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Table 2 Diagnostic value of warning signs at admission according to dengue severity

From: Diagnostic accuracy of peripheral venous lactate and the 2009 WHO warning signs for identifying severe dengue in Thai adults: a prospective observational study

 

The 2009 WHO definitions

Sensitivity

(95 % CI)

Specificity

(95 % CI)

PPV

(95 % CI)

NPV

(95 % CI)

LR+

(95 % CI)

LR–

(95 % CI)

Severe

(n = 20)

Non-severe

(n = 105)

Individual warning sign

 Abdominal pain

9

44

45.0

(23.1–68.5)

58.1

(48.1–67.7)

17.0

(8.1–29.8)

84.7

(74.3–92.1)

1.1

(0.6–1.8)

0.9

(0.6–1.4)

 Persistent vomiting

8

12

40.0

(19.1–64.0)

88.6

(80.9–94.0)

40.0

(19.1–64.0)

88.6

(80.9–94.0)

3.5

(1.6–7.4)

0.7

(0.5–1.0)

 Clinical fluid accumulation

15

10

75.0

(50.9–91.3)

90.5

(83.2–95.3)

60.0

(38.7–78.9)

95.0

(88.7–98.4)

7.9

(4.2–15.0)

0.3

(0.1–0.6)

 Lethargy

18

76

90.0

(68.3–98.8)

27.6

(19.3–37.2)

19.2

(11.8–28.6)

93.6

(78.6–99.2)

1.2

(1.0–1.5)

0.4

(0.1–1.4)

 Liver span of >15 cm

12

17

60.0

(36.0–80.9)

83.8

(75.4–90.3)

41.4

(23.5–61.1)

91.7

(84.2–96.3)

3.7

(2.1–6.5)

0.5

(0.3–0.8)

 Mucosal bleeding

14

39

70.0

(45.7–88.1)

62.9

(52.9–72.1)

26.4

(15.3–40.3)

91.7

(82.7–96.9)

1.9

(1.3–2.8)

0.5

(0.2–1.0)

 Hematocrit >2 % and platelets ≤100 × 103/μL

12

42

60.0

(36.0–80.9)

60.0

(50.0–69.4)

22.2

(12.0–35.6)

88.7

(79.0–95.0)

1.5

(1.0–2.3)

0.7

(0.4–1.2)

Number of warning signs

  ≥ 1

20

95

100.0

(83.2–100.0)

9.5

(4.7–16.8)

17.4

(11.0–25.6)

100.0

(69.2–100.0)

1.1

(1.0–1.2)

0

  ≥ 2

19

71

95.0

(75.1–99.9)

32.4

(23.6–42.1)

21.1

(13.2–31.0)

97.1

(85.1–99.9)

1.4

(1.2–1.7)

0.2

(0–1.1)

  ≥ 3

17

43

85.0

(62.1–96.8)

59.0

(49.0–68.6)

28.3

(17.4–41.4)

95.4

(87.1–99.0)

2.1

(1.6–2.8)

0.2

(0.1–0.7)

  ≥ 4

14

21

70.0

(45.7–88.1)

80.0

(71.1–87.2)

40.0

(23.9–57.9)

93.3

(86.0–97.5)

3.5

(2.2–5.6)

0.4

(0.2–0.7)

  ≥ 5

11

8

55.0

(31.5–76.9)

92.4

(85.5–96.6)

57.9

(33.5–79.8)

91.5

(84.5–96.0)

7.2

(3.3–15.7)

0.5

(0.3–0.8)

  ≥ 6

5

2

25.0

(8.7–49.1)

98.1

(93.3–99.8)

71.4

(29.0–96.3)

87.3

(79.9–92.7)

13.1

(2.7–63.0)

0.8

(0.6–1.0)

  1. WHO World Health Organization; CI confidence interval; PPV positive predictive value; NPV negative predictive value; LR+ positive likelihood ratio; LR– negative likelihood ratio