Evaluating the validity of dengue clinical-epidemiological criteria for diagnosis in patients residing in a Brazilian endemic area

Autor(es)

da Silva Ferreira, Elis Regina ^[1] ; de Oliveira Goncalves, Ana Carolina ^[2] ; Verro, Alice Tobal ^[2] ; Undurraga, Eduardo A. ^[3] ; Nogueira, Mauricio Lacerda ^[4] ; Estofolete, Cassia Fernanda ^[4] ; da Silva, Natal Santos ^[1]

Afiliação do(s) autor(es)

^[1] Fac Med Sao Jose do Rio Preto, Programa Posgrad Ciencias Saude, Av Brg Faria Limo, 5416 Vila Sao Pedro, BR-15090000 Sao Jose Do Rio Preto, SP - Brazil

^[2] Uniao Fac Grandes Lagos, Fac Med, BR-15030070 Sao Jose Do Rio Preto, SP - Brazil

^[3] Pontificia Univ Catolica Chile, Escuela Gobierno, Santiago 13083872, Region Metropol - Chile

^[4] Fac Med Sao Jose do Rio Preto, Lab Pesquisas Virol, BR-15090000 Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Transactions of the Royal Society of Tropical Medicine and Hygiene; v. 114, n. 8, p. 603-611, AUG 2020.
• Citações Web of Science: 1

Resumo

Background: We evaluated the validity of clinical diagnosis compared with Laboratory diagnosis of dengue in a retrospective sample of patients in Sao Jose do Rio Preto, Brazil. Methods: Our sample included 148 299 clinically (56.3%) or Laboratory-diagnosed (43.7%) dengue cases. We compared the sensitivity, specificity, positive and negative predictive value (PPV and NPV) of dengue patients' demographic and clinical characteristics with Laboratory-based diagnosis. We used Logistic regressions to estimate the correlation between clinical and Laboratory diagnosis of dengue and a full set of dengue signs and symptoms. Results: We found substantial variability in sensitivity and specificity of signs and symptoms ranging from 0.8-81.1 and 21.5-99.6, respectively. Thrombocytopenia exhibited the highest PPV (92.0) and Lowest NPV (42.2) and was the only symptom showing agreement with Laboratory-confirmed dengue (gyp = 0.38). The presence of exanthema and thrombocytopenia Led to a greater Likelihood of concordant clinical and Laboratory diagnoses (exanthema: OR: 4.23; 95% CI: 2.09 to 8.57; thrombocytopenia: OR: 4.02; 95% CI: 1.32 to 12.27). Conclusions: We found substantial variation in sensitivity, specificity, PPV and NPV of dengue signs and symptoms. For accuracy, clinical and Laboratory diagnosis of dengue should be performed concurrently. When Laboratory tests are not available, we suggest focusing on the clinical manifestations most associated with dengue. (AU)

• Processo FAPESP: 13/21719-3 - Estudo epidemiológico da dengue (sorotipos 1 a 4) em coorte prospectiva de São José do Rio Preto, São Paulo, Brasil, durante 2014 a 2018
• Beneficiário: Maurício Lacerda Nogueira
• Modalidade de apoio: Auxílio à Pesquisa - Temático