ArticlePLoS neglected tropical diseases2019
Assessment of the new World Health Organization's dengue classification for predicting severity of illness and level of healthcare required.
Article in PLoS neglected tropical diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06744777 (The Comparative Efficacy of Standard Treatment Plus Ribavirin vs Standard Treatment Alone in Preventing Clinically Significant Hemorrhage in Patients With Dengue Fever), which is not on this map. Cited by 39 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Comparative Efficacy of Standard Treatment Plus Ribavirin vs Standard Treatment Alone in Preventing Clinically Significant Hemorrhage in Patients With Dengue Fever: A Double-blind, Randomized Control Trial
Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Routine blood parameters of dengue infected children and adults. A meta-analysis.Pathogens and global health · 2023Pooled it
- Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.PLoS neglected tropical diseases · 2021Pooled it
- Abdominal Symptoms During the Febrile Phase Indicate Profound Innate Immune Responses in Dengue.Biology · 2026Article
- A Prothrombotic Shift: Cerebral Venous Sinus Thrombosis in the Recovery Phase of Dengue Fever-A Case Report.Clinical case reports · 2026Article
- Article
- Comorbidity of Dengue and Hereditary Spherocytosis in an 18-Year-Old Patient: A Case Report.Cureus · 2026Article
- Epidemiological Characteristics of Dengue Disease in Mexico (2014-2025): A Descriptive Analysis of a Hyperendemic Country.Pathogens (Basel, Switzerland) · 2026Review
- Assessing the diagnostic performance of clinical, serological and molecular approaches to improve dengue case detection in the Peruvian Amazon.PLoS neglected tropical diseases · 2026Article
- Exploring potential gene signatures in dengue through machine learning and deep learning approaches.Virus genes · 2026Article
- Article
- Epidemiological Profile and Clinical Determinants of Dengue Severity in a Colombian Andean Municipality.The Yale journal of biology and medicine · 2025Observational
- Dengue and Acute Pancreatitis: A Systematic Review.Tropical medicine and infectious disease · 2025Review
- The Emerging Role of Circulating T Follicular Helper Cells in Dengue Virus Immunity: Balancing Protection and Pathogenesis.Viruses · 2025Review
- A New Dengue Rapid Test to Simultaneously Detect All Four Dengue Virus Serotypes.Journal of medical virology · 2025Article
- Different Clinical Severity and Outcomes in a Cohort of Patients With Dengue With Warning Signs in an Endemic Latin American City.Open forum infectious diseases · 2025Article
- Exploring Central Venous Thrombosis as a Rare Postinfectious Complication of Dengue: A Case Report.Case reports in neurological medicine · 2025Article
- Modeling and analysis of dengue transmission in fuzzy-fractional framework: a hybrid residual power series approach.Scientific reports · 2024Article
- Article
- Immunization of recombinant NS3 protein (protease region) of dengue virus induces high levels of CTLA-4 and apoptosis in splenocytes of BALB/c mice.Virus genes · 2024Article
- Pre-or co-SARS-CoV-2 Infections Significantly Increase Severe Dengue Virus Disease Criteria: Implications for Clinicians.Pathogens (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The objective of this study was to assess the validity of the new dengue classification proposed by the World Health Organization (WHO) in 2009 and to develop pragmatic guidelines for case triage and management. This retrospective study involved 357 laboratory-confirmed cases of dengue infection diagnosed at King Abdulaziz University Hospital, Jeddah, Saudi Arabia over a 4-year period from 2014 to 2017. The sensitivity of the new classification for identifying severe cases was limited (65%) but higher than the old one (30%). It had a higher sensitivity for identifying patients who needed advanced healthcare compared to the old one (72% versus 32%, respectively). We propose adding decompensation of chronic diseases and thrombocytopenia-related bleeding to the category of severe dengue in the new classification. This modification improves sensitivity from 72% to 98% for identifying patients who need advanced healthcare without altering specificity (97%). It also improves sensitivity in predicting severe outcomes from 32% to 88%. In conclusion, the new classification had a low sensitivity for identifying patients needing advanced care and for predicting morbidity and mortality. We propose to include decompensation of chronic diseases and thrombocytopenia-related bleeding to the category of severe dengue in the new classification to improve the sensitivity of predicting cases requiring advanced care.
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