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Clinical and laboratory signs as dengue markers during an outbreak in Rio de Janeiro
S R L Passos1, S J Bedoya, Y H M Hökerberg
1Clinical Epidemiology Laboratory, Evandro Chagas Clinical Research Institute, Av Brasil 4365 Manguinhos, Rio de Janeiro, 21045900, Brazil. sonialambert@ipec.fiocruz.br
Background:
One of the main challenges for clinical research in dengue is the low validity of clinical diagnosis.
Objective:
To analyze clinical and laboratory data as predicitve factors of dengue diagnosis at Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, during the 2001-2002 dengue outbreak in Rio de Janeiro.
Methods:
Cross sectional study comparing clinical laboratory data collected from the National Information System for Compulsory Notification Diseases (SINAN) in two serologically confirmed groups: dengue D (N = 453) and non-dengue ND (N = 80).
Results:
Fever, exanthema, itching, mean platelet count < 150,000, WBC count < 4,000 and absence of vomiting and of abdominal pain help to distinguish D from ND groups. When considered individually, these signs and symptoms enhance diagnostic sensitivity and, when used in combination, improve specificity.
Conclusion:
A combination of symptoms not necessarily considered indicative of dengue diagnosis could improve surveillance and medical decision-making in simple clinical settings.
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