Severe Dengue: Developing a Universally Applicable Simple Prediction Model
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Globally dengue causes 50 million infections per year and an estimated 20,000 deaths annually, posing a large disease and economic burden. In 2009, World Health Organization (WHO) proposed a classification categorising the disease as dengue with or without warning signs and severe dengue, to enhance early recognition of severe dengue . The 2009 classification suggests 7 clinical signs as warning signs for severe dengue based on a multicenter study in Southeast Asia and Latin American countries  and global expert consensus. WHO guidelines suggest that presence of any warning sign should lead to admission to a healthcare facility and intravenous fluid therapy . A systematic review showed that sensitivity of 2009 classification to identify severe dengue ranged between 59 and 98% (88%/98%: prospective studies), and specificity between 41 and 99% (99%: prospective studies) . Although the WHO 2009 guidelines’ system of early warning signs is easy to use and sensitive in...
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