The Value of Warning Signs From the WHO 2009 Dengue Classification in Detecting Severe Dengue in Children Article Swipe
Mulya Rahma Karyanti
,
Cuno S.P.M. Uiterwaal
,
Sri Rezeki Hadinegoro
,
Indah Suci Widyahening
,
Siti Rizny F Saldi
,
Hans Heesterbeek
,
Arno W. Hoes
,
Patricia Bruijning‐Verhagen
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1097/inf.0000000000004326
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1097/inf.0000000000004326
Background: World Health Organization proposed 7 warning signs to identify the risk of severe dengue in 2009. This study aimed to evaluate the value of these warning signs in detecting severe dengue in children. Material and Methods: A cross-sectional study was conducted utilizing data of children with clinical dengue infection obtained from medical records between January 2009 and December 2018 in Jakarta. Children with confirmed dengue were analyzed and stratified into 3 age groups: infants less than 1 year old, children 1–14 years and adolescents 15–18 years of age. Positive predictive value, negative predictive value (NPV), sensitivity and specificity of each warning sign present or absent on admission in detecting severe dengue were computed. Results: Six hundred ninety-nine children with clinical dengue infection were enrolled, among whom 614 (87.8%) had confirmed dengue infection, either by antigen or antibody serological tests. Severe dengue occurred in 211/614 (34.4%) cases. In infants, important warning signs on admission to detect or exclude severe dengue were liver enlargement (NPV 80.8%) and clinical fluid accumulation (NPV 75%). In children and adolescents, warning sign with highest NPV (in children 76.6% and in adolescents 91.9%) was increase in hematocrit concurrent with a rapid decrease in platelet count. Other warning signs with high NPV values in children were abdominal pain (72%), vomiting (70%), clinical fluid accumulation (69.3%), and in adolescents’ abdominal pain (80.7%), vomiting (75.7%), clinical fluid accumulation (82.7%). NPVs increase with more than 1 warning sign in all age groups. Conclusion: In infants, liver enlargement or clinical fluid accumulation are important warning signs for severe dengue, when both are absent, severe dengue is unlikely. In older children and adolescents, an increase in hematocrit with the concurrent rapid decrease in platelet count is most discriminative; followed by the absence of abdominal pain, vomiting or fluid accumulation are unlikely severe dengue.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1097/inf.0000000000004326
- OA Status
- hybrid
- Cited By
- 7
- References
- 19
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4395033968
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4395033968Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1097/inf.0000000000004326Digital Object Identifier
- Title
-
The Value of Warning Signs From the WHO 2009 Dengue Classification in Detecting Severe Dengue in ChildrenWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-04-19Full publication date if available
- Authors
-
Mulya Rahma Karyanti, Cuno S.P.M. Uiterwaal, Sri Rezeki Hadinegoro, Indah Suci Widyahening, Siti Rizny F Saldi, Hans Heesterbeek, Arno W. Hoes, Patricia Bruijning‐VerhagenList of authors in order
- Landing page
-
https://doi.org/10.1097/inf.0000000000004326Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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hybridOpen access status per OpenAlex
- OA URL
-
https://doi.org/10.1097/inf.0000000000004326Direct OA link when available
- Concepts
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Dengue fever, Medicine, Vomiting, Warning signs, Abdominal pain, Pediatrics, Nausea, Dengue virus, Internal medicine, Immunology, Engineering, Transport engineeringTop concepts (fields/topics) attached by OpenAlex
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7Total citation count in OpenAlex
- Citations by year (recent)
