Lai et al developed a number of screening tools for Dengue Fever (DF) in children. Longer screening tools with 11 and 14 items include both clinical and laboratory findings. The authors are from Chi-Mei Medical Center in Taiwan.
Patient selection: child <= 16 years of age in southern Taiwan
Parameters for the 11-item screening tool (DF-11):
(1) white blood cell count
(2) platelet count
(3) family history
(4) high fever (> 39°C)
(5) biphasic fever
(6) skin rash
(7) petechiae
(8) retrobulbar pain
(9) bone pain
(10) abdominal pain
(11) anorexia
Additional laboratory data for the 14-item screening tool (DF-14) which may not be readily available:
(12) CRP in mg/L
(13) AST in IU/L
(14) ALT in IU/L
|
Parameter |
Finding |
Points |
|
white blood cell count |
< 3,000 per µL |
2 |
|
|
3,000 to 5,000 per µL |
1 |
|
|
> 5,000 per µL |
0 |
|
platelet count |
< 100,000 per µL |
2 |
|
|
100,000 to 150,000 per µL |
1 |
|
|
> 150,000 per µL |
0 |
|
family history |
no |
0 |
|
|
yes |
1 |
|
fever > 39°C |
no |
0 |
|
|
yes |
1 |
|
biphasic fever |
no |
0 |
|
|
yes |
1 |
|
skin rash |
no |
0 |
|
|
yes |
1 |
|
petechiae |
no |
0 |
|
|
yes |
1 |
|
retrobulbar pain |
no |
0 |
|
|
yes |
1 |
|
bone pain |
no |
0 |
|
|
yes |
1 |
|
abdominal pain |
no |
0 |
|
|
yes |
1 |
|
anorexia |
no |
0 |
|
|
yes |
1 |
|
CRP |
<= 25 mg/L |
0 |
|
|
> 25 mg/L |
1 |
|
AST |
<= 40 IU/L |
0 |
|
|
> 40 IU/L |
1 |
|
ALT |
<= 40 IU/L |
0 |
|
|
> 40 IU/L |
1 |
total score for DF-11 =
= SUM(points for first 11 parameters)
total score for DF-14 =
= SUM(points for all 14 parameters)
Interpretation:
• minimum DF-11 and DF-14: 0
• maximum DF-11: 13
• maximum DF-14: 16
• The higher the score the greater the risk for Dengue Fever.
• A DF-11 >= 3 was considered a positive screen for Dengue Fever.
• A DF-14 >= 5 was considered a positive screen for Dengue Fever.
• If a screening test is positive then serologic testing should be performed.
Performance:
• This would depend on the prevalence of Dengue Fever in the community.
Specialty: Infectious Diseases
ICD-10: ,
