Abstract
Objectives: To study Malaysian dengue clinical practice guideline (CPG) warning signs (WS) in predicting severe dengue (SD) and its associated factors among confirmed cases presented to a teaching hospital in north-eastern Malaysia in 2014. Methods: A cross-sectional study was performed in February 2015 using secondary data acquired from the hospital records. There were 2607 confirmed dengue cases presented to Hospital Universiti Sains Malaysia (HUSM) in 2014. Seven hundred patients were selected after proportionate stratified random sampling conducted according to the number of cases in 12 different months in 2014. Data were collected and analysed using SPSS version 22.0. Results: Severe dengue outcomes represented 4.9% of cases. The prevalence of any of WS in SD was 91.2%. The most common WSs prior to SD were persistent vomiting (55.9%), and abdominal pain/tenderness (52.9%). The most sensitive warning sign in detecting SD was abdominal pain (59%). Specificity of individual WS were generally good, especially of clinical fluid accumulation (99%), hepatomegaly (98%) and mucosal bleeding (93%). Factors associated with SD were persistent vomiting (Adjusted odds ratio (aOR)): 2.41), mucosal bleeding (aOR: 4.73) and haematocrit rise with rapid platelet drop (aOR: 2.74). Conclusion: A focus on sensitivity, specificity, predictive values and association of a number of particular WS should be emphasized in order to better predict severe dengue outcomes.
Highlights
Dengue has become a significant public health interest all over the world since the 1950s [1].World Health Organization (WHO) predicts that 2.5 billion people were exposed to dengue and its complications
Our results showed that the prevalence of severe dengue (SD) was 4.9%, which was quite similar to the previous studies by Zakaria et al (2014) and Zhang et al (2014) with the prevalence rate of 4.6% and 5.6%
Our study demonstrated that out of seven warning signs, only hepatomegaly had a sensitivity of less than 25%
Summary
Dengue has become a significant public health interest all over the world since the 1950s [1]. World Health Organization (WHO) predicts that 2.5 billion people were exposed to dengue and its complications. A current model calculates 390 million cases per year, with 96 million cases manifesting with at least some clinical presentations [2]. Almost 2.5% died from the infection [3]. Dengue affects tropical and subtropical nations around the world, especially in city and non-rural areas. In Malaysia, the reported dengue cases have generally been increasing in the recent years.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
