Abstract

LOVERA, Dolores  and  ARBO, Antonio. Prospective study of the effectiveness of WHO Dengue 1997 classification for the clinical management in children. Rev. Inst. Med. Trop. [online]. 2014, vol.9, n.2, pp.3-9. ISSN 1996-3696.

Abstract Introduction: The early recognition and care and handling of fluids represent the key management of dengue. To evaluate the effectiveness of the 2009 classification of dengue for early detection of patients (pts) who require intervention (DRI). Population and methods: All pts <15 years admitted to the Institute of Tropical Medicine (IMT) during the outbreak of dengue 2011 laboratory confirmed (IgM ELISA, Ag NS1 or RT-PCR) or epidemiological link were ranked by criteria 1997 [Dengue Fever (DF), dengue hemorrhagic fever (DHF) and Dengue Shock (SSD)] or 2009 (dengue with / without warning signs and severe dengue). DRI is defined cases requiring management with intravenous fluids and / or hospitalization. Results: During the outbreak, 1120 pts were admitted to IMT, of which 123 were children with a mean age of 11 ± 3 years. Using the classification 2009, 119 pts (97%) cases were DRI (75% with warning signs and signs with severe 25%), while only the classification 1997 67 pts (54%) cases were DRI (p < 0.001). With the 1997 classification, 13 pts (10%) were classified as severe cases (FHD III / IV) vs 30 pts (24%) with the classification 2009 (p <0.05). Severe cases undetected 1997 classification included 11 pts (9%) with hemoconcentration (HC) without bleeding or hypotension without HC and 4 pts (3%) with visceral involvement (encephalitis / hepatitis). Conclusions: This study confirms that the 2009 WHO dengue classification is better at detecting severe dengue compared with the previous WHO classification (1997) and has an impact in the clinical setting.

Keywords : Classification 1997; Dengue; WHO .

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