scholarly journals The clinical characteristics and outcome of children hospitalized with dengue in Barbados, an English Caribbean country

2015 ◽  
Vol 9 (04) ◽  
pp. 394-401 ◽  
Author(s):  
Alok Kumar ◽  
Marquita Gittens-St. Hilair ◽  
Vincent Jason ◽  
Christian Ugwuagu ◽  
Kandamaran Krishnamurthy
Keyword(s):  
Case Fatality Rate ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Population Based ◽  
Warning Signs ◽  
Severe Dengue ◽  
Fatality Rate ◽  
Case Files ◽  
Dengue With Warning Signs

Introduction: Although dengue is endemic in all English-speaking Caribbean countries, there are no published studies on the clinical presentations and outcomes of children hospitalized with dengue from this region. This study aims to assess the clinical charcteristics and the outcome in children hospitalized with dengue. Methods: This was a population-based prospective study of all the children hospitalized with confirmed dengue in 2009 in Barbados. All children suspected to have dengue were routinely screened for dengue infection and underwent routine blood tests. Relevant data was extracted from their case files at the time of their discharge from the hospital. Results: Of the 199 children who were hospitalized with suspected dengue, 115 (58%) were confirmed. The overall incidence rate of  dengue among children that required hospitalization was 2.1/1,000 children. Besides the typical clinical features of dengue, 64 children hospitalized with confirmed dengue also presented with gastrointestinal manifestations (56%), 39 with respiratory manifestations (51%), 11 with hepatic manifestations (10%), 8 with neurologic manifestations (7%), and 7 with cardiovascular manifestations (6%). Twenty (17.4%) children hospitalized with confirmed dengue met the criteria for the diagnosis of severe dengue. The other 82.6% had uncomplicated or non-severe (53.9% had dengue and 28.7% had dengue with warning signs) forms of dengue. The case fatality rate in this series was 1.7%. Conclusions: Less than a third of all the children with confirmed dengue required hospitalization. Atypical clinical manifestations were common, and only a minority of these children had severe dengue. Overall, the case fatality rate for dengue in this select population of children hospitalized with dengue was low.

scholarly journals Case Fatality Rate Related to Microcephaly Congenital Zika Syndrome and Associated Factors: A Nationwide Retrospective Study in Brazil †

Viruses ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 1228
Author(s):  
Maria Conceição N. Costa ◽  
Luciana Lobato Cardim ◽  
Maria Gloria Teixeira ◽  
Mauricio L. Barreto ◽  
Rita de Cassia Oliveira de Carvalho-Sauer ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Very Low Birth Weight ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Preterm Births ◽  
Population Based ◽  
Fatality Rate ◽  
Maternal Characteristics ◽  
Logistic Regression Models ◽  
Congenital Zika Syndrome

Background: The clinical manifestations of microcephaly/congenital Zika syndrome (microcephaly/CZS) have harmful consequences on the child’s health, increasing vulnerability to childhood morbidity and mortality. This study analyzes the case fatality rate and child–maternal characteristics of cases and deaths related to microcephaly/CZS in Brazil, 2015–2017. Methods: Population-based study developed by linkage of three information systems. We estimate frequencies of cases, deaths, case fatality rate related to microcephaly/CZS according to child and maternal characteristics and causes of death. Multivariate logistic regression models were applied. Results: The microcephaly/CZS case fatality rate was 10% (95% CI 9.2–10.7). Death related to microcephaly/CZS was associated to moderate (OR = 2.15; 95% CI 1.63–2.83), and very low birth weight (OR = 3.77; 95% CI 2.20–6.46); late preterm births (OR = 1.65; 95% CI 1.21–2.23), Apgar < 7 at 1st (OR = 5.98; 95% CI 4.46–8.02) and 5th minutes (OR = 4.13; 95% CI 2.78–6.13), among others. Conclusions: A high microcephaly/CZS case fatality rate and important factors associated with deaths related to this syndrome were observed. These results can alert health teams to these problems and increase awareness about the factors that may be associated with worse outcomes.

