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Assessment of severity among adult dengue patients in Colombo district, Sri Lanka
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2015 (English)In: Tropical medicine & international health, ISSN 1360-2276, E-ISSN 1365-3156, Vol. 20, no Suppl. 1, 416-416 p.Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Introduction: Dengue is a major acute febrile illness in Sri Lanka and reported in epidemic proportions. From 2009 to 2013 an average of 35 000 cases were reported annually with over 60% above 15 years of age. Clinical case classification of dengue was originally based on paediatric patients. Here we assess severity of dengue illness among adults according to both WHO classical and TDR classifications.

Methods: A study was conducted in 100 adult patients presenting to ID Hospital, Colombo with fever <7 days, in 2013. All were tested for dengue ELISA NS1/IgM and RT-PCR. Of them 88 were confirmed as having dengue, and were classified into two WHO classifications. Type of care received was categorized into three levels as:

Category 1 – general ward,

Category 2 – special dengue unit,

Category 3 – intensive care unit.

Results: According to classical classification, 47 (53.4%) were Dengue Fever (DF) patients. Of them 31and 16 received Category 1 and 2 care respectively. None received Category 3 care. 41 (46.6%) Dengue Haemorrhagic Fever (DHF) patients. Of them 14 received category 1 care while 25 and two received Category 2 and Category 3 care respectively. Classical classification and level of care sensitivity was 62.8% (CI 48–78) while specificity was 68.9% (CI 55–82). According to TDR classification 29 (32.9%) were Dengue patients without warning signs. Of them 22 and 07 received Category 1 and 2 level of care respectively and none went into category 3. 48 (55%) were Dengue with warning signs and 11 (13%) severe dengue patients. Of them 18 received Category 1 care while 39 and two received category 2 and category 3 care respectively. TDR classification and level of care sensitivity was 85.4% (CI 75–95) Specificity 55% (CI 39–70).

Conclusions: WHO TDR classification captures more patients who need closer observation in Category 2 and three levels of care than classical classification. This may warrant additional hospital resources in developing country settings.

Disclosure: This research was funded by the European Union 7th Framework Programme through 'DengueTools'.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015. Vol. 20, no Suppl. 1, 416-416 p.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-109919ISI: 000360758802279OAI: oai:DiVA.org:umu-109919DiVA: diva2:861395
Conference
The 9th European Congress on Tropical Medicine and International Health (ECTMIH), Basel, Switzerland, September 6-10, 2015
Available from: 2015-10-16 Created: 2015-10-09 Last updated: 2015-10-16Bibliographically approved

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Wilder-Smith, Annelies
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