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Nurses play a major role in the triage and care of dengue patients in many countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>This is a sub\u2010study on interobserver agreement performed as part of a cross\u2010sectional diagnostic accuracy study for acute febrile illness (AFI) using the checklist STARD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A previously validated semi\u2010structured sign and symptom standardised questionnaire for AFI was independently administered to 374 patients by physician and nurse pairs. The interobserver agreement was estimated using kappa statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For a set of 27 signs and symptoms, we found six interobserver discrepancies (examiner detected red eyes, lethargy, exanthema, dyspnoea, bleeding and myalgia) as identified by regular and moderate kappa indexes. Four signs (patient observed red eyes, cough, diarrhoea and vomiting) and one symptom (earache) had near\u2010perfect agreement. Most signs and symptoms showed substantial agreement. The WHO (Dengue guidelines for diagnosis, treatment, prevention and control: new edition, World Health Organization, 2009) clinical criteria\u00a0for dengue comprise a group of symptoms known as \u201cpains and aches.\u201d Interobserver agreement for abdominal pain, retro\u2010orbital pain and arthralgia exceed that found for headache and myalgia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>During a dengue outbreak, the interobserver agreement for most of the signs and symptoms used to assess AFI was substantial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>This result suggests good potential applicability of the tool by health professionals following training. A well\u2010trained health professional is qualified to apply the standardised questionnaire to evaluate suspected dengue cases during outbreaks.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.15229","type":"journal-article","created":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T04:39:13Z","timestamp":1582605553000},"page":"1590-1598","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Pitfalls in acute febrile illness diagnosis: Interobserver agreement of signs and symptoms during a dengue outbreak"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0843-1783","authenticated-orcid":false,"given":"Sibelle Nogueira","family":"Buonora","sequence":"first","affiliation":[{"name":"Laboratory of Clinical Epidemiology Evandro Chagas National Institute of Infectious Diseases Oswaldo Cruz Foundation Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9947-2291","authenticated-orcid":false,"given":"Sonia Regina Lambert","family":"Passos","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Epidemiology Evandro Chagas National Institute of Infectious Diseases Oswaldo Cruz Foundation Rio de Janeiro Brazil"},{"name":"Universidade Est\u00e1cio de S\u00e1 Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8923-7711","authenticated-orcid":false,"given":"Regina Paiva","family":"Daumas","sequence":"additional","affiliation":[{"name":"Germano Sinval Faria Teaching Primary Care Center National School of Public Health Oswaldo Cruz Foundation Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0538-2349","authenticated-orcid":false,"given":"Matheus Garcia Lago","family":"Machado","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Epidemiology Evandro Chagas National Institute of Infectious Diseases Oswaldo Cruz Foundation Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6511-7558","authenticated-orcid":false,"given":"Guilherme Migu\u00e9is","family":"Berardinelli","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Epidemiology Evandro Chagas National Institute of Infectious Diseases Oswaldo Cruz Foundation Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9166-4296","authenticated-orcid":false,"given":"Diana Neves Rodrigues","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Epidemiology Evandro Chagas National Institute of Infectious Diseases Oswaldo Cruz Foundation Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9387-8645","authenticated-orcid":false,"given":"Raquel de Vasconcellos Carvalhaes","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Epidemiology Evandro Chagas National Institute of Infectious Diseases Oswaldo Cruz Foundation Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,10]]},"reference":[{"issue":"10","key":"e_1_2_10_2_1","first-page":"1","article-title":"Validity and accuracy of maternal tactile assessment for fever in under\u2010 five children in North Central Nigeria: A cross\u2010sectional study","volume":"4","author":"Abdulkadir M. 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