scholarly journals Clinico-epidemiological study of dengue fever in Ajmer region

2019 ◽  
Vol 6 (5) ◽  
pp. 2046
Author(s):  
Dharmendra Rawat ◽  
Kanwar Singh ◽  
Pukhraj Garg
Keyword(s):  
Dengue Fever ◽  
Case Fatality Rate ◽  
Wide Spectrum ◽  
Dengue Infection ◽  
Case Fatality ◽  
Hemorrhagic Fever ◽  
Severe Dengue ◽  
Common Disease ◽  
Hemorrhagic Disease ◽  
Fatality Rate

Background: Dengue infection is a major challenge to public health, especially in South-East Asia. It present with a diverse clinical spectrum. Estimates suggest that annually over 50 million cases of dengue hemorrhagic fever (DHF) occur in Asian countries with a case fatality rate of less than 5%. Of those with DHF, at least 90% are children younger than 15 years old. In humans, dengue infection causes a spectrum of illness ranging from relatively mild, non-specific viral syndrome known as Dengue fever (DF) to severe hemorrhagic disease and death. Definitive early Dengue diagnosis requires laboratory tests and those suitable for use at this stage of illness are either costly, such as RT-PCR for Dengue; not sufficiently rapid, such as virus isolation. Currently test available are NS1 antigen detection and ELISA for dengue, IgM and IgG antibodies. Objective of this study is to study clinico-epidemiological and haematological features of Dengue infection.Methods: Prospective observational study involving initial 100 registered cases who were serologically confirmed dengue infection for a period of one year.Results: DF, DHF and DSS were found in 41%, 53% and 6% patients respectively. Most common presenting complaint and bleeding manifestation were fever and petechiae. Uncommonly altered sensorium and icterus were found in severe dengue infection. 6% patients had coagulopathy, 37 patients had hepatic involvement and 2 patients had deranged renal function who had DSS. Fever was present in (100%) cases of DF, DHF and DSS. 26% patients had their platelet count <50000/mm3.Conclusions: Dengue is a common disease in the India with wide spectrum of clinical presentations, affecting 5-15 years age group children commonly. It is one of the dreaded fevers but early diagnosis and management according to recent WHO guidelines can decrease case fatality rate significantly.

FACTORS PREDICTING SEVERITY OF ILLNESS IN DENGUE FEVER: AN OBSERVATIONAL STUDY

2021 ◽  
pp. 54-55
Author(s):  
Abhay John Gray ◽  
Sheela Mathew ◽  
Gayathri R ◽  
Akhila Arya ◽  
Aswathy MA ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Ldl Cholesterol ◽  
Severe Disease ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Severity Of Illness ◽  
Warning Signs ◽  
Severe Dengue ◽  
Detailed History ◽  
Dengue With Warning Signs

Introduction: Dengue is a systemic viral infection caused by the virus from genus Flaviviridae. Dengue infection has got a wide clinical spectrum that includes both severe and non-severe clinical manifestations. The group progressing from non-severe to severe disease is difcult to dene. Early detection and access to proper medical care signicantly lower fatality rates and would help to reduce the burden of hospital stay and economy loss. Objectives: To study the inammatory markers predicting the severity of dengue infection. Methods: 250 diagnosed patients were evaluated with detailed history, physical examination and blood investigations. Inammatory markers associated with severity of dengue were studied. Observations and conclusions- 97 patients (39%) had dengue without warning signs, 62(25%) had dengue with warning signs, 63(25%) had severe dengue and 28(11%) had expanded dengue. Low CRP, ESR, HDL and LDL cholesterol were observed in dengue fever, without any statistical signicance. Ferritin levels more than 1000 and triglyceride more than 200 was signicantly associated with severity of dengue.

scholarly journals Increased levels of pentraxins protein and cytokines bear good association in patients with severe dengue infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Goutam Patra ◽  
Bibhuti Saha ◽  
Sumi Mukhopadhyay
Keyword(s):  
Dengue Infection ◽  
Clinical Manifestations ◽  
Blood Parameters ◽  
Warning Signs ◽  
Severe Dengue ◽  
Disease Manifestation ◽  
Mild Disease ◽  
Tnf Α ◽  
The Status ◽  
The Tropics

