title: A comparison of WHO guidelines issued in 1997 and 2009 for dengue fever - single centre experience.
abstract: OBJECTIVE
  To compare the original (1997) and revised (2009) versions of World Health Organization guidelines for dengue patients
  
  
  METHODS
  Adult patients with a positive dengue Immunoglobulin M serology, and a diagnosis of dengue were included in the study at Aga Khan University Hospital during a three-year period from January 2005 to December 2007. Data related to these dengue patients was collected from their medical records. Guidelines were then applied by the research assistant and correlation among these guidelines was computed. SPSS 19 was used for statistical analysis.
  
  
  RESULTS
  A total of 612 patients were found with a diagnosis of dengue, but only 439 (71.73%) had a positive IgM. The median age of these 439 patients was 28 (interquartile range: 18) years and majority of them were males, 295 (67%). According to the 1997 guidelines, 383 (87%) patients were classified as having dengue, while according to the 2009 guidelines, all the 439 (100%) patients were classified with a dengue infection. Under WHO 1997, 21 (5.5%) cases were classified as dengue shock syndrome, while 2009 guidelines labelled 88 (20%) cases as severe dengue. There was a consensus on only 11 severe cases by both the guidelines, showing different results between the two.
  
  
  CONCLUSIONS
  By using 2009 guidelines, a physician would classify more dengue patients as having severe disease.
authors.affiliation: Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan. munawar.khursheed@aku.edu
authors.forename: Munawar
authors.initials: M
authors.lastname: Khursheed
authors.forename: Uzma Rahim
authors.initials: UR
authors.lastname: Khan
authors.forename: Kiran
authors.initials: K
authors.lastname: Ejaz
authors.forename: Jabeen
authors.initials: J
authors.lastname: Fayyaz
authors.forename: Irum
authors.initials: I
authors.lastname: Qamar
authors.forename: Junaid Abdul
authors.initials: JA
authors.lastname: Razzak
mesh_terms: D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D003715:Dengue / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D003716:Dengue Virus / Q000276:immunology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology*; D015994:Incidence; D008297:Male; D058069:Neglected Diseases; D010154:Pakistan / Q000453:epidemiology; D017410:Practice Guidelines as Topic / Q000592:standards*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014944:World Health Organization
chemical_list: D000888:Antibodies, Anti-Idiotypic; D007075:Immunoglobulin M