American Journal of Tropical Medicine and Hygiene · 2005 · 108 citations · 0 references
Veterinary MedicineHematologyInfectious DiseasesClinical EpidemiologyEpidemiologyInfectious Disease EpidemiologyMosquito-borne DiseasesTropical MedicineDengue FeverDengue Hemorrhagic FeverDifferential Diagnosis Of FeverHemorrhagic ManifestationsTropical Disease DiagnosticsWho Grading Classification
The World Health Organization (WHO) scheme for classification of dengue severity was evaluated in a three-year study of 1,671 confirmed dengue cases in three Nicaraguan hospitals. The WHO classification of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) was compared with the presence of hemorrhagic manifestations, signs of vascular permeability, marked thrombocytopenia, and shock in 114 infants, 1,211 children, and 346 adults. We found that strict application of the WHO criteria fails to detect a significant number of patients with severe manifestations of dengue, especially in adults.