Prognostic prediction of dengue hemorrhagic fever in pediatric patients with suspected dengue infection: A multi-site study.

Dengue virus (DENV) infection is a major global health problem. While DENV infection rarely results in serious complications, the more severe illness dengue hemorrhagic fever (DHF) has a significant mortality rate due to the associated plasma leakage that may lead to hypovolemic shock. Proper care t...

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Main Authors: Myat Su Yin, Peter Haddawy, Panhavath Meth, Araya Srikaew, Chonnikarn Wavemanee, Saranath Lawpoolsri Niyom, Kanokwan Sriraksa, Wannee Limpitikul, Preedawadee Kittirat, Nasikarn Angkasekwinai, Oranich Navanukroh, Arunee Mapralub, Supansa Pakdee, Chotika Kaewpuak, Nattaya Tangthawornchaikul, Prida Malasit, Panisadee Avirutnan, Dumrong Mairiang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0327360
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author Myat Su Yin
Peter Haddawy
Panhavath Meth
Araya Srikaew
Chonnikarn Wavemanee
Saranath Lawpoolsri Niyom
Kanokwan Sriraksa
Wannee Limpitikul
Preedawadee Kittirat
Nasikarn Angkasekwinai
Oranich Navanukroh
Arunee Mapralub
Supansa Pakdee
Chotika Kaewpuak
Nattaya Tangthawornchaikul
Prida Malasit
Panisadee Avirutnan
Dumrong Mairiang
author_facet Myat Su Yin
Peter Haddawy
Panhavath Meth
Araya Srikaew
Chonnikarn Wavemanee
Saranath Lawpoolsri Niyom
Kanokwan Sriraksa
Wannee Limpitikul
Preedawadee Kittirat
Nasikarn Angkasekwinai
Oranich Navanukroh
Arunee Mapralub
Supansa Pakdee
Chotika Kaewpuak
Nattaya Tangthawornchaikul
Prida Malasit
Panisadee Avirutnan
Dumrong Mairiang
author_sort Myat Su Yin
collection DOAJ
description Dengue virus (DENV) infection is a major global health problem. While DENV infection rarely results in serious complications, the more severe illness dengue hemorrhagic fever (DHF) has a significant mortality rate due to the associated plasma leakage that may lead to hypovolemic shock. Proper care thus requires identifying patients with DHF among those with suspected dengue so that they can be provided with adequate and prompt fluid replacement. In this study we used seventeen years of pediatric patient data from a prospective cohort study in two hospitals in Thailand to develop models to predict DHF among patients with suspected dengue infection. We produced models for a general hospital setting and for a primary care unit setting lacking lab facilities. The best model using combined data from both hospitals achieved an AUC of 0.90 for the general hospital setting and 0.79 for the primary care unit setting. We then investigated the generalizability of the models by training models with data from one hospital and testing them with data from the other. For some models, we found a significant reduction in performance. Possible sources of this are differences in how attributes are defined or measured and differences in the hematological parameters of the two patient populations. We conclude that while high accuracy prediction of DHF is possible, care must be taken when applying DHF predictive models from one clinical setting to another.
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spelling doaj-art-1a48eff574bd455ead5b214d290c22c12025-08-25T05:31:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01208e032736010.1371/journal.pone.0327360Prognostic prediction of dengue hemorrhagic fever in pediatric patients with suspected dengue infection: A multi-site study.Myat Su YinPeter HaddawyPanhavath MethAraya SrikaewChonnikarn WavemaneeSaranath Lawpoolsri NiyomKanokwan SriraksaWannee LimpitikulPreedawadee KittiratNasikarn AngkasekwinaiOranich NavanukrohArunee MapralubSupansa PakdeeChotika KaewpuakNattaya TangthawornchaikulPrida MalasitPanisadee AvirutnanDumrong MairiangDengue virus (DENV) infection is a major global health problem. While DENV infection rarely results in serious complications, the more severe illness dengue hemorrhagic fever (DHF) has a significant mortality rate due to the associated plasma leakage that may lead to hypovolemic shock. Proper care thus requires identifying patients with DHF among those with suspected dengue so that they can be provided with adequate and prompt fluid replacement. In this study we used seventeen years of pediatric patient data from a prospective cohort study in two hospitals in Thailand to develop models to predict DHF among patients with suspected dengue infection. We produced models for a general hospital setting and for a primary care unit setting lacking lab facilities. The best model using combined data from both hospitals achieved an AUC of 0.90 for the general hospital setting and 0.79 for the primary care unit setting. We then investigated the generalizability of the models by training models with data from one hospital and testing them with data from the other. For some models, we found a significant reduction in performance. Possible sources of this are differences in how attributes are defined or measured and differences in the hematological parameters of the two patient populations. We conclude that while high accuracy prediction of DHF is possible, care must be taken when applying DHF predictive models from one clinical setting to another.https://doi.org/10.1371/journal.pone.0327360
spellingShingle Myat Su Yin
Peter Haddawy
Panhavath Meth
Araya Srikaew
Chonnikarn Wavemanee
Saranath Lawpoolsri Niyom
Kanokwan Sriraksa
Wannee Limpitikul
Preedawadee Kittirat
Nasikarn Angkasekwinai
Oranich Navanukroh
Arunee Mapralub
Supansa Pakdee
Chotika Kaewpuak
Nattaya Tangthawornchaikul
Prida Malasit
Panisadee Avirutnan
Dumrong Mairiang
Prognostic prediction of dengue hemorrhagic fever in pediatric patients with suspected dengue infection: A multi-site study.
PLoS ONE
title Prognostic prediction of dengue hemorrhagic fever in pediatric patients with suspected dengue infection: A multi-site study.
title_full Prognostic prediction of dengue hemorrhagic fever in pediatric patients with suspected dengue infection: A multi-site study.
title_fullStr Prognostic prediction of dengue hemorrhagic fever in pediatric patients with suspected dengue infection: A multi-site study.
title_full_unstemmed Prognostic prediction of dengue hemorrhagic fever in pediatric patients with suspected dengue infection: A multi-site study.
title_short Prognostic prediction of dengue hemorrhagic fever in pediatric patients with suspected dengue infection: A multi-site study.
title_sort prognostic prediction of dengue hemorrhagic fever in pediatric patients with suspected dengue infection a multi site study
url https://doi.org/10.1371/journal.pone.0327360
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