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2025: 5, 2024: 2Per-year citation counts (last 5 years)
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19Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.groups. | 241 |
| abstract_inverted_index.groups: | 73 |
| abstract_inverted_index.highest | 178 |
| abstract_inverted_index.hundred | 116 |
| abstract_inverted_index.infants | 74 |
| abstract_inverted_index.medical | 52 |
| abstract_inverted_index.present | 103 |
| abstract_inverted_index.records | 53 |
| abstract_inverted_index.warning | 6, 26, 101, 150, 175, 200, 236, 253 |
| abstract_inverted_index.(69.3%), | 217 |
| abstract_inverted_index.(75.7%), | 225 |
| abstract_inverted_index.(80.7%), | 223 |
| abstract_inverted_index.(82.7%). | 229 |
| abstract_inverted_index.Children | 62 |
| abstract_inverted_index.December | 58 |
| abstract_inverted_index.Jakarta. | 61 |
| abstract_inverted_index.Material | 34 |
| abstract_inverted_index.Methods: | 36 |
| abstract_inverted_index.Positive | 89 |
| abstract_inverted_index.Results: | 114 |
| abstract_inverted_index.analyzed | 67 |
| abstract_inverted_index.antibody | 137 |
| abstract_inverted_index.children | 45, 80, 118, 172, 181, 207, 268 |
| abstract_inverted_index.clinical | 47, 120, 166, 214, 226, 248 |
| abstract_inverted_index.decrease | 195, 279 |
| abstract_inverted_index.evaluate | 21 |
| abstract_inverted_index.followed | 286 |
| abstract_inverted_index.identify | 9 |
| abstract_inverted_index.increase | 188, 231, 272 |
| abstract_inverted_index.infants, | 148, 244 |
| abstract_inverted_index.negative | 92 |
| abstract_inverted_index.obtained | 50 |
| abstract_inverted_index.occurred | 142 |
| abstract_inverted_index.platelet | 197, 281 |
| abstract_inverted_index.proposed | 4 |
| abstract_inverted_index.unlikely | 298 |
| abstract_inverted_index.vomiting | 212, 224, 293 |
| abstract_inverted_index.abdominal | 209, 221, 291 |
| abstract_inverted_index.admission | 107, 153 |
| abstract_inverted_index.children. | 33 |
| abstract_inverted_index.computed. | 113 |
| abstract_inverted_index.conducted | 41 |
| abstract_inverted_index.confirmed | 64, 130 |
| abstract_inverted_index.detecting | 29, 109 |
| abstract_inverted_index.enrolled, | 124 |
| abstract_inverted_index.important | 149, 252 |
| abstract_inverted_index.infection | 49, 122 |
| abstract_inverted_index.unlikely. | 265 |
| abstract_inverted_index.utilizing | 42 |
| abstract_inverted_index.concurrent | 191, 277 |
| abstract_inverted_index.hematocrit | 190, 274 |
| abstract_inverted_index.infection, | 132 |
| abstract_inverted_index.predictive | 90, 93 |
| abstract_inverted_index.stratified | 69 |
| abstract_inverted_index.Background: | 0 |
| abstract_inverted_index.Conclusion: | 242 |
| abstract_inverted_index.adolescents | 84, 185 |
| abstract_inverted_index.enlargement | 162, 246 |
| abstract_inverted_index.ninety-nine | 117 |
| abstract_inverted_index.sensitivity | 96 |
| abstract_inverted_index.serological | 138 |
| abstract_inverted_index.specificity | 98 |
| abstract_inverted_index.Organization | 3 |
| abstract_inverted_index.accumulation | 168, 216, 228, 250, 296 |
| abstract_inverted_index.adolescents, | 174, 270 |
| abstract_inverted_index.adolescents’ | 220 |
| abstract_inverted_index.cross-sectional | 38 |
| abstract_inverted_index.discriminative; | 285 |
| cited_by_percentile_year.max | 98 |
| cited_by_percentile_year.min | 94 |
| corresponding_author_ids | https://openalex.org/A5056733498, https://openalex.org/A5112061626 |
| countries_distinct_count | 2 |
| institutions_distinct_count | 8 |
| corresponding_institution_ids | https://openalex.org/I193662353, https://openalex.org/I29617571, https://openalex.org/I3018483916 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/10 |
| sustainable_development_goals[0].score | 0.6700000166893005 |
| sustainable_development_goals[0].display_name | Reduced inequalities |
| citation_normalized_percentile.value | 0.95265244 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |