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Table 3 Performance of warning signs in the predictive diagnosis of dengue severe manifestations, National Paediatric Hospital, Phnom Penh, Sep. 2011–Jan. 2013

From: Early diagnosis of dengue disease severity in a resource-limited Asian country

 

DHF/DSS

Severe Dengue

Se

Sp

PPVa

NPVb

Se

Sp

PPV

NPV

Warning Signs

 Abdominal tenderness

43.2

77.0

43.2

86.8

40.0

74.6

10.9

94.1

 Persistent vomiting

21.1

97.0

58.8

85.6

37.5

96.3

44.1

95.2

 Clinical fluid accumulation

66.3

96.1

77.8

93.3

90.0

91.3

44.4

99.2

 Mucosal bleeding

22.1

92.0

36.2

85.1

20.0

90.3

13.8

93.6

 Lethargy/restlessness

44.2

83.3

35.3

87.9

60.0

81.6

20.2

96.3

 Liver enlargement > 2 cm

55.8

82.0

39.0

90.0

65.0

78.7

19.1

96.7

Warning Signs Count

• at least one

92.6

51.8

28.3

97.2

92.5

47.1

11.9

98.8

• at least two

73.7

82.9

47.0

93.9

80.0

77.4

21.5

98.0

• at least three

52.6

95.2

69.4

90.7

70.0

91.5

38.9

97.5

• at least four

22.1

98.3

72.4

86.0

42.5

97.7

58.6

95.7

• at least five

9.5

99.4

75.0

84.2

22.5

99.4

75.0

94.3

• All six are present

2.1

100.0

100.0

83.2

7.2

100.0

100.0

93.2

  1. a PPV positive predictive value
  2. b NPV negative predictive value