Comparison between the traditional (1997) and revised (2009) WHO classifications of dengue disease: a retrospective study of 30 670 patients

• Published in: Tropical medicine & international health 2018-12, Vol.23 (12), p.1282-1293
• Main Authors: Silva, Natal Santos, Undurraga, Eduardo A., Verro, Alice Tobal, Nogueira, Maurício Lacerda
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Brazil - epidemiology; Classification; classification de la dengue; clinical guidelines; Demographics; Demography; dengue; Dengue - classification; Dengue - epidemiology; dengue diagnosis; Dengue fever; Dependence; Detection; diagnostic de la dengue; Female; Guidelines; Human diseases; Humans; Infections; maladies tropicales; Male; neglected tropical diseases; négligées; Organisation Mondiale de la Santé; Patients; Regression analysis; Retrospective Studies; Severity of Illness Index; Sex Distribution; Signs and symptoms; Symptoms; Vector-borne diseases; Viral diseases; World Health Organization; Young Adult
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.13155

Objective To compare WHO's traditional (1997) and revised (2009) guidelines for dengue classification, using a large sample of patients of all ages with varying clinical conditions from a dengue‐endemic area in Brazil. Methods We compared 30 670 laboratory‐confirmed dengue cases (1998–2012) using both WHO's dengue classification guidelines. Stereotype ordinal logistic regressions were used to analyse the association between patients’ demographics and signs and symptoms related to dengue infection severity, as defined in the 1997 and 2009 guidelines. We then compared the degree of agreement in dengue classification of both guidelines. Results Dengue signs and symptoms in patients were poorly correlated to disease severity as defined by both guidelines (Cramer's V test