Dengue Fever Scoring System: New Strategy for the Early Detection of Acute Dengue Virus Infection in Taiwan

被引:22
作者
Chang, Ko [2 ,3 ]
Lu, Po-Liang [2 ,5 ,6 ]
Ko, Wen-Chien [7 ]
Tsai, Jih-Jin [2 ,5 ]
Tsai, Wu-Hsiung
Chen, Chaur-Doug [4 ]
Chen, Yen-Hsu [2 ,5 ]
Chen, Tun-Chieh [2 ,5 ]
Hsieh, Hsiao-Chen [2 ,3 ]
Pan, Chao-Ying [4 ]
Harn, Ming-Rong [1 ]
机构
[1] Kaohsiung Med Univ, Grad Inst Occupat Safety & Hlth, Kaohsiung 807, Taiwan
[2] Kaohsiung Med Univ, Coll Med, Dept Internal Med, Kaohsiung 807, Taiwan
[3] Kaohsiung Municipal Hsaio Kang Hosp, Dept Internal Med, Kaohsiung, Taiwan
[4] Kaohsiung Med Univ Hosp, Bur Publ Hlth, Kaohsiung, Taiwan
[5] Kaohsiung Med Univ Hosp, Dept Internal Med, Kaohsiung, Taiwan
[6] Kaohsiung Med Univ Hosp, Lab Med, Kaohsiung, Taiwan
[7] Natl Cheng Kung Univ, Dept Internal Med, Div Infect Dis, Tainan 70101, Taiwan
关键词
dengue; murine typhus; Q fever; scoring system; scrub typhus; TRAVELERS;
D O I
10.1016/S0929-6646(09)60420-4
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background/Purpose: Dengue fever is an important public health problem in Southern Taiwan. The purpose of this study was to develop a dengue scoring system using a three-stage process, which may be used as a guidance tool for the early diagnosis of dengue fever. Methods: A retrospective study was conducted to identify factors useful for the early diagnosis of dengue fever. We assessed the clinical and laboratory features of 89 adult patients with dengue from 2002 to 2004 at a community-based hospital. They were compared with 14 patients with scrub typhus, 104 with Q fever, and 35 with murine typhus, which might present similar symptoms and signs as dengue infection. A scoring system was designed after analysis of the retrospective study and with the assistance of 10 expert clinicians. For the second stage, we evaluated efficiency in differentiating dengue fever from Q fever, scrub typhus and murine typhus in three hospitals from 2002 to 2005. For the third stage, we prospectively used the dengue scoring system for 498 cases that clinically were suspected as having dengue infection in the city of Kaohsiung from January 2006 to September 2006. Results: The performance of the scoring system was 88.1% sensitivity, 94.9% specificity, 95.7% positive predictive value (PPV), and 86.1% negative predictive value (NPV). Evaluation of the scoring system at the third stage revealed 90.7% sensitivity, 86.9% specificity, 81.4% PPV, and 93.6% NPV. Conclusion: The dengue scoring system had a high NPV that might be helpful in the early diagnosis of dengue fever in adults before laboratory data are available. [J Formos Med Assoc 2009; 108(11):879-885]
引用
收藏
页码:879 / 885
页数:7
相关论文
共 14 条
[1]   Prevalence of relative bradycardia in Orientia tsutsugamushi infection [J].
Aronoff, DM ;
Watt, G .
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, 2003, 68 (04) :477-479
[2]   Distinguishing dengue fever from other infections on the basis of simple clinical and laboratory features: Application of logistic regression analysis [J].
Chadwick, D ;
Arch, B ;
Wilder-Smith, A ;
Paton, N .
JOURNAL OF CLINICAL VIROLOGY, 2006, 35 (02) :147-153
[3]  
Chang Ko, 2004, Journal of Microbiology Immunology and Infection, V37, P103
[4]   Incidence and risk factors of probable dengue virus infection among Dutch travellers to Asia [J].
Cobelens, FGJ ;
Groen, J ;
Osterhaus, ADME ;
Leentvaar-Kuipers, A ;
Wertheim-van Dillen, PME ;
Kager, PA .
TROPICAL MEDICINE & INTERNATIONAL HEALTH, 2002, 7 (04) :331-338
[5]   More Dengue, more questions [J].
Halstead, SB .
EMERGING INFECTIOUS DISEASES, 2005, 11 (05) :740-741
[6]   MEASURES OF THE VALUE OF A DIAGNOSTIC-TEST DERIVED FROM STOCHASTIC THRESHOLDS [J].
HARTZ, A ;
CENTOR, R .
MEDICAL DECISION MAKING, 1986, 6 (03) :149-153
[7]  
Ko WC, 1997, J FORMOS MED ASSOC, V96, P295
[8]  
Lai Ping-Chang, 2004, Journal of Microbiology Immunology and Infection, V37, P266
[9]  
Lee Min-Sheng, 2006, Journal of Microbiology Immunology and Infection, V39, P121
[10]  
Pickard Amy L., 2004, Southeast Asian Journal of Tropical Medicine and Public Health, V35, P657