Diagnostic precision of local and World Health Organization definitions of symptomatic COVID-19 cases: an analysis of Mexico's capital

Case definitions are vital in a pandemic to effectively identify, isolate, and contact trace, particularly where testing is slow, scant, or not available. While case definitions have been developed in the COVID-19 pandemic, their diagnostic properties have not been adequately assessed. This study�...

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Bibliographic Details
Published in:Public health (London) 2022-04, Vol.205, p.187-191
Main Authors: Núñez, I., Caro-Vega, Y., Belaunzarán-Zamudio, P.F.
Format: Article
Language:English
Subjects:
Cities
Contact
Contact tracing
Coronaviruses
COVID-19
COVID-19 - diagnosis
COVID-19 - epidemiology
Diagnostic systems
Disease transmission
Epidemiologic surveillance
Epidemiology
Humans
Medical diagnosis
Metropolitan areas
Mexico
Mexico - epidemiology
Pandemics
Sensitivity and Specificity
Short Communication
Usefulness
World Health Organization
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Summary:Case definitions are vital in a pandemic to effectively identify, isolate, and contact trace, particularly where testing is slow, scant, or not available. While case definitions have been developed in the COVID-19 pandemic, their diagnostic properties have not been adequately assessed. This study's objective is to determine the diagnostic properties of local and World Health Organization (WHO) COVID-19 case definitions in the large metropolitan area of Mexico City. We calculated the diagnostic properties of five COVID-19 definitions (three of the Mexican government and two of the WHO) using open data of suspected COVID-19 cases in Mexico City from March 24th, 2020, until May 15th, 2021. All 2,564,782 people included in the analysis met the WHO suspected case definition (sensitivity: 100%, specificity: 0%). The WHO probable case definition was met by 1.2%, while the first and second Mexican suspected case had sensitivities of 61% and specificities of 61% and 67%, respectively. Confirmed case by epidemiological contact had a low sensitivity (32%) but slightly higher specificity (81%). Case definitions should maximize sensitivity, especially in a high-transmission area such as Mexico City. The WHO suspected case definition has the potential for detecting most symptomatic cases. We underline the need for routine evaluation of case definitions as new evidence arises to maximize their usefulness.
ISSN:0033-3506
1476-5616
DOI:10.1016/j.puhe.2022.02.010