Sensitivity and specificity of the World Health Organization dengue classification schemes for severe dengue assessment in children in Rio de Janeiro

• Published in: PloS one 2014-04, Vol.9 (4), p.e96314-e96314
• Main Authors: Macedo, Gleicy A, Gonin, Michelle Luiza C, Pone, Sheila M, Cruz, Oswaldo G, Nobre, Flávio F, Brasil, Patrícia
• Format: Article
• Language: English
• Subjects: Adolescent; Brazil - epidemiology; Child; Child, Preschool; Children; Classification; Classification schemes; Control; Critical Care - statistics & numerical data; Dengue; Dengue fever; Dengue hemorrhagic fever; Diagnostic tests; Distribution; Female; Fever; Health aspects; Hospitalization; Hospitals; Hospitals - statistics & numerical data; Humans; Infant; Infant, Newborn; Laboratories; Male; Medicine and Health Sciences; Patients; Pediatrics; Plasma; Public health; Reference Standards; Research and Analysis Methods; Sensitivity; Sensitivity and Specificity; Sepsis; Severe Dengue - classification; Severe Dengue - diagnosis; Severe Dengue - epidemiology; Therapeutic applications; Vector-borne diseases; Viral diseases; Working groups; World Health Organization
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0096314

The clinical definition of severe dengue fever remains a challenge for researchers in hyperendemic areas like Brazil. The ability of the traditional (1997) as well as the revised (2009) World Health Organization (WHO) dengue case classification schemes to detect severe dengue cases was evaluated in 267 children admitted to hospital with laboratory-confirmed dengue. Using the traditional scheme, 28.5% of patients could not be assigned to any category, while the revised scheme categorized all patients. Intensive therapeutic interventions were used as the reference standard to evaluate the ability of both the traditional and revised schemes to detect severe dengue cases. Analyses of the classified cases (n = 183) demonstrated that the revised scheme had better sensitivity (86.8%, P