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Free Content Dengue in travellers: applicability of the 1975–1997 and the 2009 WHO classification system of dengue fever

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Objectives  The aim of this study was to assess the applicability and benefits of the new WHO dengue fever guidelines in clinical practice, for returning travellers.

Methods  We compared differences in specificity and sensitivity between the old and the new guidelines for diagnosing dengue and assessed the usefulness in predicting the clinical course of the disease. Also, we investigated whether hypertension, diabetes or allergies, ethnicity or high age influenced the course of disease.

Results  In our setting, the old classification, compared with the new, had a marginally higher sensitivity for diagnosing dengue. The new classification had a slightly higher specificity and was less rigid. Patients with dengue who had warning signs as postulated in the new classification were admitted more often than those who had no warning signs (RR, 8.09 [1.80–35.48]). We did not find ethnicity, age, hypertension, diabetes mellitus or allergies to be predictive of the clinical course.

Conclusions  In our cohort of returned travellers, the new classification system did not differ in sensitivity and specificity from the old system to a clinically relevant degree. The guidelines did not improve identification of severe disease.
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Language: English

Document Type: Research Article

Affiliations: 1:  Center for Tropical Medicine and Travel Medicine, University of Amsterdam, Amsterdam, The Netherlands 2:  Laboratory of Clinical Virology, University of Amsterdam, Amsterdam, The Netherlands

Publication date: August 1, 2012

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