Clinical evaluation of dengue and identification of risk factors for severe disease: protocol for a multicentre study in 8 countries

Abstract

Background: The burden of dengue continues to increase globally, with an estimated 100 million clinically apparent infections occurring each year. Although most dengue infections are asymptomatic, patients can present with a wide spectrum of clinical symptoms ranging from mild febrile illness through to severe manifestations of bleeding, organ impairment, and hypovolaemic shock due to a systemic vascular leak syndrome. Clinical diagnosis of dengue and identification of which patients are likely to develop severe disease remain challenging. This study aims to improve diagnosis and clinical management through approaches designed a) to differentiate between dengue and other common febrile illness within 72 h of fever onset, and b) among patients with dengue to identify markers that are predictive of the likelihood of evolving to a more severe disease course.

Rapid and specific detection of Asian- and African-lineage Zika viruses

“…The Recife cohort samples used for the assays described here were collected from individuals presenting with acute febrile illnesses in an urgent health care clinic in the Recife Metropolitan Region from May 2015 to April 2016, as part of the International Research Consortium on Dengue Risk Assessment, Management and Surveillance (IDAMS) study (49). The ages of patients from whom sera were used for the assays varied from 9 to 62 years (mean age, 32), where 27 were females and 23 were males.…”

Mosquito-transmitted viruses – the great Brazilian challenge

“…DF is a complex illness, with a wide spectrum of clinical manifestations, which, often, are unrecognized or misdiagnosed as other fever-causing tropical illness. Among symptomatic cases of DF, a wide variety of clinical manifestations can be observed, ranging from mild febrile illness to severe DF and potentially fatal DHF 53 . After an incubation period of 3–5 days (usually 5–8), the illness begins abruptly and passes through three phases: febrile, critical, and recovery.…”

“…Although severe illness is historically associated with pediatric populations in the hyper-endemic regions,58, 59 current trends show that adults may also be at risk 60, 61, 62, 63. The risk factors for the development of severe DF include prior infection by the heterotypic serotype, 64 but, currently, the ability to predict the development of complications such as shock due to systemic vascular leak syndrome is currently poor 53 . Although the clinical definition of DF is available, clinical and laboratory presentations do vary in some cases, often overlapping with other infections; therefore, laboratory confirmation is considered plausible.…”

“…In Brazil, DENV is endemic, causing an overlap between this virus and other arboviruses. Other febrile illnesses such as measles, typhoid, leptospirosis, and influenza can also present with similar characteristics, in particular, during the early phase, 53 thereby leading to overlapping diagnosis. In many regions of Brazil, with low economic status and reduced availability of diagnostic services, diagnosis usually depends exclusively on the clinical manifestation.…”

Morbimortalidade da dengue em idosos no Brasil - Dengue morbidity and mortality in elderly in Brazil

“…O diagnóstico clínico e identificação de quais pacientes são propensos a desenvolver doença grave na dengue, são aspectos ainda desafiadores. 3 Sabe-se da importância do conhecimento sobre os vários aspectos da dengue revelado pela população exposta para melhoria dos coeficientes de morbimortalidade. Contudo, o conhecimento da população alvo é na maioria das vezes incompleto e às vezes equivocado, fragmentado, com baixo grau de integração entre as partes: identifica-se que a dengue tem a ver com recipientes, água, mosquitos, larvas, ovos, vírus, lixo, trabalho integrado entre poder público e população, mas é fraca ou quase nula a consciência da adequada relação entre esses elementos.…”