Paternina-Caicedo Angel, De la Hoz-Restrepo Fernando, Díaz-Quijano Fredi, Caicedo-Torres William, Auxiliadora Badillo-Viloria María, Bula-Anichiarico Doris, Alvis-Guzmán Nelson, Mattar Salim, Constenla Dagna, Pinzón-Redondo Hernando
Departamento de Epidemiologia, Hospital Infantil Napoleón Franco Pareja-La Casa del Niño, Cartagena, Colombia.
Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
J Trop Pediatr. 2018 Feb 1;64(1):31-37. doi: 10.1093/tropej/fmx024.
We aimed to assess clinical and laboratory differences between dengue and chikungunya in children <24 months of age in a comparative study. We collected retrospective clinical and laboratory data confirmed by NS1/IgM for dengue for 19 months (1 January 2013 to 17 August 2014). Prospective data for chikungunya confirmed by real-time polymerase chain reaction were collected for 4 months (22 September 2014-14 December 2014). Sensitivity and specificity [with 95% confidence interval (CI)] were reported for each disease diagnosis. A platelet count <150 000 cells/ml at emergency admission best characterized dengue, with a sensitivity of 67% (95% CI, 53-79) and specificity of 95% (95% CI, 82-99). The algorithm developed with classification and regression tree analysis showed a sensitivity of 93% (95% CI, 68-100) and specificity of 38% (95% CI, 9-76) to diagnose dengue. Our study provides potential differential characteristics between chikungunya and dengue in young children, especially low platelet counts.
在一项对比研究中,我们旨在评估24个月以下儿童登革热和基孔肯雅热的临床及实验室差异。我们收集了19个月(2013年1月1日至2014年8月17日)经NS1/IgM确诊的登革热回顾性临床和实验室数据。收集了4个月(2014年9月22日至2014年12月14日)经实时聚合酶链反应确诊的基孔肯雅热前瞻性数据。报告了每种疾病诊断的敏感性和特异性[95%置信区间(CI)]。急诊入院时血小板计数<150 000个细胞/ml最能表征登革热,敏感性为67%(95%CI,53 - 79),特异性为95%(95%CI,82 - 99)。通过分类和回归树分析开发的算法诊断登革热的敏感性为93%(95%CI,68 - 100),特异性为38%(95%CI,9 - 76)。我们的研究提供了幼儿基孔肯雅热和登革热之间潜在的鉴别特征,尤其是低血小板计数。