title: Sensitivity and specificity of a novel classifier for the early diagnosis of dengue.
abstract: BACKGROUND
  Dengue is the commonest arboviral disease of humans. An early and accurate diagnosis of dengue can support clinical management, surveillance and disease control and is central to achieving the World Health Organisation target of a 50% reduction in dengue case mortality by 2020.
  
  
  METHODS
  5729 children with fever of <72 hrs duration were enrolled into this multicenter prospective study in southern Vietnam between 2010-2012. A composite of gold standard diagnostic tests identified 1692 dengue cases. Using statistical methods, a novel Early Dengue Classifier (EDC) was developed that used patient age, white blood cell count and platelet count to discriminate dengue cases from non-dengue cases.
  
  
  RESULTS
  The EDC had a sensitivity of 74.8% (95%CI: 73.0-76.8%) and specificity of 76.3% (95%CI: 75.2-77.6%) for the diagnosis of dengue. As an adjunctive test alongside NS1 rapid testing, sensitivity of the composite test was 91.6% (95%CI: 90.4-92.9%).
  
  
  CONCLUSIONS
  We demonstrate that the early diagnosis of dengue can be enhanced beyond the current standard of care using a simple evidence-based algorithm. The results should support patient management and clinical trials of specific therapies.
authors.affiliation: Children's Hospital No. 1, Ho Chi Minh City, Vietnam.
authors.forename: Nguyen Minh
authors.initials: NM
authors.lastname: Tuan
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Ho Thi
authors.initials: HT
authors.lastname: Nhan
authors.affiliation: Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Nguyen Van Vinh
authors.initials: NV
authors.lastname: Chau
authors.affiliation: Children's Hospital No. 1, Ho Chi Minh City, Vietnam.
authors.forename: Nguyen Thanh
authors.initials: NT
authors.lastname: Hung
authors.affiliation: Children's Hospital No. 2, Ho Chi Minh City, Vietnam.
authors.forename: Ha Manh
authors.initials: HM
authors.lastname: Tuan
authors.affiliation: Tien Giang Provincial Hospital, My Tho, Tien Giang Province, Vietnam.
authors.forename: Ta Van
authors.initials: TV
authors.lastname: Tram
authors.affiliation: Dong Nai Children's Hospital, Bien Hoa, Dong Nai Province, Vietnam.
authors.forename: Nguyen Le Da
authors.initials: Nle D
authors.lastname: Ha
authors.affiliation: Long An Provincial Hospital, Tan An, Long An Province, Vietnam.
authors.forename: Phan
authors.initials: P
authors.lastname: Loi
authors.affiliation: Binh Duong Provincial Hospital, Thu Dau Mot, Binh Duong Province, Vietnam.
authors.forename: Han Khoi
authors.initials: HK
authors.lastname: Quang
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Duong Thi Hue
authors.initials: DT
authors.lastname: Kien
authors.affiliation: Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Sonya
authors.initials: S
authors.lastname: Hubbard
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Tran Nguyen Bich
authors.initials: TN
authors.lastname: Chau
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Bridget
authors.initials: B
authors.lastname: Wills
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Marcel
authors.initials: M
authors.lastname: Wolbers
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Nossal Institute of Global Health, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Simmons
mesh_terms: D000367:Age Factors; D000465:Algorithms; D002648:Child; D003715:Dengue / Q000175:diagnosis* / Q000276:immunology; D042241:Early Diagnosis; D006801:Humans; D007958:Leukocyte Count; D010976:Platelet Count; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014744:Vietnam
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