med. 2017;37(5):357-361.
- Cingi C, Songu M, Ural A, et al. The Score For Allergic Rhinitis study in Turkey. Am J Rhinol Allergy. 2011; 25(5):333-7.
- Tantilipikorn P, Pinkaew B, Talek K, Assanasen P, Triphoon Suwanwech TS, Bunnag C. Pattern of allergic sensitization in chronic rhinitis: A 19-year retrospective study. Asian Pac J Allergy Immunol. 2021 Sep;39(3):156-162. doi: 10.12932/AP-080719-0597. PMID: 32247303
- Ciprandi G, Alesina R, Ariano R, Aurnia P, et al. Characteristics of patients with allergic polysensitization: the POLISMAIL study. European annals of allergy and clinical immunology. 2008;40(3):77-83.
- Bellonti J A, Wallerstedt DB. Allergic rhinitis update: Epiddemiology and nature history. Allergy Asthma Proceedings. 2000;21(6):367-70.
- Rosário CS, Cardozo CA, Neto HJC, Filho NAR. Do gender and puberty influence allergic diseases? Allergol Immunopathol (Madr). 2021 Mar 1;49(2):122-125. doi: 10.15586/aei.v49i2.49. PMID: 33641303.
- Ologe FE, Adebola SO, Dunmade AD, Adeniji KA, Oyejola BA. Symptom score for allergic rhinitis. Otolaryngol Head Neck Surg. 2013;148(4):557-63.
- Lam SC, Yeung CCY, Chan JHM, Lam DWC, Lam AHY, Annesi-Maesano I, Bousquet J. Adaptation of the Score for Allergic Rhinitis in the Chinese Population: Psychometric Properties and Diagnostic Accuracy. Int Arch Allergy Immunol. 2017;173(4):213-224.
- Nendaz M.R., Perrier A. Sensibilité, spécificité, valeur prédictive positive et valeur prédictive négative d’un tes diagnostique. Rev mal respir 2004 ; 21 : 390-3.
References
Braun J J, Devillier P , Wallaert B, Rancé F, Jankowski R, Acquavita J-L, Beley G, Demoly P. Recommandations pour le diagnostic et la la prise en charge de la rhinite allergique (épidémiologie et physiopathologie exclues) - texte long Revue française d'allergologie. 2010;27:79-105.
Skoner D. Allergic rhinitis: definition,epidemiology,pathophysiology, detection and diagnosis. Journal of Allergy and Clinical Immunology. 2001;108(1):2-8.
Bousquet J, Van Cauwenberg P, Khaltaev N, ARIA workshop group, World Health Organization. Allergic rhinitis and its impact on asthma. The Journal of allergy and clinical immunology. 2001;108(5):147-334.
Hamouda S, Scheinmann P, de Blic J. Diagnostic et fréquence de la rhinite allergique chez l'enfant asthmatique. Revue française d'allergologie. 2006;46:584-7.
Sanli A, Aydin Sadate, Ates gunay, Eken Mehmet, Celebi özlem. Comparison of nasal smear eosinophilia with skin prick test positivity in patients with allergic rhinitis. 2006;16(2):60-3.
Schwartz D A. Gene-environment interactions and airway disease in children. pediatrics. 2009;123(3):151-9.
Annesi-Maesano I, Didier A , Klossek M, Chanal I, Moreau D, Bousquet J. Le Score For Allergic Rhinitis (SFAR) - version française. Revue Française d'allergologie et d'immunologie clinique. 2004;44:396-99.
Pefura-Yone EW, Kengne AP, Balkissou AD, et al. Prevalence of asthma and allergic rhinitis among adults in Yaounde, Cameroon. PLoS One 2015;10:e0123099. 10.1371/journal.pone.0123099
Alharethy S, Wedami MA, Syouri F, et al. Validation of the Arabic version of the score for allergic rhinitis tool. Ann Saudi Med. 2017;37(5):357-361.
Cingi C, Songu M, Ural A, et al. The Score For Allergic Rhinitis study in Turkey. Am J Rhinol Allergy. 2011; 25(5):333-7.
Tantilipikorn P, Pinkaew B, Talek K, Assanasen P, Triphoon Suwanwech TS, Bunnag C. Pattern of allergic sensitization in chronic rhinitis: A 19-year retrospective study. Asian Pac J Allergy Immunol. 2021 Sep;39(3):156-162. doi: 10.12932/AP-080719-0597. PMID: 32247303
Ciprandi G, Alesina R, Ariano R, Aurnia P, et al. Characteristics of patients with allergic polysensitization: the POLISMAIL study. European annals of allergy and clinical immunology. 2008;40(3):77-83.
Bellonti J A, Wallerstedt DB. Allergic rhinitis update: Epiddemiology and nature history. Allergy Asthma Proceedings. 2000;21(6):367-70.
Rosário CS, Cardozo CA, Neto HJC, Filho NAR. Do gender and puberty influence allergic diseases? Allergol Immunopathol (Madr). 2021 Mar 1;49(2):122-125. doi: 10.15586/aei.v49i2.49. PMID: 33641303.
Ologe FE, Adebola SO, Dunmade AD, Adeniji KA, Oyejola BA. Symptom score for allergic rhinitis. Otolaryngol Head Neck Surg. 2013;148(4):557-63.
Lam SC, Yeung CCY, Chan JHM, Lam DWC, Lam AHY, Annesi-Maesano I, Bousquet J. Adaptation of the Score for Allergic Rhinitis in the Chinese Population: Psychometric Properties and Diagnostic Accuracy. Int Arch Allergy Immunol. 2017;173(4):213-224.
Nendaz M.R., Perrier A. Sensibilité, spécificité, valeur prédictive positive et valeur prédictive négative d’un tes diagnostique. Rev mal respir 2004 ; 21 : 390-3.