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Am. J. Trop. Med. Hyg., 73(6), 2005, pp. 1059-1062
Copyright © 2005 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


ASSESSMENT OF THE WORLD HEALTH ORGANIZATION SCHEME FOR CLASSIFICATION OF DENGUE SEVERITY IN NICARAGUA

ANGEL BALMASEDA{dagger}, SAMANTHA NADIA HAMMOND{dagger}, MARIA ANGELES PÉREZ, RICARDO CUADRA, SORAYA SOLANO, JULIO ROCHA, WENDY IDIAQUEZ, AND EVA HARRIS*
Departamento de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud, Managua, Nicaragua; Division of Infectious Diseases, School of Public Health, University of California, Berkeley, California; Infectious Diseases Unit, Hospital Infantil Manuel de Jesús Rivera, Managua, Nicaragua; Hospital Escuela Oscar Danilo Rosales Arguello, León, Nicaragua

 

ABSTRACT

The World Health Organization (WHO) scheme for classification of dengue severity was evaluated in a three-year study of 1,671 confirmed dengue cases in three Nicaraguan hospitals. The WHO classification of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) was compared with the presence of hemorrhagic manifestations, signs of vascular permeability, marked thrombocytopenia, and shock in 114 infants, 1,211 children, and 346 adults. We found that strict application of the WHO criteria fails to detect a significant number of patients with severe manifestations of dengue, especially in adults.

Received May 6, 2005. Accepted for publication August 20, 2005.

Acknowledgments: We thank Juan José Amador for his continuous support and Stephen Waterman for editorial comments.

Financial support: This work was supported by grant TW-0095 from the Fogarty International Center (National Institutes of Health).

{dagger} These two authors contributed equally to this study.

* Address correspondence to Eva Harris, Division of Infectious Diseases, School of Public Health, 140 Warren Hall, University of California, Berkeley, CA 94720-7360. E-mail: eharris{at}berkeley.edu

Authors’ addresses: Angel Balmaseda, Departamento de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud, Complejo de Salud Dra. Concepcion Palacios, Primero de Mayo, Managua, Nicaragua, Telehone and Fax: 505-289-7723. Samantha Nadia Hammond and Eva Harris, Division of Infectious Diseases, School of Public Health, 140 Warren Hall, University of California, Berkeley, CA 94720-7360, Telephone: 510-642-4845, Fax: 510-642-6350, E-mail: eharris{at}berkeley.edu. Maria Angeles Pérez, Soraya Solano, and Wendy Idiaquez, Infectious Diseases Unit, Hospital Infantil Manuel de Jesus Rivera, Barrio Ariel Darce, Distrito no. 5, Managua, Nicaragua, Telephone: 505-289-7702, Fax: 505-289-7408. Ricardo Cuadro and Julio Rocha, Hospital Escuela Dr. Oscar Danilo Rosales Arguello Iglesia Catedral 1, Cuadra al Sur, León, Nicaragua, Telephone and Fax: 505-311-5939.




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