{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:16:58Z","timestamp":1787847418740,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Background &amp; objectives<\/jats:italic>\n                      : World Health Organization (WHO) revised its guidelines for classification and management of dengue in 2009. This revised system was found out to have good sensitivity and negative predictive value but poor specificity as well as positive predictive value.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Methods:<\/jats:italic>\n                      This retrospective study was carried out in a tertiary care hospital of Delhi, India to assess factors predicting the occurrence of severe dengue in children as per the revised classification. A total of 647 suspected dengue cases were admitted in the hospital in the year 2015. Detailed clinical and epidemiological data of 170 patients who were confirmed as dengue either by NS1 antigen test or by serology (Ig M positive) were recorded and statistically analyzed.\n                      <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                      The number of laboratory-confirmed cases was 170 and included thirty (17.65%) dengue fever (DF), 106 (62.35%) dengue with warning signs (DWS) and 34 (20.0%) severe dengue (SD) patients. Regression analysis revealed that presence of vomiting, altered sensorium, shock, peri-orbital edema, hepatomegaly, splenomegaly, severe anemia, thrombocytopenia, elevated urea and creatinine, decreased total protein and globulin were significantly associated with occurrence of severe disease.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Interpretation &amp; conclusion:<\/jats:italic>\n                      The addition of clinical features (peri-orbital edema and splenomegaly); and laboratory findings (elevated urea and creatinine, decreased serum protein and globulin) might help improve the sensitivity and specificity of the revised WHO dengue classification in predicting severe dengue.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0972-9062.318312","type":"journal-article","created":{"date-parts":[[2021,6,13]],"date-time":"2021-06-13T07:04:58Z","timestamp":1623567898000},"page":"329-334","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Predictors of severe dengue amongst children as per the revised WHO classification"],"prefix":"10.4103","volume":"58","author":[{"given":"Shilpa Khanna","family":"Arora","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devki","family":"Nandan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pronita","family":"Benerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhirendra Pratap","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-7-20240830","doi-asserted-by":"crossref","first-page":"e0146539","DOI":"10.1371\/journal.pone.0146539","article-title":"The spread of dengue in an endemic urban milieu - The case of Delhi, India","volume":"11","author":"Telle","year":"2016","journal-title":"PLoS One"},{"key":"R3-7-20240830","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1179\/2046904712Z.00000000052","article-title":"The revised WHO dengue case classification: does the system need to be modified?","volume":"52","author":"Hadinegoro","year":"2012","journal-title":"Paediatr Int Child Health"},{"key":"R4-7-20240830","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1179\/2047773215Y.0000000003","article-title":"WHO dengue case classification 2009 and its usefulness in practice: an expert consensus in the Americas","volume":"109","author":"Horstick","year":"2015","journal-title":"Pathog Glob Health"},{"key":"R6-7-20240830","doi-asserted-by":"crossref","first-page":"621","DOI":"10.4269\/ajtmh.13-0676","article-title":"Comparing the usefulness of the 1997 and 2009 WHO dengue case classification: a systematic literature review","volume":"91","author":"Horstick","year":"2014","journal-title":"Am J Trop Med Hyg"},{"key":"R7-7-20240830","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1007\/s15010-013-0405-3","article-title":"Accuracy and applicability of the revised WHO classification (2009) of dengue in children seen at a tertiary healthcare facility in northern India","volume":"41","author":"Prasad","year":"2013","journal-title":"Infection"},{"key":"R8-7-20240830","doi-asserted-by":"crossref","first-page":"e96314","DOI":"10.1371\/journal.pone.0096314","article-title":"Sensitivity and specificity of the World Health Organization dengue classification schemes for severe dengue assessment in children in Rio de Janeiro. Ooi EE, ed","volume":"9","author":"Macedo","year":"2014","journal-title":"PLoS ONE"},{"key":"R9-7-20240830","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/1471-2334-11-106","article-title":"Usefulness and applicability of the revised dengue case classification by disease: multi-centre study in 18 countries","volume":"11","author":"Barniol","year":"2011","journal-title":"BMC Infect Dis"},{"key":"R10-7-20240830","doi-asserted-by":"crossref","first-page":"e0161696","DOI":"10.1371\/journal.pone.0161696","article-title":"Proposal of a Clinical Decision Tree Algorithm Using Factors Associated with Severe Dengue Infection","volume":"11","author":"Tamibmaniam","year":"2016","journal-title":"PLoS One"},{"key":"R11-7-20240830","doi-asserted-by":"crossref","first-page":"e2023","DOI":"10.1371\/journal.pntd.0002023","article-title":"Utilities and limitations of the World Health Organization 2009 warning signs for adult dengue severity","volume":"7","author":"Thein","year":"2013","journal-title":"PLoS Negl Trop Dis"}],"container-title":["Journal of Vector Borne Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/0972-9062.318312","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:17:17Z","timestamp":1787843837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/0972-9062.318312"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/0972-9062.318312","relation":{},"ISSN":["0972-9062"],"issn-type":[{"value":"0972-9062","type":"print"}],"subject":[],"published":{"date-parts":[[2021,10]]}}}