AbstractDengue is an arboviral infection with high rates of morbidity and mortality throughout the tropics and sub-tropics. This work studied the status of pentraxin (CRP/SAP) protein, ferritin, TNF-α and IL-1β levels in Dengue patients of different pathophysiological manifestations. Accordingly, clinically confirmed Dengue cases (n = 97) were enrolled and subsequently blood parameters were studied by Haematology cell counter and Biochemistry Autoanalyser. CRP, SAP, ferritin, TNF-α and IL-1β ELISA were done in all the samples by using standard ELISA kits. Statistical Analysis was done in all the experiments. The levels of CRP (p < 0.0001), SAP (p < 0.0001), ferritin (p < 0.0001), TNF-α (p < 0.0001) and IL-1β (p < 0.0001) were high in patients with Severe Dengue as compared to Dengue without warning signs. High levels of SGOT, SGPT and decreased platelet counts were found in severe patients as compared to Healthy donor. CRP/SAP as well as TNF-α/IL-1β were independently associated with both dengue severity and overall disease manifestation. Statistically significant increased CRP, SAP, ferritin, TNF-α and IL-1β titres were correlated in patients with severe clinical manifestations as compared to mild disease forms of dengue. Elevated levels of pentraxin, TNF-α/IL-1β in blood during dengue infection could act as an early predictor in Severe Dengue infection.

scholarly journals Epidemiological and Clinical Features of Dengue Infection in Adults in the 2017 Outbreak in Vietnam

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bui Vu Huy ◽  
Le Nguyen Minh Hoa ◽  
Dang Thi Thuy ◽  
Nguyen Van Kinh ◽  
Ta Thi Dieu Ngan ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Dengue Fever ◽  
Clinical Features ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Severe Dengue ◽  
Severe Bleeding ◽  
Cross Sectional ◽  
Number Of Patients

Purpose. The clinical features and laboratory results of dengue-infected adult patients admitted to the hospital during the 2017 outbreak were analyzed in this study. Method. This is a cross-sectional study. 2922 patients aged 18 years or more with dengue fever in National Hospital for Tropical Diseases (NHTD) in the North and Hospital for Tropical Disease (HTD) in the South of Vietnam were recruited in this study. Result. Patients were admitted in the hospital around the year and concentrated from August to December, in 53/63 (84.0%) provinces in Vietnam, and patients in all ages were affected. The number of patients with dengue fever was 1675 (57.3%), dengue with warning signs 914 (31.3%), and severe dengue 333 (11.4%), respectively. Among patients with severe dengue, severe plasma leakage and dengue shock account for 238 (8.1%), severe organ impairment 73 (2.5%), and severe bleeding 22 (0.75%). The rate of mortality was 0.8%, and the outcome of dengue patients is worse in the elderly and people with underlying diseases. Conclusion. The 2017 dengue outbreak occurred in a larger scale than in the previous years in terms of time, location, and number of patients. More elderly patients were infected by dengue in this outbreak, and this may contribute to the mortality rate. Clinical manifestations of dengue patients in Southern Vietnam are more typical than the northern, but the rate of severe dengue is not different. The mortality risk and underlying conditions associated with dengue-infected elderly patients are worthy of further investigations in the future.

scholarly journals Pediatric Stroke Rates Over 17 Years: Report From a Population-Based Study

2018 ◽  
Vol 33 (7) ◽  
pp. 463-467 ◽  
Author(s):  
Laura L. Lehman ◽  
Jane C. Khoury ◽  
J. Michael Taylor ◽  
Samrat Yeramaneni ◽  
Heidi Sucharew ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Pediatric Stroke ◽  
Stroke Rate ◽  
Fatality Rate ◽  
Population Based Study ◽  
Study Region ◽  
Stroke Study ◽  
Stroke Type

