Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Diagnostic accuracy of the who clinical definitions for dengue and implications for surveillance: A systematic review and meta-analysis
PLoS Neglected Tropical Diseases, Volume 15, No. 4, Article e0009359, Year 2021
Notification
URL copied to clipboard!
Description
Background Dengue is the world’s most common mosquito-borne virus but remains diagnostically challenging due to its nonspecific presentation. Access to laboratory confirmation is limited and thus most reported figures are based on clinical diagnosis alone, the accuracy of which is uncertain. This systematic review assesses the diagnostic accuracy of the traditional (1997) and revised (2009) WHO clinical case definitions for dengue fever, the basis for most national guidelines. Methodology/Principal findings PubMed, EMBASE, Scopus, OpenGrey, and the annual Dengue Bulletin were searched for studies assessing the diagnostic accuracy of the unmodified clinical criteria. Two reviewers (NR/SL) independently assessed eligibility, extracted data, and evaluated risk of bias using a modified QUADAS-2. Additional records were found by citation network analysis. A meta-analysis was done using a bivariate mixed-effects regression model. Studies that modified criteria were analysed separately. This systematic review protocol was registered on PROS-PERO (CRD42020165998). We identified 11 and 12 datasets assessing the 1997 and 2009 definition, respectively, and 6 using modified criteria. Sensitivity was 93% (95% CI: 77–98) and 93% (95% CI: 86–96) for the 1997 and 2009 definitions, respectively. Specificity was 29% (95% CI: 8–65) and 31% (95% CI: 18–48) for the 1997 and 2009 definitions, respec-tively. Diagnostic performance suffered at the extremes of age. No modification significantly improved accuracy. Conclusions/Significance Diagnostic accuracy of clinical criteria is poor, with significant implications for surveillance and public health responses for dengue control. As the basis for most reported figures, this has relevance to policymakers planning resource allocation and researchers modelling transmission, particularly during COVID-19. © 2021 Raafat et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC8102005/bin/pntd.0009359.s001.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8102005/bin/pntd.0009359.s002.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8102005/bin/pntd.0009359.s003.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8102005/bin/pntd.0009359.s004.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8102005/bin/pntd.0009359.s005.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8102005/bin/pntd.0009359.s006.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8102005/bin/pntd.0009359.s007.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8102005/bin/pntd.0009359.s008.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC8102005/bin/pntd.0009359.s009.tif
https://efashare.b-cdn.net/share/pmc/articles/PMC8102005/bin/pntd.0009359.s010.tif
https://efashare.b-cdn.net/share/pmc/articles/PMC8102005/bin/pntd.0009359.s011.docx
Authors & Co-Authors
Loganathan, Shanghavie
United Kingdom, Oxford
University of Oxford
Mukaka, Mavuto F.J.
Thailand, Nakhon Pathom
Mahidol University
United Kingdom, Oxford
University of Oxford
Blacksell, Stuart D.
Thailand, Nakhon Pathom
Mahidol University
United Kingdom, Oxford
University of Oxford
Maude, Richard J.
Thailand, Nakhon Pathom
Mahidol University
United Kingdom, Oxford
University of Oxford
United States, Cambridge
Harvard University
Statistics
Citations: 7
Authors: 4
Affiliations: 3
Identifiers
Doi:
10.1371/journal.pntd.0009359
ISSN:
19352727
Research Areas
Covid
Health System And Policy
Infectious Diseases
Study Approach
Systematic review