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A screening tool for dengue fever in children
Wen-Pin Lai1, Tsair-Wei Chien, Hung-Jung Lin
1Department of Emergency Medicine, Chi-Mei Medical Cente, Chia-Nan University of Pharmacy and Science, Taiwan.
Insights
A new Dengue Fever (DF) scale (DF-14) effectively identifies pediatric cases using clinical and lab data. This tool aids early DF detection in children, potentially reducing the need for complex diagnostic tests.
Area of Science:
- Pediatric infectious diseases
- Clinical diagnostics
- Public health surveillance
Background:
- Dengue fever (DF) poses a significant public health challenge in Asia.
- Accurate and rapid case-finding tools are crucial for managing DF outbreaks.
- Early detection in children is vital for timely intervention and reducing disease burden.
Purpose of the Study:
- To develop and validate a rapid, accurate case-finding tool for Dengue Fever in pediatric populations.
- To utilize clinical and laboratory data for predicting DF risk in children.
- To create a cost-effective diagnostic aid for DF in resource-limited settings.
Main Methods:
- Retrospective analysis of 24 DF-related characteristics (17 clinical, 7 laboratory) from 177 pediatric patients.
- Psychometric evaluation of data using a Rasch measurement model.
- Assessment of predictive values for DF risk using derived scales.
Main Results:
- The 14-item Dengue Fever scale (DF-14) demonstrated a good fit with the measurement model.
- At a cutoff of -1.15 (logit), the DF-14 scale achieved 0.76 sensitivity and 0.76 specificity.
- The DF-2 scale, using white blood cell and platelet counts, showed clinical utility for simple DF assessment.
- The Area Under the Curve (AUC) for the DF-14 scale was 0.93, indicating high diagnostic accuracy.
Conclusions:
- Simple laboratory data, as incorporated in the DF-2 and DF-14 scales, are valuable for early Dengue Fever risk detection in children.
- The DF-14 scale effectively differentiates Dengue Fever from other febrile illnesses.
- These scales may reduce reliance on expensive and time-consuming confirmatory dengue diagnostic tests.
Background:
Dengue fever (DF) is a significant public health issue in Asia. We aimed to use clinical and laboratory data to derive a rapid and accurate case-finding tool for DF in children.
Methods:
This retrospective study used 24 DF-related characteristics and clinical features (17 clinical; 7 laboratory) of 177 pediatric patients (69 diagnosed with DF). Data were psychometrically evaluated using a Rasch measurement model, and their values for predicting DF risk were evaluated.
Results:
The 14-item scale (DF-14) fit the measurement model in assessing the likelihood of DF. When a cutoff point of -1.15 (in logit) of the DF-14 scale was used, the sensitivity was 0.76 and the specificity was 0.76. The area under the curve was 0.93 (95% confidence interval: 0.89-0.97). The DF-2 scale, comprised of white blood cell and platelet counts, was simple but clinically useful.
Conclusions:
Simple laboratory data, such as those in the DF-2 and DF-14 scales, are useful for the early detection of DF risk in children. The DF-14 scale helps discriminate DF from other febrile illnesses and may eliminate the need for a costly and time-consuming dengue confirmation test.