We previously published rates of pediatric stroke using our population-based Greater Cincinnati Northern Kentucky Stroke Study (GCNK) for periods July 1993–June 1994 and 1999. We report population-based rates from 2 additional study periods: 2005 and 2010. We identified all pediatric strokes for residents of the GCNK region that occurred in July 1, 1993–June 30, 1994, and calendar years 1999, 2005, and 2010. Stroke cases were ascertained by screening discharge ICD-9 codes, and verified by a physician. Pediatric stroke was defined as stroke in those <20 years of age. Stroke rates by study period, overall, by age and by race, were calculated. Eleven children died within 30 days, yielding an all-cause case fatality rate of 15.7% (95% confidence interval 1.1%, 26.4%) with 3 (27.3%) ischemic, 6 (54.5%) hemorrhagic, and 2 (18.2%) unknown stroke type. The pediatric stroke rate of 4.4 per 100 000 in the GCNK study region has not changed over 17 years.

Factors predicting the severity of dengue in patients with warning signs in Rio de Janeiro, Brazil (1986–2012)

2019 ◽  
Vol 113 (11) ◽  
pp. 670-677 ◽  
Author(s):  
Bianca De Santis Gonçalves ◽  
Rita Maria Ribeiro Nogueira ◽  
Ana Maria Bispo de Filippis ◽  
Marco Aurélio Pereira Horta
Keyword(s):  
Rio De Janeiro ◽  
Dengue Infection ◽  
Warning Signs ◽  
Severe Dengue ◽  
Enzyme Linked Immunosorbent Assay ◽  
Infection Status ◽  
Viral Loads ◽  
Dengue Virus Type 3 ◽  
Dengue With Warning Signs ◽  
Type 3

AbstractBackgroundSince 1981, >12 million cases of dengue have been reported in Brazil. Early prediction of severe dengue with no warning signs is crucial to avoid progression to severe dengue. Here we aimed to identify early markers of dengue severity and characterize dengue infection in patients in Rio de Janeiro.MethodsWe evaluated early severity markers, serotypes, infection status, number of days of illness and viral loads associated with dengue fever in patients from Rio de Janeiro, Brazil through an observational retrospective study (1986–2012). We compared dengue without warning signs and dengue with warning signs/severe dengue (DWWS/SD). Infection status was classified by enzyme-linked immunosorbent assay and viraemia was quantified by quantitative real-time reverse transcription polymerase chain reaction.ResultsThe presence of DWWS/ SD was significantly associated with younger age; patients 13–19 y of age had a significantly greater chance of presenting warning signs. Dengue virus type 3 (DENV3) was more likely to induce DWWS/SD, which was more frequent on days 4–5 of illness.ConclusionsDENV3, 4–5 d of illness and 13–19 y of age were early biomarkers of dengue severity. To our knowledge, this was the first study to analyse the characteristics of dengue severity in the state of Rio de Janeiro over 27 y of epidemics since the introduction of DENV.

scholarly journals Serum sodium level in dengue infected children: a retrospective study

2018 ◽  
Vol 5 (5) ◽  
pp. 1801
Author(s):  
Reshma Raj ◽  
Rashmi Alva
Keyword(s):  
Dengue Fever ◽  
Serum Sodium ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Severe Dengue ◽  
Dengue With Warning Signs ◽  
Group B

Background: Dengue fever is one of the most common arbo virus mediated outbreaks, being reported from different parts of the world. Now as the outbreaks are hitting different geographic locations, different clinical manifestations are being reported recently. Aim of this study is to document the serum Sodium level in dengue infected children in a tertiary care centre.Methods: A total 128 cases of NS1 antigen, IgM positive or ELISA positive dengue patients were included in this observational study and analyzed.Results: The serum Sodium level in dengue varies according to the different groups. In group A (dengue with no warning signs) the serum Sodium level was normal, whereas in case of group B (dengue with warning signs), there was significant hyponatremia. In group C, severe dengue the serum Sodium was normalConclusions: Mild hyponatremia is a common electrolyte disturbance in patients with dengue with warning signs. Hence, the lower the serum Sodium levels the higher is the incidence of complications associated with dengue fever.

scholarly journals Immunophenotyping and transcriptional profiling of human plasmablasts in dengue.

