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

Autor(es)

Diaz-Quijano, Fredi A. ^[1] ; Figueiredo, Gerusa M. ^[2] ; Waldman, Eliseu A. ^[1] ; Figueiredo, Walter M. ^[3] ; Cardoso, Maria R. A. ^[1] ; Campos, Sergio R. C. ^[2] ; Costa, Angela A. ^[3] ; Pannuti, Claudio S. ^{[2, 4]} ; Luna, Expedito J. A. ^[2]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Publ Hlth, Dept Epidemiol, Av Dr Arnaldo 715, BR-01246904 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Inst Med Trop Sao Paulo, Av Dr Eneas Carvalho Aguiar 470, BR-05403000 Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Sch Publ Hlth, Serv Especial Saude Araraquara, Rua Italia 1617, BR-14801350 Araraquara, SP - Brazil

^[4] Univ Sao Paulo, Fac Med, Lab Virol LIM HC, Av Dr Eneas Carvalho Aguiar 470, BR-05403000 Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Transactions of the Royal Society of Tropical Medicine and Hygiene; v. 113, n. 4, p. 212-220, APR 2019.
• Citações Web of Science: 0

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. (AU)

• Processo FAPESP: 14/21527-0 - Validação de definições de caso de dengue em crianças e adolescentes residentes em Araraquara, uma cidade endêmica do estado de São Paulo
• Beneficiário: Fredi Alexander Diaz Quijano
• Modalidade de apoio: Auxílio à Pesquisa - Regular