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Comparison of clinical tools for dengue diagnosis in a pediatric population-based cohort.

Abstract：

BACKGROUND:We aimed to estimate and compare the ability of clinical tools for dengue diagnosis in a pediatric population. METHODS:We prospectively evaluated episodes of acute febrile syndrome identified during the follow-up of a population-based cohort of children and adolescents residing in a dengue endemic city. We estimated the area under the receiver operating characteristic curve (AU-ROC) for dengue diagnosis of three clinical tools: the summation of manifestations of the WHO case definition, a predefined clinical scale and a logistic regression model obtained in this study. RESULTS:We compared 219 dengue cases (confirmed by laboratory) and 286 patients with other febrile illnesses. In a multiple model, variables independently associated with dengue included the duration of fever, sleepiness and exanthema. Rhinorrhea, cough and minimal leukocyte count were inversely associated with dengue. This model reached an accuracy of 84.2% (for a cut-off of >0.5, sensitivity: 79.5%, specificity: 87.9%, positive predictive value: 83.7%, negative predictive value: 84.6%). The AU-ROC of this model (89.8%) was significantly higher than that obtained with either the predefined scale (82.1%) or the WHO definition manifestations (77%). CONCLUSION:We validated a predefined scale and identified a multiple model suitable for the clinical diagnosis of dengue in the pediatric population.

journal_name

Trans R Soc Trop Med Hyg

journal_title

Transactions of the Royal Society of Tropical Medicine and Hygiene

authors

Diaz-Quijano FA,Figueiredo GM,Waldman EA,Figueiredo WM,Cardoso MRA,Campos SRC,Costa AA,Pannuti CS,Luna EJA

doi

10.1093/trstmh/try135

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

212-220

issue

4

eissn

0035-9203

issn

1878-3503

pii

5268877

journal_volume

113

pub_type

杂志文章

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