Table 2.
Diagnostic value of warning signs at admission according to dengue severity
| The 2009 WHO definitions | Sensitivity (95 % CI) |
Specificity (95 % CI) |
PPV (95 % CI) |
NPV (95 % CI) |
LR+ (95 % CI) |
LR– (95 % CI) |
||
|---|---|---|---|---|---|---|---|---|
| Severe (n = 20) |
Non-severe (n = 105) |
|||||||
| Individual warning sign | ||||||||
| Abdominal pain | 9 | 44 | 45.0 (23.1–68.5) |
58.1 (48.1–67.7) |
17.0 (8.1–29.8) |
84.7 (74.3–92.1) |
1.1 (0.6–1.8) |
0.9 (0.6–1.4) |
| Persistent vomiting | 8 | 12 | 40.0 (19.1–64.0) |
88.6 (80.9–94.0) |
40.0 (19.1–64.0) |
88.6 (80.9–94.0) |
3.5 (1.6–7.4) |
0.7 (0.5–1.0) |
| Clinical fluid accumulation | 15 | 10 | 75.0 (50.9–91.3) |
90.5 (83.2–95.3) |
60.0 (38.7–78.9) |
95.0 (88.7–98.4) |
7.9 (4.2–15.0) |
0.3 (0.1–0.6) |
| Lethargy | 18 | 76 | 90.0 (68.3–98.8) |
27.6 (19.3–37.2) |
19.2 (11.8–28.6) |
93.6 (78.6–99.2) |
1.2 (1.0–1.5) |
0.4 (0.1–1.4) |
| Liver span of >15 cm | 12 | 17 | 60.0 (36.0–80.9) |
83.8 (75.4–90.3) |
41.4 (23.5–61.1) |
91.7 (84.2–96.3) |
3.7 (2.1–6.5) |
0.5 (0.3–0.8) |
| Mucosal bleeding | 14 | 39 | 70.0 (45.7–88.1) |
62.9 (52.9–72.1) |
26.4 (15.3–40.3) |
91.7 (82.7–96.9) |
1.9 (1.3–2.8) |
0.5 (0.2–1.0) |
| Hematocrit >2 % and platelets ≤100 × 103/μL | 12 | 42 | 60.0 (36.0–80.9) |
60.0 (50.0–69.4) |
22.2 (12.0–35.6) |
88.7 (79.0–95.0) |
1.5 (1.0–2.3) |
0.7 (0.4–1.2) |
| Number of warning signs | ||||||||
| ≥ 1 | 20 | 95 | 100.0 (83.2–100.0) |
9.5 (4.7–16.8) |
17.4 (11.0–25.6) |
100.0 (69.2–100.0) |
1.1 (1.0–1.2) |
0 |
| ≥ 2 | 19 | 71 | 95.0 (75.1–99.9) |
32.4 (23.6–42.1) |
21.1 (13.2–31.0) |
97.1 (85.1–99.9) |
1.4 (1.2–1.7) |
0.2 (0–1.1) |
| ≥ 3 | 17 | 43 | 85.0 (62.1–96.8) |
59.0 (49.0–68.6) |
28.3 (17.4–41.4) |
95.4 (87.1–99.0) |
2.1 (1.6–2.8) |
0.2 (0.1–0.7) |
| ≥ 4 | 14 | 21 | 70.0 (45.7–88.1) |
80.0 (71.1–87.2) |
40.0 (23.9–57.9) |
93.3 (86.0–97.5) |
3.5 (2.2–5.6) |
0.4 (0.2–0.7) |
| ≥ 5 | 11 | 8 | 55.0 (31.5–76.9) |
92.4 (85.5–96.6) |
57.9 (33.5–79.8) |
91.5 (84.5–96.0) |
7.2 (3.3–15.7) |
0.5 (0.3–0.8) |
| ≥ 6 | 5 | 2 | 25.0 (8.7–49.1) |
98.1 (93.3–99.8) |
71.4 (29.0–96.3) |
87.3 (79.9–92.7) |
13.1 (2.7–63.0) |
0.8 (0.6–1.0) |
WHO World Health Organization; CI confidence interval; PPV positive predictive value; NPV negative predictive value; LR+ positive likelihood ratio; LR– negative likelihood ratio