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The Sensitivity, Specificity and Accuracy of Warning Signs in Predicting Severe Dengue, the Severe Dengue Prevalence and Its Associated Factors

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  • Mohd Hanief Ahmad

    (Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia)

  • Mohd Ismail Ibrahim

    (Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia)

  • Zeehaida Mohamed

    (Department of Microbiology & Parasitology, School of Medical Sciences, Hospital Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia)

  • Nabilah Ismail

    (Department of Microbiology & Parasitology, School of Medical Sciences, Hospital Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia)

  • Muhammad Amiruddin Abdullah

    (Department of Microbiology & Parasitology, School of Medical Sciences, Hospital Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia)

  • Rafidah Hanim Shueb

    (Department of Microbiology & Parasitology, School of Medical Sciences, Hospital Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia)

  • Mohd Nazri Shafei

    (Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia)

Abstract

Objectives: To study Malaysian dengue clinical practice guideline (CPG) warning signs (WS) in predicting severe dengue (SD) and its associated factors among confirmed cases presented to a teaching hospital in north-eastern Malaysia in 2014. Methods: A cross-sectional study was performed in February 2015 using secondary data acquired from the hospital records. There were 2607 confirmed dengue cases presented to Hospital Universiti Sains Malaysia (HUSM) in 2014. Seven hundred patients were selected after proportionate stratified random sampling conducted according to the number of cases in 12 different months in 2014. Data were collected and analysed using SPSS version 22.0. Results: Severe dengue outcomes represented 4.9% of cases. The prevalence of any of WS in SD was 91.2%. The most common WSs prior to SD were persistent vomiting (55.9%), and abdominal pain/tenderness (52.9%). The most sensitive warning sign in detecting SD was abdominal pain (59%). Specificity of individual WS were generally good, especially of clinical fluid accumulation (99%), hepatomegaly (98%) and mucosal bleeding (93%). Factors associated with SD were persistent vomiting (Adjusted odds ratio (aOR)): 2.41), mucosal bleeding (aOR: 4.73) and haematocrit rise with rapid platelet drop (aOR: 2.74). Conclusion: A focus on sensitivity, specificity, predictive values and association of a number of particular WS should be emphasized in order to better predict severe dengue outcomes.

Suggested Citation

  • Mohd Hanief Ahmad & Mohd Ismail Ibrahim & Zeehaida Mohamed & Nabilah Ismail & Muhammad Amiruddin Abdullah & Rafidah Hanim Shueb & Mohd Nazri Shafei, 2018. "The Sensitivity, Specificity and Accuracy of Warning Signs in Predicting Severe Dengue, the Severe Dengue Prevalence and Its Associated Factors," IJERPH, MDPI, vol. 15(9), pages 1-12, September.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:9:p:2018-:d:170052
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    1. Samir Bhatt & Peter W. Gething & Oliver J. Brady & Jane P. Messina & Andrew W. Farlow & Catherine L. Moyes & John M. Drake & John S. Brownstein & Anne G. Hoen & Osman Sankoh & Monica F. Myers & Dylan , 2013. "The global distribution and burden of dengue," Nature, Nature, vol. 496(7446), pages 504-507, April.
    2. Kuan-Meng Soo & Bahariah Khalid & Siew-Mooi Ching & Hui-Yee Chee, 2016. "Meta-Analysis of Dengue Severity during Infection by Different Dengue Virus Serotypes in Primary and Secondary Infections," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-16, May.
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    1. Giordana Poletti-Jabbour & Natalia Elejalde-Farfán, 2019. "Comments on the Study “The Sensitivity, Specificity and Accuracy of Warning Signs in Predicting Severe Dengue, the Severe Dengue Prevalence and Its Associated Factors”," IJERPH, MDPI, vol. 16(6), pages 1-2, March.

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