Global dengue death before and after the new World Health Organization 2009 case classification: A systematic review and meta-regression analysis

Gary Kim-Kuan Low; Simon A. Ogston; Mun-Hin Yong; Seng-Chiew Gan; Hui-Yee Chee

doi:10.1016/j.actatropica.2018.03.014

Global dengue death before and after the new World Health Organization 2009 case classification: A systematic review and meta-regression analysis

Gary Kim-Kuan Low (Lead / Corresponding author), Simon A. Ogston, Mun-Hin Yong, Seng-Chiew Gan, Hui-Yee Chee

Research output: Contribution to journal › Review article › peer-review

11 Citations (Scopus)

Abstract

Background: Since the introduction of 2009 WHO dengue case classification, no literature was found regarding its effect on dengue death. This study was to evaluate the effect of 2009 WHO dengue case classification towards dengue case fatality rate.

Methods: Various databases were used to search relevant articles since 1995. Studies included were cohort and cross-sectional studies, all patients with dengue infection and must report the number of death or case fatality rate. The Joanna Briggs Institute appraisal checklist was used to evaluate the risk of bias of the full-texts. The studies were grouped according to the classification adopted: WHO 1997 and WHO 2009. Meta-regression was employed using a logistic transformation (log-odds) of the case fatality rate. The result of the meta-regression was the adjusted case fatality rate and odds ratio on the explanatory variables.

Results: A total of 77 studies were included in the meta-regression analysis. The case fatality rate for all studies combined was 1.14% with 95% confidence interval (CI) of 0.82-1.58%. The combined (unadjusted) case fatality rate for 69 studies which adopted WHO 1997 dengue case classification was 1.09% with 95% CI of 0.77-1.55%; and for eight studies with WHO 2009 was 1.62% with 95% CI of 0.64-4.02%. The unadjusted and adjusted odds ratio of case fatality using WHO 2009 dengue case classification was 1.49 (95% CI: 0.52, 4.24) and 0.83 (95% CI: 0.26, 2.63) respectively, compared to WHO 1997 dengue case classification. There was an apparent increase in trend of case fatality rate from the year 1992 to 2016. Neither was statistically significant.

Conclusions: The WHO 2009 dengue case classification might have no effect towards the case fatality rate although the adjusted results indicated a lower case fatality rate. Future studies are required for an update in the meta-regression analysis to confirm the findings.

Original language	English
Pages (from-to)	237-245
Number of pages	9
Journal	Acta Tropica
Volume	182
Early online date	12 Mar 2018
DOIs	https://doi.org/10.1016/j.actatropica.2018.03.014
Publication status	Published - Jun 2018

Keywords

Journal article
Case fatality rate
Clinical practice guideline
Mortality
Severe dengue
Neglected tropical disease
Case fatality rate
Severe dengue
Clinical practice guideline
Humans
Middle Aged
Male
Dengue/classification
Young Adult
Aged, 80 and over
Adult
Female
Odds Ratio
Child
Databases, Factual
International Classification of Diseases
World Health Organization
Cross-Sectional Studies
Regression Analysis
Adolescent
Aged
Global Health/standards

ASJC Scopus subject areas

Insect Science
Infectious Diseases
veterinary (miscalleneous)
Parasitology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.actatropica.2018.03.014Licence: Elsevier User Licence

Cite this

@article{e010b20bcbce457a9b2dda9bd25aee41,

title = "Global dengue death before and after the new World Health Organization 2009 case classification: A systematic review and meta-regression analysis",

abstract = "Background: Since the introduction of 2009 WHO dengue case classification, no literature was found regarding its effect on dengue death. This study was to evaluate the effect of 2009 WHO dengue case classification towards dengue case fatality rate.Methods: Various databases were used to search relevant articles since 1995. Studies included were cohort and cross-sectional studies, all patients with dengue infection and must report the number of death or case fatality rate. The Joanna Briggs Institute appraisal checklist was used to evaluate the risk of bias of the full-texts. The studies were grouped according to the classification adopted: WHO 1997 and WHO 2009. Meta-regression was employed using a logistic transformation (log-odds) of the case fatality rate. The result of the meta-regression was the adjusted case fatality rate and odds ratio on the explanatory variables.Results: A total of 77 studies were included in the meta-regression analysis. The case fatality rate for all studies combined was 1.14% with 95% confidence interval (CI) of 0.82-1.58%. The combined (unadjusted) case fatality rate for 69 studies which adopted WHO 1997 dengue case classification was 1.09% with 95% CI of 0.77-1.55%; and for eight studies with WHO 2009 was 1.62% with 95% CI of 0.64-4.02%. The unadjusted and adjusted odds ratio of case fatality using WHO 2009 dengue case classification was 1.49 (95% CI: 0.52, 4.24) and 0.83 (95% CI: 0.26, 2.63) respectively, compared to WHO 1997 dengue case classification. There was an apparent increase in trend of case fatality rate from the year 1992 to 2016. Neither was statistically significant.Conclusions: The WHO 2009 dengue case classification might have no effect towards the case fatality rate although the adjusted results indicated a lower case fatality rate. Future studies are required for an update in the meta-regression analysis to confirm the findings.",

keywords = "Journal article, Case fatality rate , Clinical practice guideline , Mortality, Severe dengue , Neglected tropical disease, Case fatality rate, Severe dengue, Clinical practice guideline, Humans, Middle Aged, Male, Dengue/classification, Young Adult, Aged, 80 and over, Adult, Female, Odds Ratio, Child, Databases, Factual, International Classification of Diseases, World Health Organization, Cross-Sectional Studies, Regression Analysis, Adolescent, Aged, Global Health/standards",

author = "Low, {Gary Kim-Kuan} and Ogston, {Simon A.} and Mun-Hin Yong and Seng-Chiew Gan and Hui-Yee Chee",

note = "No funding",

year = "2018",

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doi = "10.1016/j.actatropica.2018.03.014",

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T1 - Global dengue death before and after the new World Health Organization 2009 case classification

T2 - A systematic review and meta-regression analysis

AU - Low, Gary Kim-Kuan

AU - Ogston, Simon A.

