Clinical Characteristics and Predictive Score of Chikungunya Virus Disease versus Dengue Fever in Children
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Abstract
Background: Clinical manifestations of chikungunya virus disease and dengue fever are comparable. It might be challenging to distinguish between these two illnesses in some situations based on clinical presentation and physical examination. Although supportive care is the mainstay of treatment for both illnesses, dengue infection necessitates continuous monitoring due to possibility of a potentially life-threatening event.
Objective: To compare the clinical variables that would help differentiate chikungunya virus disease from dengue fever in pediatric patients and to develop a clinical predictive score.
Methods: This was a retrospective case-control study that collected data from medical records of patients aged 1 month to less than 15 years who admitted in Surin Hospital between January 1st, 2018 and January 31st, 2022. Clinical and biological variables were compared, and a multivariable analysis was performed. A clinical predictive score was developed using the beta-coefficients to differentiate the diseases.
Results: A total of 125 patients were included in the study. Thirty cases were chikungunya virus disease and 95 cases were dengue fever. The clinical presentations that associated with chikungunya virus disease when using multivariable analysis were joint pain (adjusted OR 1,150.44, 95% CI 23.73-55,785.3, p-value <0.001), rash (adjusted OR 33.03, 95% CI 4.17-261.93, p-value 0.001), negative tourniquet test (adjusted OR 24.05, 95% CI 1.71-338.50, p-value 0.018) and platelet count > 180 x 103/µL (adjusted OR 16.58, 95% CI 1.43-191.93, p-value 0.025). The clinical predictive score was developed using all of these clinical variables. The score of more than 3 points had a positive likelihood ratio of 26.39 (95% CI 8.57-81.28, p-value <0.001), sensitivity of 83.3% and specificity of 96.8% for diagnosis chikungunya virus disease.
Conclusion: The use of the proposed clinical predictive score during the acute phase of the disease would help differentiate chikungunya virus disease from dengue fever in the pediatric population.
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