Evaluation of the World Health Organization standard tourniquet test and a modified tourniquet test in the diagnosis of dengue infection in Viet Nam

摘要: Summary OBJECTIVES A positive tourniquet test is one of several clinical parameters considered by the World Health Organization to be important in diagnosis dengue haemorrhagic fever, but no formal evaluation has been undertaken. As many doctors remain unconvinced its usefulness, this study was designed assess diagnostic utility both standard and a commonly employed modified test. METHODS prospective sphygmomanometer cuff test, compared with simple elastic carried out 1136 children suspected infection admitted provincial paediatric hospital southern Viet Nam. RESULTS There good agreement between independent observers for techniques, method resulted consistently greater numbers petechiae. This had sensitivity 41.6% infection, specificity 94.4%, predictive value 98.3% negative 17.3%. The differentiated poorly fever (45% positive) (38% positive). less sensitive than cuff, at threshold 10 petechiae (compared WHO recommendation 20) per 2.5 cm 2 rose 45% (specificity 85%). Other evidence bleeding frequently present provided additional information aid only 5% cases. CONCLUSION conventional adds little hospitalized children. simple, cheap may useful diagnosing busy rural health stations endemic areas tropics. should prompt close observation or early referral, does not exclude infection.