title: Clinical and laboratory signs as dengue markers during an outbreak in Rio de Janeiro.
abstract: BACKGROUND
  One of the main challenges for clinical research in dengue is the low validity of clinical diagnosis.
  
  
  OBJECTIVE
  To analyze clinical and laboratory data as predicitve factors of dengue diagnosis at Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, during the 2001-2002 dengue outbreak in Rio de Janeiro.
  
  
  METHODS
  Cross sectional study comparing clinical laboratory data collected from the National Information System for Compulsory Notification Diseases (SINAN) in two serologically confirmed groups: dengue D (N = 453) and non-dengue ND (N = 80).
  
  
  RESULTS
  Fever, exanthema, itching, mean platelet count < 150,000, WBC count < 4,000 and absence of vomiting and of abdominal pain help to distinguish D from ND groups. When considered individually, these signs and symptoms enhance diagnostic sensitivity and, when used in combination, improve specificity.
  
  
  CONCLUSIONS
  A combination of symptoms not necessarily considered indicative of dengue diagnosis could improve surveillance and medical decision-making in simple clinical settings.
authors.affiliation: Clinical Epidemiology Laboratory, Evandro Chagas Clinical Research Institute, Av Brasil 4365 Manguinhos, Rio de Janeiro, 21045900, Brazil. sonialambert@ipec.fiocruz.br
authors.forename: S R L
authors.initials: SR
authors.lastname: Passos
authors.forename: S J
authors.initials: SJ
authors.lastname: Bedoya
authors.forename: Y H M
authors.initials: YH
authors.lastname: Hökerberg
authors.forename: S C
authors.initials: SC
authors.lastname: Maia
authors.forename: I
authors.initials: I
authors.lastname: Georg
authors.forename: R M R
authors.initials: RM
authors.lastname: Nogueira
authors.forename: R V
authors.initials: RV
authors.lastname: Souza
authors.forename: K B F
authors.initials: KB
authors.lastname: Marzochi
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques; D003430:Cross-Sectional Studies; D003715:Dengue / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D003716:Dengue Virus; D004196:Disease Outbreaks; D005260:Female; D005334:Fever; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers