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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Low sensitivity of the tourniquet test for differential diagnosis of dengue: an analysis of 28,000 trials in patients

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Author(s):
Furlan, Nathalia Barbosa ; Tukasan, Caroline ; Estofolete, Cassia Fernanda ; Nogueira, Mauricio Lacerda ; da Silva, Natal Santos
Total Authors: 5
Document type: Journal article
Source: BMC INFECTIOUS DISEASES; v. 16, NOV 3 2016.
Web of Science Citations: 3
Abstract

Background: The aim of this study was to evaluate the utility of the tourniquet test (TT) for dengue diagnosing. To our knowledge, no previous study with such a large sample, of this duration, with as many laboratory methods referenced, or relating the results of the TT to the 2009 WHO classification of severity has been conducted thus far. Methods: In this study, we analyzed the records of 119,589 suspected dengue cases in a Brazilian city, with 30,670 confirmed cases. The Cohen's Kappa test was applied to evaluate the degree of agreement between the tests, and the sensitivity and specificity was calculated for the TT. Results: Twenty-eight thousand six hundred thirty-five TT were performed. No association between the outcome of the TT and greater severity of infection, according to the 2009 guideline, was observed (P = 0.28); furthermore, relevant agreement with the final diagnosis (kappa = 0.01; 95 % CI = 0.00 to 0.02) or individually with the IgM enzyme-linked immunoassay was not observed (kappa = 0.05; 95 % CI = 0.04 to 0.06), and was even lower with PCR (kappa = 0.27; 95 % CI = 0.06 to 0.49). Most importance of the TT was shown in relation to specificity (88.9 %; 95 % CI = 0.88 to 0.89) and negative predictive value (70.3 %; CI 95 % = 0.70 to 0.71). Conclusions: TT was more effective in detecting cases that were truly negative than positive. These results suggest that the TT should not be used as diagnosis of dengue. (AU)

FAPESP's process: 13/21719-3 - Epidemiological study of dengue (serotypes1-4) in a cohort of São José do Rio Preto, São Paulo, Brazil, during 2014-2018
Grantee:Maurício Lacerda Nogueira
Support Opportunities: Research Projects - Thematic Grants