Comparing the Usefulness of the 1997 and 2009 WHO Dengue Case Classification: A Systematic Literature Review

Horstick, Olaf; Jaenisch, Thomas; Martínez, Eric; Kroeger, Axel; See, Lucy Lum Chai; Farrar, Jeremy; Ranzinger, Silvia Runge

doi:10.4269/ajtmh.13-0676

Cited by 81 publications

(80 citation statements)

References 25 publications

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“…Because DHF/DSS is a reportable disease in Taiwan, which should be notified within 24 hours after diagnosis, our finding suggests limitations of the 1997 WHO DF/DHF classification when applied in clinical management of dengue. Because the 2009 WHO dengue classification is regarded as able to detect disease severity with high sensitivity and assist clinical management, potentially contributing to reduced dengue mortality, 38 the Taiwan Centers for Disease Control adopted the 2009 WHO classification for dengue surveillance in May 2015.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Risk Factors for Fatality in Patients with Dengue Hemorrhagic Fever, Taiwan, 2014

Wei¹,

Shu

Hung³

2016

The American Journal of Tropical Medicine and Hygiene

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Abstract. An unprecedented dengue outbreak involving more than 15,000 infections, including 136 dengue hemorrhagic fever (DHF) cases and 20 fatalities, occurred in Taiwan in 2014. The median age of the DHF cases was 71 years (range: 4-92 years) and most of them (N = 100, 73.5%) had comorbidities, of which the majority were hypertension (56%) and diabetes mellitus (DM; 27%). Only approximately half of the DHF cases (59/136) were classified as severe dengue, based on the 2009 WHO-revised dengue classification. The fatality rate for this DHF outbreak was 14.7%. DM (odds ratio [OR] = 3.60, 95% confidence interval [CI] = 1.22-10.63) and presentation with severe plasma leakage (OR = 6.42, 95% CI = 1.76-23.63) were independent risk factors for fatality.

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Section: Discussionmentioning

confidence: 99%

Characteristics and Risk Factors for Fatality in Patients with Dengue Hemorrhagic Fever, Taiwan, 2014

Wei¹,

Shu

Hung³

2016

The American Journal of Tropical Medicine and Hygiene

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“…Step 2: Systematic review of globally published studies comparing the two dengue case classifications (the systematic review has been published separately, 3 and the results are only referred to in the following reporting).…”

Section: Methodsmentioning

confidence: 99%

WHO Dengue Case Classification 2009 and its usefulness in practice: an expert consensus in the Americas

Horstick

Martínez

Guzmán

et al. 2015

Pathogens and Global Health

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Introduction: In 2009, the new World Health Organization (WHO) dengue case classification -dengue/ severe dengue (D/SD) -was introduced, replacing the 1997 WHO dengue case classification: dengue fever/dengue haemorrhagic fever/dengue shock syndrome (DF/DHF/DSS). Methods: A 2-day expert consensus meeting in La Habana/Cuba aimed to (1) share the experiences from Pan American Health Organization (PAHO) member states when applying D/SD, (2) present national and local data using D/SD, and (3) agree with the presented evidence on a list of recommendations for or against the use of D/SD for PAHO, and also globally. Results: Eight key questions were discussed, concluding: (1) D/SD is useful describing disease progression because it considers the dynamic nature of the disease, (2) D/SD helps defining dengue cases correctly for clinical studies, because it defines more precisely disease severity and allows evaluating dynamically the progression of cases, (3) D/SD describes correctly all clinical forms of severe dengue. Further standards need to be developed regionally, especially related to severe organ involvement, (4) D/SD allows for pathophysiological research identifying -in a sequential manner -the clinical manifestations of dengue related to pathophysiological events, (5) the warning signs help identifying early cases at risk of shock (children and adults), pathophysiology of the warning signs deserves further studies, (6) D/SD helps treating individual dengue cases and also the reorganization of health-care services for outbreak management, (7) D/SD helps diagnosing dengue, in presumptive diagnosis and follow-up of the disease, because of its high sensitivity and high negative predictive value (NPV), and (8) there is currently no update of the International Disease Classification10 (ICD10) to include the new classification of dengue (D/SD); therefore, there are not enough experiences of epidemiological reporting. Once D/SD has been implemented in epidemiological surveillance, D/SD allows to (1) identify severity of dengue cases in real time, for any decision-making on actions, (2) measure and compare morbidity and mortality in countries, and also globally, and (3) trigger contingency plans early, not only based on the number of reported cases but also on the reported severity of cases. Conclusion: The expert panel recommends to (1) update ICD10, (2) include D/SD in country epidemiological reports, and (3) implement studies improving sensitivity/specificity of the dengue case definition.