AU - Yong, Mun-Hin

AU - Gan, Seng-Chiew

AU - Chee, Hui-Yee

N1 - No funding

PY - 2018/6

Y1 - 2018/6

N2 - Background: Since the introduction of 2009 WHO dengue case classification, no literature was found regarding its effect on dengue death. This study was to evaluate the effect of 2009 WHO dengue case classification towards dengue case fatality rate.Methods: Various databases were used to search relevant articles since 1995. Studies included were cohort and cross-sectional studies, all patients with dengue infection and must report the number of death or case fatality rate. The Joanna Briggs Institute appraisal checklist was used to evaluate the risk of bias of the full-texts. The studies were grouped according to the classification adopted: WHO 1997 and WHO 2009. Meta-regression was employed using a logistic transformation (log-odds) of the case fatality rate. The result of the meta-regression was the adjusted case fatality rate and odds ratio on the explanatory variables.Results: A total of 77 studies were included in the meta-regression analysis. The case fatality rate for all studies combined was 1.14% with 95% confidence interval (CI) of 0.82-1.58%. The combined (unadjusted) case fatality rate for 69 studies which adopted WHO 1997 dengue case classification was 1.09% with 95% CI of 0.77-1.55%; and for eight studies with WHO 2009 was 1.62% with 95% CI of 0.64-4.02%. The unadjusted and adjusted odds ratio of case fatality using WHO 2009 dengue case classification was 1.49 (95% CI: 0.52, 4.24) and 0.83 (95% CI: 0.26, 2.63) respectively, compared to WHO 1997 dengue case classification. There was an apparent increase in trend of case fatality rate from the year 1992 to 2016. Neither was statistically significant.Conclusions: The WHO 2009 dengue case classification might have no effect towards the case fatality rate although the adjusted results indicated a lower case fatality rate. Future studies are required for an update in the meta-regression analysis to confirm the findings.

AB - Background: Since the introduction of 2009 WHO dengue case classification, no literature was found regarding its effect on dengue death. This study was to evaluate the effect of 2009 WHO dengue case classification towards dengue case fatality rate.Methods: Various databases were used to search relevant articles since 1995. Studies included were cohort and cross-sectional studies, all patients with dengue infection and must report the number of death or case fatality rate. The Joanna Briggs Institute appraisal checklist was used to evaluate the risk of bias of the full-texts. The studies were grouped according to the classification adopted: WHO 1997 and WHO 2009. Meta-regression was employed using a logistic transformation (log-odds) of the case fatality rate. The result of the meta-regression was the adjusted case fatality rate and odds ratio on the explanatory variables.Results: A total of 77 studies were included in the meta-regression analysis. The case fatality rate for all studies combined was 1.14% with 95% confidence interval (CI) of 0.82-1.58%. The combined (unadjusted) case fatality rate for 69 studies which adopted WHO 1997 dengue case classification was 1.09% with 95% CI of 0.77-1.55%; and for eight studies with WHO 2009 was 1.62% with 95% CI of 0.64-4.02%. The unadjusted and adjusted odds ratio of case fatality using WHO 2009 dengue case classification was 1.49 (95% CI: 0.52, 4.24) and 0.83 (95% CI: 0.26, 2.63) respectively, compared to WHO 1997 dengue case classification. There was an apparent increase in trend of case fatality rate from the year 1992 to 2016. Neither was statistically significant.Conclusions: The WHO 2009 dengue case classification might have no effect towards the case fatality rate although the adjusted results indicated a lower case fatality rate. Future studies are required for an update in the meta-regression analysis to confirm the findings.

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KW - Severe dengue

KW - Neglected tropical disease

KW - Case fatality rate

KW - Severe dengue

KW - Clinical practice guideline

KW - Humans

KW - Middle Aged

KW - Male

KW - Dengue/classification

KW - Young Adult

KW - Aged, 80 and over

KW - Adult

KW - Female

KW - Odds Ratio

KW - Child

KW - Databases, Factual

KW - International Classification of Diseases

KW - World Health Organization

KW - Cross-Sectional Studies

KW - Regression Analysis

KW - Adolescent

KW - Aged

KW - Global Health/standards

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U2 - 10.1016/j.actatropica.2018.03.014

DO - 10.1016/j.actatropica.2018.03.014

M3 - Review article

C2 - 29545158

SN - 0001-706X

VL - 182

SP - 237

EP - 245

JO - Acta Tropica

JF - Acta Tropica

ER -

Global dengue death before and after the new World Health Organization 2009 case classification: A systematic review and meta-regression analysis

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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