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Clinicians' diagnostic practice of dengue infections.
J Clin Virol. 2007 Nov; 40(3):202-6.JC

Abstract

BACKGROUND

Difficulties in the classification of dengue infection have been documented. Such difficulties could be due to the low awareness of the World Health Organization diagnostic guidelines among clinicians.

OBJECTIVE

To study the diagnostic practices of clinicians in classifying patients as dengue fever (DF) or dengue haemorrhagic fever (DHF)/dengue shock syndrome (DSS) at the time of discharge during an outbreak.

METHODS

A prospective descriptive study of clinical features and disease classification in adult and pediatric dengue patients in the University of Malaya Medical Centre.

RESULTS

Five hundred and twenty adult and 191 pediatric patients were enrolled. Thrombocytopenia and evidence of plasma leakage were present in 8% of adult and 19% of pediatric patients. Of these, 93% and 49%, respectively, were given the discharge diagnoses of DF instead of DHF/DSS. Hemoconcentration, serous effusion and thrombocytopenia were not recognized in clinicians' discharge diagnosis of DHF/DSS for adult patients. The receiver operating characteristic (ROC) curve suggested a lack of consistency in the use of WHO guidelines in establishing DHF/DSS in adult patients, while implying otherwise for pediatric patients.

CONCLUSION

DHF/DSS is an under-recognized condition by clinicians managing these patients. This can affect the case fatality rate of DHF/DSS and the economic burden of the disease. The lack of awareness in disease manifestations especially plasma leakage, can lead to delayed recognition of DHF/DSS.

Authors+Show Affiliations

Department of Applied Statistics, Faculty of Economics and Administration, University of Malaya, Malaysia. chrisng@um.edu.myNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17928264

Citation

Ng, Chris Fook Sheng, et al. "Clinicians' Diagnostic Practice of Dengue Infections." Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, vol. 40, no. 3, 2007, pp. 202-6.
Ng CF, Lum LC, Ismail NA, et al. Clinicians' diagnostic practice of dengue infections. J Clin Virol. 2007;40(3):202-6.
Ng, C. F., Lum, L. C., Ismail, N. A., Tan, L. H., & Tan, C. P. (2007). Clinicians' diagnostic practice of dengue infections. Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, 40(3), 202-6.
Ng CF, et al. Clinicians' Diagnostic Practice of Dengue Infections. J Clin Virol. 2007;40(3):202-6. PubMed PMID: 17928264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinicians' diagnostic practice of dengue infections. AU - Ng,Chris Fook Sheng, AU - Lum,Lucy Chai See, AU - Ismail,Noor Azina, AU - Tan,Lian Huat, AU - Tan,Christina Phoay Lay, PY - 2007/03/08/received PY - 2007/08/18/revised PY - 2007/08/20/accepted PY - 2007/10/12/pubmed PY - 2007/12/12/medline PY - 2007/10/12/entrez SP - 202 EP - 6 JF - Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology JO - J Clin Virol VL - 40 IS - 3 N2 - BACKGROUND: Difficulties in the classification of dengue infection have been documented. Such difficulties could be due to the low awareness of the World Health Organization diagnostic guidelines among clinicians. OBJECTIVE: To study the diagnostic practices of clinicians in classifying patients as dengue fever (DF) or dengue haemorrhagic fever (DHF)/dengue shock syndrome (DSS) at the time of discharge during an outbreak. METHODS: A prospective descriptive study of clinical features and disease classification in adult and pediatric dengue patients in the University of Malaya Medical Centre. RESULTS: Five hundred and twenty adult and 191 pediatric patients were enrolled. Thrombocytopenia and evidence of plasma leakage were present in 8% of adult and 19% of pediatric patients. Of these, 93% and 49%, respectively, were given the discharge diagnoses of DF instead of DHF/DSS. Hemoconcentration, serous effusion and thrombocytopenia were not recognized in clinicians' discharge diagnosis of DHF/DSS for adult patients. The receiver operating characteristic (ROC) curve suggested a lack of consistency in the use of WHO guidelines in establishing DHF/DSS in adult patients, while implying otherwise for pediatric patients. CONCLUSION: DHF/DSS is an under-recognized condition by clinicians managing these patients. This can affect the case fatality rate of DHF/DSS and the economic burden of the disease. The lack of awareness in disease manifestations especially plasma leakage, can lead to delayed recognition of DHF/DSS. SN - 1386-6532 UR - https://www.unboundmedicine.com/medline/citation/17928264/Clinicians'_diagnostic_practice_of_dengue_infections_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1386-6532(07)00303-4 DB - PRIME DP - Unbound Medicine ER -