Clinical and laboratory signs associated to serious dengue disease in hospitalized children

Pone, Sheila Moura; Hökerberg, Yara Hahr Marques; Oliveira, Raquel de Vasconcellos Carvalhaes de; Daumas, Regina Paiva; Pone, Tamiris Moura; Pone, Marcos Vinícius da Silva; Brasil, Patrícia

doi:10.1016/j.jped.2015.12.005

Cited by 20 publications

(12 citation statements)

References 25 publications

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“…The clinical parameters of warning signs were more frequent in severe dengue patients, which was in agreement with previous studies; hepatomegaly was a risk factor of DSS or severe dengue infection [37–42], abdominal pain was a prognostic factor for severe dengue [43, 44], and lethargy was the best clinical sign to identify patients who may progress to severe dengue [45]. Although there were no patients with persistent vomiting, those who had a history of vomiting were frequently more present in the severe dengue patient group.…”

Section: Discussionsupporting

confidence: 90%

Impact of glucose-6-phosphate dehydrogenase deficiency on dengue infection in Myanmar children

et al. 2019

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Glucose-6-phosphate dehydrogenase (G6PD) deficiency may affect the clinical presentation of dengue due to the altered redox state in immune cells. We aimed to determine the association between G6PD deficiency and severity of dengue infection in paediatric patients in Myanmar. A cross-sectional study was conducted among paediatric patients aged 2–13 years with dengue in Yankin Children Hospital, Myanmar. One hundred and ninety-six patients positive for dengue infection, as determined via PCR or ELISA, were enrolled. Dengue severity was determined according to the 2009 WHO classification guidelines. Spectrophotometric assays determined G6PD levels. The adjusted median G6PD value of males in the study population was used to define various cut-off points according to the WHO classification guidelines. G6PD genotyping for Mahidol, Kaiping and Mediterranean mutations was performed for 128 out of 196 samples by real-time multiplex PCR. 51 of 196 (26.0%) patients had severe dengue. The prevalence of G6PD phenotype deficiency (< 60% activity) in paediatric patients was 14.8% (29/196), specifically, 13.6% (14/103) in males and 16.2% (15/93) in females. Severe deficiency (< 10% activity) accounted for 7.1% (14/196) of our cohort, occurring 11.7% (12/103) in males and 2.2% (2/93) in females. Among 128 samples genotyped, the G6PD gene mutations were detected in 19.5% (25/128) of patients, with 20.3% (13/ 64) in males and 18.8% (12/64) in females. The G6PD Mahidol mutation was 96.0% (24/25) while the G6PD Kaiping mutation was 4.0% (1/25). Severe dengue was not associated with G6PD enzyme deficiency or presence of the G6PD gene mutation. Thus, no association between G6PD deficiency and dengue severity could be detected.Trial registration: The study was registered following the WHO International Clinical Trials Registry Platform (WHO-ICTRP) on Thai Clinical Trials Registry (TCTR) website, registration number # TCTR20180720001

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Section: Discussionsupporting

confidence: 90%

Impact of glucose-6-phosphate dehydrogenase deficiency on dengue infection in Myanmar children

et al. 2019

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“…A study conducted in Sri Lanka with 104 children in 2004 corroborates this, as hematemesis was found in 15% of cases involving the old classification of hemorrhagic fever. ( 12 )…”

Section: Discussionmentioning

confidence: 99%

“…Lethargy is a neurological sign of great importance as a predictor for cases that are candidates for progression to severe dengue, presenting in 47.8% of patients with severe dengue; therefore, early detection of this central nervous system manifestation is vital. ( 12 )…”

Section: Discussionmentioning

confidence: 99%

Analysis of signs and symptoms in confirmed cases of severe dengue among children aged 0 to 10 years old

Silva,

Carvalho,

Pinto

et al. 2024

Einstein (São Paulo)

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“…The Brazilian Health Surveillance Guidelines of 2017 [21] proposed a differential clinical diagnosis between chikungunya, dengue, and Zika to orient health professionals. However, although many studies proposed clinical rules for diagnosing dengue [22][23][24][25][26][27] and Zika [23,28], almost none investigated chikungunya fever [29]. The current study thus aimed to derive and validate a clinical rule for chikungunya diagnosis based on a large sample of outpatients seen in the public healthcare system in the city of Rio de Janeiro, where dengue and Zika are endemic.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a clinical rule for the diagnosis of chikungunya fever in a dengue-endemic area

et al. 2023

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Rio de Janeiro is a dengue-endemic city that experienced Zika and chikungunya epidemics between 2015 and 2019. Differential diagnosis is crucial for indicating adequate treatment and assessing prognosis and risk of death. This study aims to derive and validate a clinical rule for diagnosing chikungunya based on 3,214 suspected cases consecutively treated at primary and secondary health units of the sentinel surveillance system (up to 7 days from onset of symptoms) in Rio de Janeiro, Brazil. Of the total sample, 624 were chikungunya, 88 Zika, 51 dengue, and 2,451 were negative for all these arboviruses according to real-time polymerase chain reaction (RT-qPCR). The derived rule included fever (1 point), exanthema (1 point), myalgia (2 points), arthralgia or arthritis (2 points), and joint edema (2 points), providing an AUC (area under the receiver operator curve) = 0.695 (95% CI: 0.662–0.725). Scores of 4 points or more (validation sample) showed 74.3% sensitivity (69.0% - 79.2%) and 51.5% specificity (48.8% - 54.3%). Adding more symptoms improved the specificity at the expense of a lower sensitivity compared to definitions proposed by government agencies based on fever alone (European Center for Disease Control) or in combination with arthralgia (World Health Organization) or arthritis (Pan American Health Organization, Brazilian Ministry of Health). The proposed clinical rule offers a rapid, low-cost, easy-to-apply strategy to differentiate chikungunya fever from other arbovirus infections during epidemics.

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Clinical and laboratory signs associated to serious dengue disease in hospitalized children

Cited by 20 publications

References 25 publications

Impact of glucose-6-phosphate dehydrogenase deficiency on dengue infection in Myanmar children

Impact of glucose-6-phosphate dehydrogenase deficiency on dengue infection in Myanmar children

Analysis of signs and symptoms in confirmed cases of severe dengue among children aged 0 to 10 years old

Development and validation of a clinical rule for the diagnosis of chikungunya fever in a dengue-endemic area

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