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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**††

The 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.

Supplemental Digital Content is available in the text.

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.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (

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.