Multicentre prospective study on dengue classification in four South‐east Asian and three Latin American countries

Abstract

Summaryobjective To evaluate the existing WHO dengue classification across all age groups and a wide geographical range and to develop a revised evidence-based classification that would better reflect clinical severity.methods We followed suspected dengue cases daily in seven countries across South-east Asia and Latin America and then categorised them into one of three intervention groups describing disease severity according to the overall level of medical and nursing support required. Using a pre-defined analysis plan, we explored the clinical and laboratory profiles characteristic of these intervention categories and presented the most promising options for a revised classification scheme to an independent group of WHO dengue experts for consideration. Potential warning signs were also evaluated by comparing contemporaneous data of patients who progressed to severe disease with the data of those who did not.results A total of 2259 patients were recruited during 2006-2007 and 230 (13%) of the 1734 laboratory-confirmed patients required major intervention. Applying the existing WHO system, 47 ⁄ 210 (22%) of patients with shock did not fulfil all the criteria for dengue haemorrhagic fever. However, no three-tier revision adequately described the different severity groups either. Inclusion of readily discernible complications (shock ⁄ severe vascular leakage and ⁄ or severe bleeding and ⁄ or severe organ

An evaluation of the World Health Organization’s 1997 and 2009 dengue classifications in hospitalized dengue patients in Malaysia

“…Several studies [10,13,14] reported that the revised WHO classification is more sensitive as well as more or comparably specific in identifying severe cases. In contrast, some still indicate that WHO 1997 is more sensitive -though less specific -in capturing severe cases [15].…”

Clinical profile and outcome of dengue fever in hospitalized children of South Rajasthan, India

“…4 The elucidation of clinical profile is very important for patient management and thus crucial for saving life. Due to limitations of World Health Organization (WHO) 1997 dengue classification guidelines WHO revised their guidelines in 2009 5 and accordingly the clinical classification was revised as dengue without warning signs, dengue with warning signs, and severe dengue which was much easier to understand. [6][7][8] The present study is an attempt to describe the salient clinical as well as laboratory findings of serologically confirmed hospitalized cases of dengue fever.…”

Dengue nos Países da Lusofonia: Que Ligações Epidemiológicas Poderemos Traçar?

“…10 Classicamente as formas clínicas eram divididas em febre da dengue, febre hemorrágica da dengue e síndrome de choque da dengue. A OMS propõe uma nova classificação com duas categorias: dengue (com ou sem sinais de alerta) e dengue grave, seguindo alguns critérios 4,11,12 ( Fig. 1).…”