ArticleTropical medicine and health2016
Criteria of "persistent vomiting" in the WHO 2009 warning signs for dengue case classification.
Article in Tropical medicine and health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.PLoS neglected tropical diseases · 2021Pooled it
- Definition of "persistent vomiting" in current medical literature: A systematic review.Medicine · 2017Pooled it
- High prevalence of dengue with warning signs but absence of severe cases in Vietnamese pediatric patients: an analysis of predictive factors.Le infezioni in medicina · 2025Article
- Survey of knowledge, attitude and practice of healthcare professionals on dengue transmission, diagnosis and clinical classification.BMC infectious diseases · 2021Article
- Factors associated with severe dengue in Savannakhet Province, Lao People's Democratic Republic.Nagoya journal of medical science · 2021Article
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Authors and funding
14 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDengue is a viral disease that spreads rapidly in the tropic and subtropic regions of the world and causes 22,000 deaths annually. In 2009, the World Health Organization (WHO) released a new classification of dengue infections, which divided them into three categories: dengue without warning sign (D), dengue with warning sign (DWS), and severe dengue (SD). However, researchers have been using different criteria to define persistent vomiting; therefore, we aimed to evaluate the ability of the number of vomiting times in early prediction of SD development among D/DWS patients.
methodA hospital-based cohort study was conducted in Ben Tre-south of Vietnam. We enrolled confirmed dengue patients with D and DWS at admission. The final classification was determined on the discharged day for every patient based on the classification of WHO 2009 without using vomiting symptom, using the receiver operating characteristic (ROC) curve to evaluate the ability of the number of vomiting times in early prediction of SD development among D/DWS patients.
resultThe prevalence of vomiting symptom was higher in SD group than D/DWS group (92 versus 46 %, p = 0.006), and the median of the number of vomiting times was higher in SD group than D/DWS group (2.5 versus 0, p = 0.001). To distinguish SD from D/DWS, the ROC curve of the number of vomiting episodes showed that the area under the curve was 0.77; with the cut point of two, the sensitivity and specificity were 92 and 52 %, respectively. DISCUSSION: The number of vomiting times could be a good clinical sign which can early predict SD from the group of D/DWS. We suggest the definition of persistent vomiting should be vomiting two times or more per day.
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