Martínez Ruth Aralí, Díaz Fredi Alexander, Villar Luis Angel
Centro de Investigaciones Epidemiológicas, Facultad de Salud, Universidad Industrial de Santander, Bucaramanga, Colombia.
Biomedica. 2005 Sep;25(3):412-6.
The distinction between dengue and other acute febrile diseases is difficult when based solely on symptoms.
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.
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.
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%.
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.
仅依据症状很难区分登革热与其他急性发热性疾病。
根据世界卫生组织推荐的定义,尝试评估在流行地区(哥伦比亚布卡拉曼加)进行登革热诊断的实用性。
在一个年龄大于12岁且有急性发热性疾病指征的队列中,根据世界卫生组织的登革热定义确定敏感性、特异性和预测值。纳入以下两种或更多症状:头痛、眶后疼痛、肌痛、关节痛、皮疹、出血表现或白细胞减少。
101例登革热病例和89例急性发热性疾病患者纳入研究。登革热病例通过血清学或病毒检测确诊。世界卫生组织的病例定义显示敏感性为99%;特异性为1%;阳性预测值为53%,阴性预测值为50%。
该临床定义显示出高敏感性,但特异性较低。因此,该临床定义对筛查有用,但无法区分登革热与其他发热性疾病。