Measuring health related quality of life for dengue patients in Iquitos, Peru

Abstract

Previous studies measuring the health-related quality of life (HRQoL) of individuals with dengue focused on treatment seeking populations. However, the vast majority of global dengue cases are unlikely to be detected by health systems. Representative measurements of HRQoL should therefore include patients with disease not likely to trigger treatment-seeking behavior. This study based in Iquitos, Peru used the Quality of Wellbeing Scale-Self Administered, a survey that enquires about not only physical health, but also psychological health, self-care, mobility, and usual social activities, and rates HRQoL between 0 (death) and 1 (optimum function), to evaluate the impact of dengue on HRQoL. In order to enroll treatment and non treatment-seeking participants, three modalities of participant recruitment were used. In addition to clinic and community-based febrile surveillance, a contact-cluster methodology was also employed to identify infected individuals less likely to seek treatment. We measured changes in HRQoL and identified common areas of health impairment in 73 virologically confirmed dengue cases at 3 time points during the participant's illness; the earlyacute (days 0-6 post symptom onset), late-acute (days 7-20), and convalescent illness phases (days 21 +). Participants reported HRQoL related impairments at significantly higher frequency during the early-acute versus convalescent illness phase (Fisher's exact: P<0.01). There was substantial heterogeneity in scores during each illness phase with median scores in the early-acute, late-acute and convalescent phases of 0.56 (IQR: 0.41-0.64), 0.70 (IQR: 0.57-0.94), and 1 (IQR: 0.80-1.00), respectively. In all illness phases PLOS NEGLECTED TROPICAL DISEASES

Measuring dengue illness intensity: Development and content validity of the dengue virus daily diary (DENV-DD)

“…This study added to the understanding of the outpatient dengue illness experience [ 31 , 32 ]. Consistent with previous literature [ 10 ], fever, headache, musculoskeletal pain, fatigue, rash, and nausea/vomiting were identified as core signs/symptoms of dengue.…”

The impact of dengue illness on social distancing and caregiving behavior

“…During that seven-day follow-up period, DENV positive (DENV+) individuals were also administered two Quality of Well-Being (QWB) surveys [ 45 ], 2–3 days and seven days after the initial PCR-positive blood test result. The QWB survey is a validated instrument used to measure an individual’s health related quality of life during chronic illness [ 45 , 46 ] that uses a weighted algorithm to produce a well-being score between 0 (death) and 1 (optimal health) [ 45 ]. On the seventh day after the initial diagnostic blood draw an expenses survey was administered, which focused on the costs incurred during dengue illness.…”

Quantifying heterogeneities in arbovirus transmission: Description of the rationale and methodology for a prospective longitudinal study of dengue and Zika virus transmission in Iquitos, Peru (2014–2019)

“…These were the same individuals participating in the mosquito feeding experiments (Project 1). By applying social and health science techniques we (1) described and quantified the association between subjective and objective measures of dengue disease severity, (2) examined and quantified human behavior changes associated with dengue disease of various severities [10,11,13], and (3) estimated individual human-mosquito contact rates to explore risk for potential forward DENV transmission (Project 3).…”

“…Due to delays associated with the COVID-19 pandemic some data analysis and laboratory testing are ongoing. Although we previously published project associated reports (i.e., spectrum of dengue illness experienced in Iquitos [10] and impact of dengue on human mobility [11,12] and quality of life measures [13]) in this publication we do not focus on project related data. Instead, we limit our presentation to the overall rationale and methodology of the study and how the project was designed to directly address key knowledge gaps in the understanding of DENV transmission.…”