Evaluating the WHO Classification System for Dengue Severity in Children
Author Information
Author(s): Setiati Tatty E, Mairuhu Albert TA, Koraka Penelopie, Supriatna Mohamed, Mac Gillavry Melvin R, Brandjes Dees PM, Osterhaus Albert DME, van der Meer Jos WM, van Gorp Eric CM, Soemantri Augustinus
Primary Institution: Department of Child Health, Dr. Kariadi Hospital, Semarang, Indonesia
Hypothesis
Is the WHO classification system appropriate for classifying dengue disease severity in children?
Conclusion
The WHO classification system is not accurate in classifying dengue disease severity and lacks sufficient agreement with clinical practice.
Supporting Evidence
- The WHO classification system had a sensitivity of 86% for detecting patients with shock.
- All modifications to the WHO classification system had a higher sensitivity than the WHO classification system.
- Six patients died due to prolonged shock, massive hemorrhage, and respiratory failure.
Takeaway
Doctors use a system to decide how serious dengue is, but it doesn't always work well, so they might need a better way to tell how sick kids are.
Methodology
Patients with suspected severe dengue were classified using the WHO system and modifications, and their classifications were compared with those of treating physicians.
Potential Biases
Treating physicians may have classified patients based on clinical judgment rather than strict criteria, leading to potential misclassification.
Limitations
The study's retrospective classification may limit its applicability for identifying at-risk patients, and it was confined to Javanese patients.
Participant Demographics
Patients aged 2 to 14 years, with a median age of 7 years.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI 76–94
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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