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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