Evaluation of the World Health Organization clinical definition of dengue.

Abstract

Introduction. The distinction between dengue and other acute febrile diseases is difficult when based solely on symptoms.
Objective. An attempt was made to evaluate usefulness of dengue diagnoses in an endemic area (Bucaramanga, Colombia), based on the definitions recommended by the World Health Organization.
Materials And Methods. In a cohort >12 years of age with indications of acute febrile illness, the sensitivity, the specificity and the predictive values were determined based on the WHO dengue definition. Two or more of the following symptoms were included: headache, retroorbital pain, myalgia, arthralgia, rash, hemorrhagic manifestations, or leucopenia.
Results. One hundred-one cases of dengue and 89 patients with acute febrile illness were enrolled in the study. The dengue cases were confirmed by serological or by virus presence. The WHO case definitions showed sensitivity, 99%; specificity, 1%; positive predictive value, 53%, and negative predictive value, 50%.
Conclusion. This clinical definition demonstrated high sensitivity, but a low specificity. Therefore, the clinical definition was useful for screening, but it did not differentiate between dengue and other febrile diseases.