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A Screening Tool for Dengue Fever in Children

Lai, Wen-Pin MD*†; Chien, Tsair-Wei MBA†‡; Lin, Hung-Jung MD, MBA; Su, Shih-Bin MD, PhD¶ ‖; Chang, Chih-Hung PhD**††

Pediatric Infectious Disease Journal: April 2013 - Volume 32 - Issue 4 - p 320–324
doi: 10.1097/INF.0b013e31827e111e
Original Studies

Background: Dengue fever (DF) is a significant public health issue in Asia. We aimed to use clinical and laboratory data to derive a rapid and accurate case-finding tool for DF in children.

Methods: This retrospective study used 24 DF-related characteristics and clinical features (17 clinical; 7 laboratory) of 177 pediatric patients (69 diagnosed with DF). Data were psychometrically evaluated using a Rasch measurement model, and their values for predicting DF risk were evaluated.

Results: The 14-item scale (DF-14) fit the measurement model in assessing the likelihood of DF. When a cutoff point of −1.15 (in logit) of the DF-14 scale was used, the sensitivity was 0.76 and the specificity was 0.76. The area under the curve was 0.93 (95% confidence interval: 0.89–0.97). The DF-2 scale, comprised of white blood cell and platelet counts, was simple but clinically useful.

Conclusions: Simple laboratory data, such as those in the DF-2 and DF-14 scales, are useful for the early detection of DF risk in children. The DF-14 scale helps discriminate DF from other febrile illnesses and may eliminate the need for a costly and time-consuming dengue confirmation test.

From the *Department of Emergency Medicine, Chi-Mei Medical Center; Department of Hospital and Health Care Administration, Chia-Nan University of Pharmacy and Science; Department of Administration, Chi-Mei Medical Center; §Department of Biotechnology; Institute of Biomedical Engineering, Southern Taiwan University; Department of Family Medicine, Chi-Mei Medical Center; **Buehler Center on Aging, Health & Society, Feinberg School of Medicine, Northwestern University, Chicago, IL; and ††Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan.

W.-P.L. and T.-W.C. conceived and designed the study, performed the statistical analyses and were in charge of recruiting study participants. Y.-C.C. and C.-H.L. helped design the study, collected information and interpreted data. H.-J.L., S.-B.S. and C.-H.C. helped design and supervise the study, and helped draft the article. All authors read and approved the final article.

This research was supported by grant Chi-Mei Foundation Hospital Research 9779 from the Chi-Mei Medical Center. The authors have no other funding or conflicts of interest to disclose.

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Address for correspondence: Chih-Hung Chang, PhD, Buehler Center on Aging, Health & Society, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Dr., Suite 601, Chicago, IL 60611. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.