2021 ◽  
Author(s):  
Charu Aggarwal ◽  
Keshav Saini ◽  
Elluri Seetharami Reddy ◽  
Mohit Singla ◽  
Kaustuv Nayak ◽  
...  
Keyword(s):  
Chemokine Receptors ◽  
Influenza Infection ◽  
Transcriptional Profiling ◽  
Dengue Infection ◽  
Warning Signs ◽  
Severe Dengue ◽  
Dengue Disease ◽  
Mucosal Tissues ◽  
Dengue With Warning Signs

Previous studies have shown that plasmablasts expand massively in dengue patients as compared to many other situations such as influenza infection or vaccination. However, a detailed understanding of the phenotypes and transcriptional features of these cells is lacking. Moreover, despite India having nearly a third of global dengue disease burden, there is virtually no information on plasmablasts responses in dengue patients from India. Here, we provide a detailed characterization of plasmablast responses from dengue confirmed febrile children in India. Immunophenotyping and RNA seq analysis showed that in addition to secreting dengue specific antibodies, these massively expanding cells expressed several adhesion molecules, chemokines and chemokine receptors that are involved in endothelial interactions, homing to skin or mucosal tissues including intestine. Surprisingly, we found that these cells also upregulated expression of several cytokine genes that are involved in angiogenesis, leukocyte extravasation and vascular permeability. These transcriptional features were qualitatively similar to plasmablasts from influenza vaccinees. Interestingly, the expansion of the plasmablasts in dengue patients was significantly lower in patients with primary dengue infection compared to those with secondary dengue. Moreover, within the primary dengue patients, their expansion was significantly lower in patients with mild dengue infection (DI) compared to patients with dengue with warning signs (DW) or severe dengue (SD). These results significantly improve our understanding of human plasmablast responses in dengue.

scholarly journals Correlation of population mortality of COVID-19 and testing coverage: a comparison among 36 OECD countries and Taiwan

2020 ◽  
Author(s):  
Chen Wei ◽  
Chien-Chang Lee ◽  
Tzu-Chun Hsu ◽  
Wan-Ting Hsu ◽  
Chang-Chuan Chan ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Disease Burden ◽  
Case Fatality ◽  
Correlation Coefficients ◽  
Oecd Countries ◽  
Population Based ◽  
Fatality Rate ◽  
Successful Infection ◽  
Population Mortality ◽  
Testing Coverage

ABSTRACTAlthough testing is widely regarded as critical to fighting the Covid-19 pandemic, what measure and level of testing best reflects successful infection control remains unresolved. Our aim was to compare the sensitivity of two testing metrics-population testing number and testing coverage-to population mortality outcomes and identify a benchmark for testing adequacy with respect to population mortality and capture of potential disease burden. This ecological study aggregated publicly available data through April 12 on testing and outcomes related to COVID-19 across 36 OECD (Organization for Economic Development) countries and Taiwan. All OECD countries and Taiwan were included in this population-based study as a proxy for countries with highly developed economic and healthcare infrastructure. Spearman correlation coefficients were calculated between the aforementioned metrics and following outcome measures: deaths per 1 million people, case fatality rate, and case proportion of critical illness. Fractional polynomials were used to generate scatter plots to model the relationship between the testing metrics and outcomes. Testing coverage, but not population testing number, was highly correlated with population mortality (rs= −0.79, P=5.975e-09 vs rs = − 0.3, P=0.05) and case fatality rate (rs= −0.67, P=9.067e-06 vs rs= −0.21, P=0.20). A testing coverage threshold of 15-45 signified adequate testing: below 15, testing coverage was associated with exponentially increasing population mortality, whereas above 45, increased testing did not yield significant incremental mortality benefit. Testing coverage was better than population testing number in explaining country performance and can be used as an early and sensitive indicator of testing adequacy and disease burden. This may be particularly useful as countries consider re-opening their economies.

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