Epidemiological assessment of the severity of dengue epidemics in French Guiana

Flamand, Claude; Fritzell, Camille; Prince, Christelle; Abboud, Philippe; Ardillon, Vanessa; Carvalho, Luisiane; Demar, Magalie; Boukhari, Rachida; Papaix-Puech, Martine; Elenga, Narcisse; Rousset, Dominique; Matheus, Séverine; Nacher, Mathieu; Quénel, Philippe; Djossou, Félix

doi:10.1371/journal.pone.0172267

Cited by 25 publications

(19 citation statements)

References 27 publications

(21 reference statements)

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“…It is possible that these patients may have not needed hospitalisation, consistent with previous findings in the literature . As dengue outbreaks often present substantial spatial and temporal clustering , misclassifying dengue patients as severe may result in unnecessary congestion of the healthcare system .…”

Section: Discussionmentioning

confidence: 99%

Comparison between the traditional (1997) and revised (2009) WHO classifications of dengue disease: a retrospective study of 30 670 patients

Silva

Undurraga

Verro

et al. 2018

Tropical Med Int Health

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Objective To compare WHO's traditional (1997) and revised (2009) guidelines for dengue classification, using a large sample of patients of all ages with varying clinical conditions from a dengue‐endemic area in Brazil. Methods We compared 30 670 laboratory‐confirmed dengue cases (1998–2012) using both WHO's dengue classification guidelines. Stereotype ordinal logistic regressions were used to analyse the association between patients’ demographics and signs and symptoms related to dengue infection severity, as defined in the 1997 and 2009 guidelines. We then compared the degree of agreement in dengue classification of both guidelines. Results Dengue signs and symptoms in patients were poorly correlated to disease severity as defined by both guidelines (Cramer's V test <0.2). Hypotensive shock was the exception for both classifications, presenting dependence (Z = 56.42; P < 0.001, and Z = 55.24; P < 0.001) and high agreement (Cramers's V = 1; P < 0.001, and Cramers's V = 0.97; P < 0.001) for WHO 1997 and 2009, respectively. Last, we also found substantial agreement in disease classification between both guidelines (Kendall tau‐b = 0.79; P < 0.001), although 2009 guidelines were more sensitive in the detection of severe cases. Conclusions We hope our results will inform the debate about dengue classification guidelines, particularly concerning clinical value, study comparability, and ways in which future guidelines can support the clinical management of dengue. Our results suggest that caution should be taken when using WHO guidelines to assess dengue severity to improve clinical management of patients.

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Section: Discussionmentioning

confidence: 99%

Comparison between the traditional (1997) and revised (2009) WHO classifications of dengue disease: a retrospective study of 30 670 patients

Silva

Undurraga

Verro

et al. 2018

Tropical Med Int Health

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“…Flamand C et al report that children aged <7 years comprised >20% of their study population, and prevalence was less in infants (4.0%) while Dias JJ Júnior reported that 66.0% of the study population wih severe dengue were children <15 years. 9,10 These reports indicate that case of fever in pediatric patients needs careful evaluation. Report from Malaysis is indicating a declining trend among pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical and diagnostic features of dengue haemorrhagic fever in children

Reddy

Nagendra

2018

Int J Contemp Pediatr

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Background: Diagnosis of dengue hemorrhagic fever (DHF) in children is based on clinical suspicion and prompting laboratory criteria.Methods: This prospective study in children (6 months-14 years) presenting with features of DHF aimed to identify symptoms and signs, laboratory parameters for in early detection and assessed the association between clinical, laboratory, immunological parameters and outcome.Results: Of 50 children, 26 were females, mean±SD age was 8.3±3.02 years; age group 8-12 years were affected the most (38.0%) and infants the least (4.0%). Fever (100%), followed by skin rash (56.0%), myalgia (52.0%) and head ache (48.0%) were the symptoms. Fever of 4-5 days (52.0%), high grade fever (84.0%) and of sudden onset (76.0%) were common. Ascitis was seen in nine. Peteche and malena (48.0%) were predominant manifestation of bleeding tendency (100%). Positive tourniquet test (48.0%) did not correlate with bleeding tendency. Lower levels of Hemoglobin (<12gms%, 100%), hematocrit (<40%, 98.0%), platelet count (<100000/mm3, 100%), serum albumin (76.0%), and abnormal liver enzymes (64.0%) along with prolonged prothrombin time (44.0%) and aPTT (18.05%) were noted. Ultrasound abdomen confirmed Pleural effusion (52.0%), ascitis (22.0%), Hepatomegaly (68.0%). Mean detection time was 4 days. Positive dengue IgM and IgG (60.0%), IgM (16%), and IgG (24%) were observed with increase of IgM in early phase.Conclusions: lower platelet count, raising haematocrit, increased liver enzymes with low serum albumin levels are early indicators. Prolonged PT and APTT are associated with severe bleeding manifestations. Apart from clinical expertise, chest X-ray, abdominal ultrasonogram are useful diagnostic tools.

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“…The 4 serotypes of DENV circulate in FG in endemic-epidemic form. In the past 10 years, there has been an increase in the number of DENV outbreaks and hospitalized cases [ 3 , 4 ]. Thus far, A aegypti mosquitoes have been the sole vector implicated in these outbreaks, and A albopictus have not been actually reported in FG [ 5 ].…”

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confidence: 99%

Poverty and Arbovirus Outbreaks: When Chikungunya Virus Hits More Precarious Populations Than Dengue Virus in French Guiana

Bonifay

Douine

Bonnefoy

et al. 2017

Open Forum Infectious Diseases

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BackgroundSince 2013, 3 successive arbovirus outbreaks, dengue (DENV), chikungunya (CHIKV), and Zika virus, have occurred in French Guiana (FG). The primary objective of this study was to describe the socioeconomic indicators of the first patients infected with CHIKV during the outbreak of 2014. The secondary objective was to compare those patients with patient infected by DENV and with the local population.MethodsA monocentric, retrospective, case-control study was conducted in Cayenne hospital in FG comparing a group of patients infected with CHIKV in 2014 with a group infected with DENV in 2013. Children aged less than 15 years and pregnant women were excluded.ResultsA total of 168 CHIKV patients were compared with 168 DENV patients. Factors associated with CHIKV were living in poor neighborhoods (82% vs 44%; odds ratio [OR], 5.81; 95% confidence interval [CI], 3.35–10.2), having a precarious status (54% vs 33%; OR, 2.37; 95% CI, 1.49–3.78), and being born abroad (70% vs 35%; OR, 4.35; 95% CI, 2.69–7.06).ConclusionsThe present results suggest that early in the epidemic, the populations most at risk for CHIKV infection were the most socially vulnerable populations in the poorest neighborhoods, whereas DENV appeared to have affected a richer population and richer areas.

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Epidemiological assessment of the severity of dengue epidemics in French Guiana

Cited by 25 publications

References 27 publications

Comparison between the traditional (1997) and revised (2009) WHO classifications of dengue disease: a retrospective study of 30 670 patients

Comparison between the traditional (1997) and revised (2009) WHO classifications of dengue disease: a retrospective study of 30 670 patients

Clinical and diagnostic features of dengue haemorrhagic fever in children

Poverty and Arbovirus Outbreaks: When Chikungunya Virus Hits More Precarious Populations Than Dengue Virus in French Guiana

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