Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators.
Dengue virus is endemic in tropical and sub-tropical resource-poor countries. Dengue illness can range from a nonspecific febrile illness to a severe disease, Dengue Shock Syndrome (DSS), in which patients develop circulatory failure. Earlier diagnosis of severe dengue illnesses would have a substan...
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ftdoajarticles:oai:doaj.org/article:8ab64c58067e49378a0a9cfd8add96fb 2023-05-15T15:11:51+02:00 Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators. James A Potts Robert V Gibbons Alan L Rothman Anon Srikiatkhachorn Stephen J Thomas Pra-On Supradish Stephenie C Lemon Daniel H Libraty Sharone Green Siripen Kalayanarooj 2010-08-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0000769 https://doaj.org/article/8ab64c58067e49378a0a9cfd8add96fb EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC2914746?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000769 https://doaj.org/article/8ab64c58067e49378a0a9cfd8add96fb PLoS Neglected Tropical Diseases, Vol 4, Iss 8, p e769 (2010) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2010 ftdoajarticles https://doi.org/10.1371/journal.pntd.0000769 2022-12-31T00:16:07Z Dengue virus is endemic in tropical and sub-tropical resource-poor countries. Dengue illness can range from a nonspecific febrile illness to a severe disease, Dengue Shock Syndrome (DSS), in which patients develop circulatory failure. Earlier diagnosis of severe dengue illnesses would have a substantial impact on the allocation of health resources in endemic countries.We compared clinical laboratory findings collected within 72 hours of fever onset from a prospective cohort children presenting to one of two hospitals (one urban and one rural) in Thailand. Classification and regression tree analysis was used to develop diagnostic algorithms using different categories of dengue disease severity to distinguish between patients at elevated risk of developing a severe dengue illness and those at low risk. A diagnostic algorithm using WBC count, percent monocytes, platelet count, and hematocrit achieved 97% sensitivity to identify patients who went on to develop DSS while correctly excluding 48% of non-severe cases. Addition of an indicator of severe plasma leakage to the WHO definition led to 99% sensitivity using WBC count, percent neutrophils, AST, platelet count, and age.This study identified two easily applicable diagnostic algorithms using early clinical indicators obtained within the first 72 hours of illness onset. The algorithms have high sensitivity to distinguish patients at elevated risk of developing severe dengue illness from patients at low risk, which included patients with mild dengue and other non-dengue febrile illnesses. Although these algorithms need to be validated in other populations, this study highlights the potential usefulness of specific clinical indicators early in illness. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 4 8 e769 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
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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 James A Potts Robert V Gibbons Alan L Rothman Anon Srikiatkhachorn Stephen J Thomas Pra-On Supradish Stephenie C Lemon Daniel H Libraty Sharone Green Siripen Kalayanarooj Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Dengue virus is endemic in tropical and sub-tropical resource-poor countries. Dengue illness can range from a nonspecific febrile illness to a severe disease, Dengue Shock Syndrome (DSS), in which patients develop circulatory failure. Earlier diagnosis of severe dengue illnesses would have a substantial impact on the allocation of health resources in endemic countries.We compared clinical laboratory findings collected within 72 hours of fever onset from a prospective cohort children presenting to one of two hospitals (one urban and one rural) in Thailand. Classification and regression tree analysis was used to develop diagnostic algorithms using different categories of dengue disease severity to distinguish between patients at elevated risk of developing a severe dengue illness and those at low risk. A diagnostic algorithm using WBC count, percent monocytes, platelet count, and hematocrit achieved 97% sensitivity to identify patients who went on to develop DSS while correctly excluding 48% of non-severe cases. Addition of an indicator of severe plasma leakage to the WHO definition led to 99% sensitivity using WBC count, percent neutrophils, AST, platelet count, and age.This study identified two easily applicable diagnostic algorithms using early clinical indicators obtained within the first 72 hours of illness onset. The algorithms have high sensitivity to distinguish patients at elevated risk of developing severe dengue illness from patients at low risk, which included patients with mild dengue and other non-dengue febrile illnesses. Although these algorithms need to be validated in other populations, this study highlights the potential usefulness of specific clinical indicators early in illness. |
format |
Article in Journal/Newspaper |
author |
James A Potts Robert V Gibbons Alan L Rothman Anon Srikiatkhachorn Stephen J Thomas Pra-On Supradish Stephenie C Lemon Daniel H Libraty Sharone Green Siripen Kalayanarooj |
author_facet |
James A Potts Robert V Gibbons Alan L Rothman Anon Srikiatkhachorn Stephen J Thomas Pra-On Supradish Stephenie C Lemon Daniel H Libraty Sharone Green Siripen Kalayanarooj |
author_sort |
James A Potts |
title |
Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators. |
title_short |
Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators. |
title_full |
Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators. |
title_fullStr |
Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators. |
title_full_unstemmed |
Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators. |
title_sort |
prediction of dengue disease severity among pediatric thai patients using early clinical laboratory indicators. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2010 |
url |
https://doi.org/10.1371/journal.pntd.0000769 https://doaj.org/article/8ab64c58067e49378a0a9cfd8add96fb |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
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PLoS Neglected Tropical Diseases, Vol 4, Iss 8, p e769 (2010) |
op_relation |
http://europepmc.org/articles/PMC2914746?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000769 https://doaj.org/article/8ab64c58067e49378a0a9cfd8add96fb |
op_doi |
https://doi.org/10.1371/journal.pntd.0000769 |
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PLoS Neglected Tropical Diseases |
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container_issue |
8 |
container_start_page |
e769 |
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