Evaluation of the Traditional and Revised WHO Classifications of Dengue Disease Severity 英文参考文献.docVIP

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Evaluation of the Traditional and Revised WHO Classifications of Dengue Disease Severity 英文参考文献.doc

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Evaluation of the Traditional and Revised WHO Classifications of Dengue Disease Severity 英文参考文献

EvaluationoftheTraditionalandRevisedWHO ClassificationsofDengueDiseaseSeverity FedericoNarvaez1,2.,GamalielGutierrez2.,MariaAngelesPe′rez1,2,DouglasElizondo2 ,Andrea Nun?ez2,3,AngelBalmaseda2,3,EvaHarris2,4 * 1Infectious Diseases Unit, Hospital Infantil Manuel de Jesu′s Rivera, Managua, Nicaragua, 2Sustainable Sciences Institute, Managua, Nicaragua, 3National Virology Laboratory, Centro Nacional de Diagno′stico y Referencia, Ministry of Health, Managua, Nicaragua, 4Division of InfectiousDiseases and Vaccinology, School of Public Health,UniversityofCalifornia,Berkeley,California,UnitedStatesofAmerica Abstract Dengueisamajorpublichealthproblemworldwideandcontinuestoincreaseinincidence.Denguevirus(DENV)infection leads to a range of outcomes, including subclinical infection, undifferentiated febrile illness, Dengue Fever (DF), life- threateningsyndromeswithfluidlossandhypotensiveshock,orotherseveremanifestationssuchasbleedingandorgan failure.Thelong-standingWorldHealthOrganization(WHO)dengueclassificationandmanagementschemewasrecently revised,replacingDF,DengueHemorrhagicFever(DHF),andDengueShockSyndrome(DSS)withDenguewithoutWarning Signs,Dengue withWarning Signs(abdominal pain,persistent vomiting, fluidaccumulation, mucosal bleeding,lethargy, liver enlargement, increasing hematocrit with decreasing platelets) and Severe Dengue (SD; dengue with severe plasma leakage,severebleeding,ororganfailure).Weevaluatedthetraditionalandrevisedclassificationschemesagainstclinical interventionlevelstodeterminehoweachcapturesdiseaseseverityusingdatafromfiveyears(2005–2010)ofahospital- based study of pediatric dengue in Managua, Nicaragua. Laboratory-confirmed dengue cases (n=544) were categorized usingbothclassificationschemesandbylevelofcare(I–III).CategoryIwasout-patientcare,CategoryIIwasin-patientcare thatdidnotmeetcriteriaforCategoryIII,whichincludedICUadmission,ventilation,administrationofinotropicdrugs,or organ failure. Sensitivity and specificity to capture Category III care