Evaluation of the traditional and revised WHO classifications of Dengue disease severity.
Dengue is a major public health problem worldwide and continues to increase in incidence. Dengue virus (DENV) infection leads to a range of outcomes, including subclinical infection, undifferentiated febrile illness, Dengue Fever (DF), life-threatening syndromes with fluid loss and hypotensive shock...
Published in: | PLoS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2011
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0001397 https://doaj.org/article/5e03f439dd6c48cf92803370bd770d86 |
id |
ftdoajarticles:oai:doaj.org/article:5e03f439dd6c48cf92803370bd770d86 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:5e03f439dd6c48cf92803370bd770d86 2023-05-15T15:14:24+02:00 Evaluation of the traditional and revised WHO classifications of Dengue disease severity. Federico Narvaez Gamaliel Gutierrez Maria Angeles Pérez Douglas Elizondo Andrea Nuñez Angel Balmaseda Eva Harris 2011-11-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0001397 https://doaj.org/article/5e03f439dd6c48cf92803370bd770d86 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3210746?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001397 https://doaj.org/article/5e03f439dd6c48cf92803370bd770d86 PLoS Neglected Tropical Diseases, Vol 5, Iss 11, p e1397 (2011) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2011 ftdoajarticles https://doi.org/10.1371/journal.pntd.0001397 2022-12-31T13:04:06Z Dengue is a major public health problem worldwide and continues to increase in incidence. Dengue virus (DENV) infection leads to a range of outcomes, including subclinical infection, undifferentiated febrile illness, Dengue Fever (DF), life-threatening syndromes with fluid loss and hypotensive shock, or other severe manifestations such as bleeding and organ failure. The long-standing World Health Organization (WHO) dengue classification and management scheme was recently revised, replacing DF, Dengue Hemorrhagic Fever (DHF), and Dengue Shock Syndrome (DSS) with Dengue without Warning Signs, Dengue with Warning Signs (abdominal pain, persistent vomiting, fluid accumulation, mucosal bleeding, lethargy, liver enlargement, increasing hematocrit with decreasing platelets) and Severe Dengue (SD; dengue with severe plasma leakage, severe bleeding, or organ failure). We evaluated the traditional and revised classification schemes against clinical intervention levels to determine how each captures disease severity using data from five years (2005-2010) of a hospital-based study of pediatric dengue in Managua, Nicaragua. Laboratory-confirmed dengue cases (n = 544) were categorized using both classification schemes and by level of care (I-III). Category I was out-patient care, Category II was in-patient care that did not meet criteria for Category III, which included ICU admission, ventilation, administration of inotropic drugs, or organ failure. Sensitivity and specificity to capture Category III care for DHF/DSS were 39.0% and 75.5%, respectively; sensitivity and specificity for SD were 92.1% and 78.5%, respectively. In this data set, DENV-2 was found to be significantly associated with DHF/DSS; however, this association was not observed with the revised classification. Among dengue-confirmed cases, the revised WHO classification for severe dengue appears to have higher sensitivity and specificity to identify cases in need of heightened care, although it is no longer as specific for a particular pathogenic entity as was ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 5 11 e1397 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Federico Narvaez Gamaliel Gutierrez Maria Angeles Pérez Douglas Elizondo Andrea Nuñez Angel Balmaseda Eva Harris Evaluation of the traditional and revised WHO classifications of Dengue disease severity. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Dengue is a major public health problem worldwide and continues to increase in incidence. Dengue virus (DENV) infection leads to a range of outcomes, including subclinical infection, undifferentiated febrile illness, Dengue Fever (DF), life-threatening syndromes with fluid loss and hypotensive shock, or other severe manifestations such as bleeding and organ failure. The long-standing World Health Organization (WHO) dengue classification and management scheme was recently revised, replacing DF, Dengue Hemorrhagic Fever (DHF), and Dengue Shock Syndrome (DSS) with Dengue without Warning Signs, Dengue with Warning Signs (abdominal pain, persistent vomiting, fluid accumulation, mucosal bleeding, lethargy, liver enlargement, increasing hematocrit with decreasing platelets) and Severe Dengue (SD; dengue with severe plasma leakage, severe bleeding, or organ failure). We evaluated the traditional and revised classification schemes against clinical intervention levels to determine how each captures disease severity using data from five years (2005-2010) of a hospital-based study of pediatric dengue in Managua, Nicaragua. Laboratory-confirmed dengue cases (n = 544) were categorized using both classification schemes and by level of care (I-III). Category I was out-patient care, Category II was in-patient care that did not meet criteria for Category III, which included ICU admission, ventilation, administration of inotropic drugs, or organ failure. Sensitivity and specificity to capture Category III care for DHF/DSS were 39.0% and 75.5%, respectively; sensitivity and specificity for SD were 92.1% and 78.5%, respectively. In this data set, DENV-2 was found to be significantly associated with DHF/DSS; however, this association was not observed with the revised classification. Among dengue-confirmed cases, the revised WHO classification for severe dengue appears to have higher sensitivity and specificity to identify cases in need of heightened care, although it is no longer as specific for a particular pathogenic entity as was ... |
format |
Article in Journal/Newspaper |
author |
Federico Narvaez Gamaliel Gutierrez Maria Angeles Pérez Douglas Elizondo Andrea Nuñez Angel Balmaseda Eva Harris |
author_facet |
Federico Narvaez Gamaliel Gutierrez Maria Angeles Pérez Douglas Elizondo Andrea Nuñez Angel Balmaseda Eva Harris |
author_sort |
Federico Narvaez |
title |
Evaluation of the traditional and revised WHO classifications of Dengue disease severity. |
title_short |
Evaluation of the traditional and revised WHO classifications of Dengue disease severity. |
title_full |
Evaluation of the traditional and revised WHO classifications of Dengue disease severity. |
title_fullStr |
Evaluation of the traditional and revised WHO classifications of Dengue disease severity. |
title_full_unstemmed |
Evaluation of the traditional and revised WHO classifications of Dengue disease severity. |
title_sort |
evaluation of the traditional and revised who classifications of dengue disease severity. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2011 |
url |
https://doi.org/10.1371/journal.pntd.0001397 https://doaj.org/article/5e03f439dd6c48cf92803370bd770d86 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 5, Iss 11, p e1397 (2011) |
op_relation |
http://europepmc.org/articles/PMC3210746?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001397 https://doaj.org/article/5e03f439dd6c48cf92803370bd770d86 |
op_doi |
https://doi.org/10.1371/journal.pntd.0001397 |
container_title |
PLoS Neglected Tropical Diseases |
container_volume |
5 |
container_issue |
11 |
container_start_page |
e1397 |
_version_ |
1766344861692198912 |