Comparison of clinical tools for dengue diagnosis in a pediatric population-based cohort

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art_DIAZ-QUIJANO_Comparison_of_clinical_tools_for_dengue_diagnosis_in_2019.PDF (404.52 KB)
Citações na Scopus
7
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
OXFORD UNIV PRESS
Autores
DIAZ-QUIJANO, Fredi A.
WALDMAN, Eliseu A.
FIGUEIREDO, Walter M.
CARDOSO, Maria R. A.
COSTA, Angela A.
Citação
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, v.113, n.4, p.212-220, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background We aimed to estimate and compare the ability of clinical tools for dengue diagnosis in a pediatric population. Methods We prospectively evaluated episodes of acute febrile syndrome identified during the follow-up of a population-based cohort of children and adolescents residing in a dengue endemic city. We estimated the area under the receiver operating characteristic curve (AU-ROC) for dengue diagnosis of three clinical tools: the summation of manifestations of the WHO case definition, a predefined clinical scale and a logistic regression model obtained in this study. Results We compared 219 dengue cases (confirmed by laboratory) and 286 patients with other febrile illnesses. In a multiple model, variables independently associated with dengue included the duration of fever, sleepiness and exanthema. Rhinorrhea, cough and minimal leukocyte count were inversely associated with dengue. This model reached an accuracy of 84.2% (for a cut-off of >0.5, sensitivity: 79.5%, specificity: 87.9%, positive predictive value: 83.7%, negative predictive value: 84.6%). The AU-ROC of this model (89.8%) was significantly higher than that obtained with either the predefined scale (82.1%) or the WHO definition manifestations (77%). Conclusion We validated a predefined scale and identified a multiple model suitable for the clinical diagnosis of dengue in the pediatric population.
Palavras-chave
accuracy, case definition, children, clinical diagnosis, dengue
URI
https://observatorio.fm.usp.br/handle/OPI/32023
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Coleções
Artigos e Materiais de Revistas Científicas - IMT
Artigos e Materiais de Revistas Científicas - FM/MIP
Artigos e Materiais de Revistas Científicas - LIM/52
Artigos e Materiais de Revistas Científicas - ODS/03