Dengue Score A Simple and Highly Specific Test for Diagnosis of Dengue Infection in Resource-limited Settings
Keywords:
mental health problems; Makkasan railway; vulnerable groupAbstract
Objective: To determine the simple and specific clinical predictors to discriminate dengue infection from other acute febrile illnesses in resource-limited settings.
Material and methods: Prospective study was conducted at Nakhonpathom Hospital, a 670-bed tertiary care hospital in Thailand during August 1 and October 31, 2015. The inclusion criteria were adults who presented with acute fever, clinically suspected to be dengue infection by attending physician. Predictive factors for dengue infection were analysed.
Result: There were 155 patients. Mean age was 33.5 ± 17.1 yrs and 51% were female. One hundred and thirteen patients (73%) had dengue and 42 (27%) had non-dengue. Factors associated with dengue including absence of cough (OR 0.3, 95%CI 0.1;0.9, p= 0.04), WBC ≤ 4x103/mm3 (OR 4.6, 95%CI 1.2;17.0, p0.02), platelet ≤ 100x103/mm3 (OR 6.6, 95%CI 1.5;29.8, p= 0.01) and ESR ≤ 20 mm/hr (OR 3.3, 95%CI 1.01;12.3, p= 0.047). Dengue score was calculated as follows (variables coded as absence = 0, presence =1): (-1.3xcough) + (1.5xWBC<4X103/mm3) + (1.9xplatelet<100x103/mm3) + (1.2xESR<20). A score ≥ 2 was the best cut-off point for predicting dengue with sensitivity, specificity, PPV and NPV of 58%, 95%, 98% and 38%, respectively.
Conclusions: Clinical presentation of dengue was similar to other acute febrile illnesses. Dengue score provides a very high specificity and PPV and can be used to diagnose dengue infection in resource-limited settings.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
