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Criteria of “persistent vomiting” in the WHO 2009 warning signs for dengue case classification


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Title: Criteria of “persistent vomiting” in the WHO 2009 warning signs for dengue case classification
Authors: Vuong, Nguyen Lam / Manh, Dao Huy / Mai, Nguyen Thi / Phuc, Le Hong / Luong, Van Thuy / Quan, Vo Duy / Thuong, Nguyen Van / Lan, Nguyen Thi Phuong / Nhon, Cao Thi My / Mizukami, Shusaku / Doan, Nguyen Ngoc / Huong, Vu Thi Que / Huy, Nguyen Tien / Hirayama, Kenji
Issue Date: 16-May-2016
Publisher: 日本熱帯医学会 / Japanese Society of Tropical Medicine
Citation: Tropical Medicine and Health, 44, 14; 2016
Abstract: Introduction: Dengue is a viral disease that spreads rapidly in the tropic and subtropic regions of the world and causes 22,000 deaths annually. In 2009, the World Health Organization (WHO) released a new classification of dengue infections, which divided them into three categories: dengue without warning sign (D), dengue with warning sign (DWS), and severe dengue (SD). However, researchers have been using different criteria to define persistent vomiting; therefore, we aimed to evaluate the ability of the number of vomiting times in early prediction of SD development among D/DWS patients. Method: A hospital-based cohort study was conducted in Ben Tre-south of Vietnam. We enrolled confirmed dengue patients with D and DWS at admission. The final classification was determined on the discharged day for every patient based on the classification of WHO 2009 without using vomiting symptom, using the receiver operating characteristic (ROC) curve to evaluate the ability of the number of vomiting times in early prediction of SD development among D/DWS patients. Result: The prevalence of vomiting symptom was higher in SD group than D/DWS group (92 versus 46 %, p = 0.006), and the median of the number of vomiting times was higher in SD group than D/DWS group (2.5 versus 0, p = 0.001). To distinguish SD from D/DWS, the ROC curve of the number of vomiting episodes showed that the area under the curve was 0.77; with the cut point of two, the sensitivity and specificity were 92 and 52 %, respectively. Conclusion: The number of vomiting times could be a good clinical sign which can early predict SD from the group of D/DWS. We suggest the definition of persistent vomiting should be vomiting two times or more per day.
Keywords: Dengue / Prediction / Severity / Vomiting / Warning sign
URI: http://hdl.handle.net/10069/37289
DOI: 10.1186/s41182-016-0014-9
Rights: © The Author(s) 2016 / This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/37289

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