COMPARATION BETWEEN WHO 1997 AND WHO 2009 CLASSIFICATION

IN DENGUE HAEMORRAGHIC FEVER CHILDREN

Ismatul Amri, Rinang Mariko , Amrin Alkamar *Department of pediatric,

Medical Faculty of Andalas University /DR. M Djamil Hospital Padang.

ORIGINAL RESEARCH

• Clinical presentations of Dengue vary widely with unpredictable clinical outcome 1.

• Changes in the epidemiology of dengue, lead to problems with the use of the existing WHO classification 1.

Background

1. Nathan Michael B. Dragar Renu D, Guzman Maria, et all. Dengue: Guidelines for diagnosis, treatment, prevention and control. WHO, 2009.

• The new classification of Dengue Haemorraghic Fever (DHF) has been published in guideline of diagnosis and treatment DHF by WHO on 2009 1.

• The new classification has not been applied in M Djamil Hospital.

Background

1. Nathan Michael B. Dragar Renu D, Guzman Maria, et all. Dengue: Guidelines for diagnosis, treatment, prevention and control. WHO, 2009.

• To compare • WHO 1997

Classification• WHO 2009

Classification

Objective WHO 1997 Classification

WHO 2009 Classification

• Subject without complete data was excluded.

• Data was analyzed with SPSS 15th version

Method ...

• Result . • There were 135 children enrolled this study,

but he common diagnosis based on WHO 1997 and 2009 classification was DHF grade 3 (45,9%) and severe dengue (54,1%).

Result

Result

Male43%

Female57%

Sex

Under-nourish

44%

Wellnourish46%

Over-weight

2%

Obesity8%

Nutritional Status

Result ...

Average age 7,3 years + 3,8

Days of fever 4,75+0,86

Result ...

DHF grade 17%

DHF grade 240%

DHF grade 351%

DHF grade 4 1%

WHO 1997 Classification

Probable dengue10%

Dengue with warning sign36%

Severe dengue54%

WHO 2009 Classification

• Result . • There were 135 children enrolled this study, but he

common diagnosis based on WHO 1997 and 2009 classification was DHF grade 3 (45,9%) and severe dengue (54,1%).

• Comparation of WHO 1997 and WHO 2009 classification were ; DHF grade 1 and probable dengue with warning sign, DHF grade 2 and probable dengue with warning sign, DHF grade 3 and severe dengue, DHF grade 4 and severe dengue, which statistically significant (P=0,001, α <0,005).

Result ...

• Result . • There were 61 children enrolled this study. • The common diagnosis based on WHO 1997

and 2009 classification was DHF grade 3 (45,9%) and severe dengue (54,1%).

Tabel Kesesuaian antara kriteria DHF WHO 1997 dan WHO 2009

WHO 2009 * WHO 1997 Crosstabulation

3 17 2 0 2275,0% 77,3% 7,1% ,0% 36,1%

0 0 26 7 33,0% ,0% 92,9% 100,0% 54,1%

1 5 0 0 625,0% 22,7% ,0% ,0% 9,8%

4 22 28 7 61100,0% 100,0% 100,0% 100,0% 100,0%

Count% within WHO 1997Count% within WHO 1997Count% within WHO 1997Count% within WHO 1997

Dengan warning sign

Dengue Berat

Presumtif dengue

WHO2009

Total

1 2 3 4WHO 1997

Total

Result

• DHF grade 1 and probable dengue with warning sign,

• DHF grade 2 and probable dengue with warning sign,

• DHF grade 3 and severe dengue, • DHF grade 4 and severe dengue, which

statistically significant (P=0,001, α <0,005).

Comparation of WHO 1997 and WHO 2009 classification

• Conclusion. • DHF grade 1 and 2 suitable with probable

dengue with warning sign, DHF grd 3 and 4 suitable with severe dengue

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