Receiver operating characteristics (ROC) analysis of two diagnostics models based on the list of criteria included in each dengue case definition, hospital-based study.

a<p>Dengue case definition.</p

Diagnostic values of the traditional and revised WHO dengue case definitions by age, hospital-based study.

<p>Diagnostic values of the traditional and revised WHO dengue case definitions by age, hospital-based study.</p

Traditional and revised WHO dengue case and criteria definitions.

<p>Traditional and revised WHO dengue case and criteria definitions.</p

General characteristics of the study population.

a<p>Among laboratory-confirmed dengue cases.</p

Receiver operating characteristics (ROC) analysis of two diagnostics models based on the list of criteria included in each dengue case definition, cohort study.

a<p>Dengue case definition.</p

Demographic and clinical characteristics of DENV-3 cases, Hospital Study, 2005–11.

1<p>In the hospital study, immune response is known in 109, 168, and 99 DENV-3 cases in years 2008–9, 2009–10, and 2010–11, respectively.</p>2<p>Hemorrhagic manifestations do not include laboratory values and are defined as presence of any of the following clinical signs and symptoms: petechiae, rash, positive tourniquet test, bruising, hematoma, hemoptysis, epistaxis, gingivorrhagia, melena, hematemesis, hematuria, subconjunctival hemorrhage, vaginal hemorrhage, hypermenorrhea and excessive bleeding at puncture site.</p>3<p>p-values were calculated using the Chi-square tests, except for mean age and mean day of presentation, for which Mann-Whitney t-tests were applied.</p

Characteristics of confirmed dengue cases, Cohort Study, 2004–10, and Hospital Study, 2005–2010.

1<p>Incidence has only been calculated in the cohort study, in which between 3,497 and 3753 subjects were active in each of the six study years, corresponding to symptomatic dengue incidence of 0.48% in 2004–5, 1.82% in 2005–6, 0.37% in 2006–7, 1.82% in 2007–8, 0.59% in 2008–9 and 4.61% in 2009–10.</p>2<p>In the cohort study, serotype is known for 14 cases in 2004–5, 56 cases in 2005–6, 10 cases in 2006–7, 62 cases in 2007–8, 21 cases in 2008–9 and 170 cases in 2009–10. In the hospital study, serotype was identified in 46, 43, 69, 139 and 197 cases in years 2005–6 through 2009–10, respectively.</p>3<p>In the cohort study, immune response is indeterminate for one case in each year, 2006–7, 2007–8 and 2008–9, and in 6 cases in 2009–10. In the hospital study, immune response is known in 55, 46, 72, 147 and 203 cases in years 2005–6 through 2009–10, respectively.</p>4<p>In 2005–6 and 2006–7, cases requiring intensive care were not documented in the hospital study.</p>5<p>p-values were calculated using the Chi-square tests except for mean age and mean day of presentation, for which Mann-Whitney t-tests were applied.</p

Presentation of signs of poor peripheral perfusion in hospital study dengue cases, 2005–9 vs. 2009–10.

<p><i>A</i>, cold extremities, <i>B</i>, poor capillary refill (>2 sec), and <i>C</i>, compensated shock. Left panel, frequency of presentation by day; right panel, Kaplan-Meier survival function adjusted for early presentation (days 1–3 after onset of fever).</p

Relative risk of DFCS and DFCS/DSS/DSAS in 2009–10 in DENV-3 cases, Hospital Study.

1<p>Relative risk for the events are adjusted for dengue season (2009–10 and 2010–11, with 2008–9 as reference), immune response (primary versus secondary DENV infection), age (<5 versus ≥5 years old), sex, and early presentation (≤3 days versus >3 days since onset of symptoms). Year 2009–10 emerged as the only significant risk factor in all models, with values as indicated.</p

Classification of severity among confirmed dengue cases by year.

<p>Dengue cases were classified according to WHO classification (Dengue Hemorrhagic Fever and Dengue Shock Syndrome), Dengue Fever with Compensated Shock (DFCS), and Dengue with Signs Associated with Shock (DSAS), in <i>A</i>, cohort study, 2004–10, and <i>B</i>, hospital study, 2005–10.</p