Development of diagnostic prediction for dengue fever in pediatric patient, Phrae Hospital
Abstract
Background: Dengue fever is a major public health problem worldwide, with approximately 390 million cases reported annually. In 2023, Thailand recorded 156,097 cumulative cases with 175 deaths; fatality rate was 0.11%. In the Department of Pediatrics at Phrae Hospital, although no dengue-related deaths have been reported, the number of cases has shown an increasing trend annually. Retrospective data from 2019 to 2023 demonstrated cumulative annual cases of 12, 1, 6, 73, and 66, respectively. The Dengue Duo test can confirm the diagnosis; however, Phrae Hospital is unable to perform this test outside official working hours, resulting in delayed diagnosis. The development of a diagnostic prediction tool may facilitate earlier diagnosis of dengue fever.
Objectives: To identify factors associated with dengue fever and to develop a diagnostic prediction tool for dengue fever in pediatric patients.
Study design: A retrospective cross-sectional study was conducted among children aged 5–15 years who presented with fever for 2–7 days at Phrae Hospital between January 1, 2019, and August 16, 2024. Patients were classified into two groups: Dengue Duo–positive and Dengue Duo–negative. Comparisons were performed using Fisher’s exact test and independent t-test. Predictive factors for dengue diagnosis were analyzed using univariable and multivariable logistic regression. The diagnostic performance of the prediction models was evaluated using the Area Under the Curve (AUC).
Results: Predictors for the diagnosis of dengue fever included age 13–15 years, white blood cell count < 5,000 cells/mm³, and platelet count <150,000 cells/mm³. The prediction model incorporating age, clinical symptoms, and hematologic parameters demonstrated the best diagnostic performance, with an area under the receiver operating characteristic (ROC) curve of 83.5%.
Conclusion: The prediction model incorporating age, clinical symptoms, and hematologic parameters can be used to aid in the diagnosis of dengue fever. However, Dengue Duo testing remains necessary to confirm the diagnosis.
Keywords: Dengue fever, Pediatric patients, Diagnostic prediction, Prediction tool
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