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“…La misma 21 OMS, desde el año 2009, ha difundido esta clasificacion . Una revisión sistemática confirmó que en los últimos 5 años, luego de esta nueva clasificación, se mejoró el manejo clínico pues presenta alta sensibilidad para 24 diagnosticar cuadros severos, lo que redujo la mortalidad . 25 Posterior a la presunción clínica, es fundamental la confirmación laboratorial.…”

Section: Introductionunclassified

Características clínicas de pacientes hospitalizados durante un brote epidémico de dengue

Galeano

2015

Rev. Virtual Soc. Parag. Med. Int

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ResumenIntroducción: el dengue es una enfermedad dinámica, multisistémica, de etiología viral, con cuatro serotipos, endémica en el Paraguay. Se presenta con espectro clínico variable. Entre los meses de febrero y abril de 2015 se registró un brote epidémico en la ciudad de Coronel Oviedo (Paraguay), por lo cual se incrementó el número de consultas y casos de pacientes que necesitaron ser hospitalizados.. Objetivos: determinar las características clínicas de los pacientes durante el brote epidémico de 2015. -Metodología: estudio observacional, transversal, retrospectivo, descriptivo, no probabilístico, con componente analítico. Fueron revisadas historias clínicas de mujeres y varones mayores de 18 años internados en el área destinada a los pacientes con dengue en el Hospital Regional de Coronel Oviedo entre los meses de febrero y abril de 2015.. Resultados: la edad media de los enfermos fue 42,1 ±18,6 años, 70,43% fueron mujeres. El 100% de los pacientes presentaban cuadro clínico compatible con dengue; en 77,05% de los casos el antígeno NS1 dio positivo y en 59,02% hubo nexo epidemiológico. El 77,05% presentaron signos de alarma, siendo la trombocitopenia el más frecuente (65,57%). Durante la fase crítica de la enfermedad se internaron el 80,33% de los pacientes. La hipertensión arterial fue la comorbilidad asociada más frecuente (39,34%). Se halló una correlación negativa débil entre el recuento plaquetario y los valores de enzimas hepáticas. La media de días de hospitalización fue 4,49±1,93 días. Conclusiones: la edad media fue 42,13 ±18,66 años, la mayoría fueron mujeres. El 100% de los pacientes presentaban cuadro clínico compatible con dengue; en la mayoría de los casos el Ag NS1 dio positivo y un alto porcentaje se confirmó por nexo epidemiológico. El 77,05% presentaron signos de alarma, siendo la trombocitopenia el más frecuente, durante la fase crítica de la enfermedad se internaron el 80,33% de los pacientes. It has a variable clinical spectrum. Between February and April 2015, there was an outbreak in the city of Coronel Oviedo (Paraguay), which increased the number of consultations and cases of patients that needed hospitalization. Objective: To determine the clinical characteristics of patients, during the 2015 outbreak. Methodology: This was an observational cross-sectional retrospective descriptive non-probabilistic study with an analytical component. The clinical records of women and men older than 18 years old and admitted into the area of dengue patients at the Regional Hospital of between February and April 2015 were evaluated. Results: Mean age of the patients was 42.1 ±18.6 years and 70.43% was women. Hundred percent of patients presented clinical symptoms compatible with dengue; in 77.05% of the cases NS1 antigen was positive and in 59.02% there was an epidemiological link. The 77.05% presented signs of alarm being thrombocytopenia the most frequent (65.57%). During the critical phase of the disease, 80.33% of the patients were hospitalized. Arterial hypertension was the most frequent assoc...

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Comparing the Usefulness of the 1997 and 2009 WHO Dengue Case Classification: A Systematic Literature Review

Cited by 81 publications

References 25 publications

Characteristics and Risk Factors for Fatality in Patients with Dengue Hemorrhagic Fever, Taiwan, 2014

Characteristics and Risk Factors for Fatality in Patients with Dengue Hemorrhagic Fever, Taiwan, 2014

WHO Dengue Case Classification 2009 and its usefulness in practice: an expert consensus in the Americas

Características clínicas de pacientes hospitalizados durante un brote epidémico de dengue

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