ArticlePathogens and global health2014
Comparative performance of the probable case definitions of dengue by WHO (2009) and the WHO-SEAR expert group (2011).
Article in Pathogens and global health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Diagnostic accuracy of the WHO clinical definitions for dengue and implications for surveillance: A systematic review and meta-analysis.PLoS neglected tropical diseases · 2021Pooled it
- Dengue infection in India: A systematic review and meta-analysis.PLoS neglected tropical diseases · 2018Pooled it
- Diagnostic performance of the WHO definition of probable dengue within the first 5 days of symptoms on Reunion Island.PloS one · 2024Article
- Dengue infections in India: A meta-analysis.Bioinformation · 2024Article
- The Effect of Age on Dengue Presentation and the Diagnostic Accuracy of the 2015 Pan American Health Organization Case Criteria in a Puerto Rican Cohort.Open forum infectious diseases · 2023Article
- Integrated systems immunology approach identifies impaired effector T cell memory responses as a feature of progression to severe dengue fever.Journal of biomedical science · 2023Article
- The Distribution of Dengue Virus Serotype in Quang Nam Province (Vietnam) during the Outbreak in 2018.International journal of environmental research and public health · 2022Article
- A 20-Gene Set Predictive of Progression to Severe Dengue.Cell reports · 2019Article
- Virus-inclusive single-cell RNA sequencing reveals the molecular signature of progression to severe dengue.Proceedings of the National Academy of Sciences of the United States of America · 2018Article
- Accuracy of clinical criteria and an immunochromatographic strip test for dengue diagnosis in a DENV-4 epidemic.BMC infectious diseases · 2016Article
- Flaviviruses as a Cause of Undifferentiated Fever in Sindh Province, Pakistan: A Preliminary Report.Frontiers in public health · 2016Article
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10 authors.
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Abstract
backgroundThe primary objective of this study was to find the performance of the 2009 probable case definition of dengue and compare it with the definition given by the WHO-SEAR expert group in 2011.
methodsA cross-sectional study was conducted in Thiruvananthapuram district of Kerala, which is hyperendemic for dengue. A consecutive series of 851 participants defined by the selection criteria were recruited from the primary, secondary, and tertiary health care settings. Sensitivity, specificity, predictive values, and likelihood ratios of the clinical case definitions were calculated using reverse transcriptase-polymerized chain reaction (RT-PCR) as gold standard in case of fever less than or equal to 5 days and serology (IgM positivity) for fever >5 days. Diagnostic odds ratio (DOR) was also calculated as a single indicator of performance of the case definition.
resultsThe 2009 World Health Organization (WHO) case definition had a sensitivity of 76·4% (69·6-82·1) and negative predictive value of 87·5%. The 2011 WHO-SEAR expert group case definition had a higher sensitivity of 87·9% (82·2-91·9) but lower negative predictive value of 86·6%. The three independent criteria which were significantly associated with dengue were thrombocytopenia less than 150,000 (OR 2·80), leukopenia (OR 2·28), and absence of backache (OR 2·68). The performance of 2009 case definition was better (DOR 2·4) than the 2011 WHO-SEAR expert group case definition. This was further enhanced when thrombocytopenia was specified as platelet count less than 150,000 (DOR2·7). When 'no backahe' was added as an additional criteria, the performance of both definitions improved.
conclusionsThe 2009 WHO case definition has better discriminatory power than the 2011 WHO-SEAR expert group case definition. The performance of 2009 WHO case definition is enhanced by specifying thrombocytopenia as platelet count less than 150,000. The inclusion of 'no backache' further improves the discriminatory power. This may be more useful in primary care settings, to rule out dengue.
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