Articles Vol. 67 No. 8 28/08/2026

CHARACTERISTICS AND CLINICAL OUTCOMES OF ADULT DENGUE PATIENTS WITH WARNING SIGNS: A CROSS-SECTIONAL STUDY AT THE HOSPITAL FOR TROPICAL DISEASES IN HO CHI MINH CITY

Nguyen Thanh Cong1,2, Nguyen Van Vinh Chau3,4, Phan Ngoc Phuong Thao5,6, Ho Dang Trung Nghia5,6,7,8
1 People's Hospital 115
2 Bệnh viện Nhân Dân 115
3 Ho Chi Minh City Department of Health
4 Sở Y tế Thành phố Hồ Chí Minh
5 Pham Ngoc Thach University of Medicine
6 Trường Đại học Y khoa Phạm Ngọc Thạch
7 Hospital for Tropical Diseases
8 Bệnh viện Bệnh Nhiệt đới
DOI: 10.52163/yhc.v67i8.6308
22 Views
0 Downloads
Keywords
Dengue fever, severe dengue, warning signs, aged 16 years or older, risk stratification
Abstract

Objective: To determine the proportion of dengue patients with warning signs who progressed to severe dengue and to describe the characteristics of warning signs, including their predictive values.

Methods: A cross-sectional descriptive study was conducted among 400 hospitalized dengue patients aged 16 years or older with warning signs at the Hospital for Tropical Diseases from May 2020 to October 2021. Warning signs were described according to severe progression status. Exploratory analyses included the predictive values of individual warning signs.

Results: Severe dengue progression occurred in 8.75% of patients, with shock due to plasma leakage being the most common severe manifestation. Most warning signs had low positive predictive values, whereas their negative predictive values were high. The number of warning signs showed good discrimination for severe progression, with an AUC of 0.883 (95% CI: 0.847-0.913). Hepatomegaly, fluid accumulation, and rising hematocrit with rapid platelet decrease were independently associated with severe progression.

Conclusion: The proportion of severe progression among adult dengue patients with warning signs was comparable to that reported in other studies. The number of warning signs may have potential value in predicting severe progression. Further validation in broader populations is needed.

References
[1]
Simmons, C. P., Farrar, J. J., Nguyen, V. V., et al. (2012). Dengue. The New England Journal of Medicine, 366(15), 1423-1432. https://doi.org/10.1056/NEJMra1110265 Google Scholar
[2]
Thein, T. L., Gan, V. C., Lye, D. C., Yung, C. F., & Leo, Y. S. (2013). Utilities and limitations of the World Health Organization 2009 warning signs for adult dengue severity. PLoS Neglected Tropical Diseases, 7(1), e2023. https://doi.org/10.1371/journal.pntd.0002023 Google Scholar
[3]
Cao, T. H., Bùi, V. H., Đặng, T. T., et al. (2020). Một số chỉ số liên quan đến tiên lượng ở bệnh nhân nhi sốt xuất huyết Dengue nặng. Tạp chí Truyền nhiễm Việt Nam, 3(31), 38-41. https://doi.org/10.59873/vjid.v3i31.185 Google Scholar
[4]
Bộ Y tế Việt Nam. (2019). Hướng dẫn chẩn đoán, điều trị sốt xuất huyết Dengue (Ban hành kèm theo Quyết định số 3705/QĐ-BYT ngày 22 tháng 8 năm 2019). Google Scholar
[5]
Huy, B. V., Hoa, L. N. M., Thuy, D. T., et al. (2019). Epidemiological and clinical features of dengue infection in adults in the 2017 outbreak in Vietnam. BioMed Research International, 2019, 3085827. https://doi.org/10.1155/2019/3085827 Google Scholar
[6]
Ahmad, M. H., Ibrahim, M. I., Mohamed, Z., et al. (2018). The sensitivity, specificity and accuracy of warning signs in predicting severe dengue, the severe dengue prevalence and its associated factors. International Journal of Environmental Research and Public Health, 15(9), 2018. https://doi.org/10.3390/ijerph15092018 Google Scholar
[7]
Cavailler, P., Tarantola, A., Leo, Y. S., et al. (2016). Early diagnosis of dengue disease severity in a resource-limited Asian country. BMC Infectious Diseases, 16(1), 512. https://doi.org/10.1186/s12879-016-1849-8 Google Scholar