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Clinico-laboratory spectrum of dengue viral infection and risk factors associated with dengue hemorrhagic fever: a retrospective study.

Mallhi TH, Khan AH, Adnan AS, Sarriff A, Khan YH, Jummaat F - BMC Infect. Dis. (2015)

Bottom Line: Skin rash, dehydration, shortness of breath, pleural effusion and thick gall bladder were more significantly (P < 0.05) associated with DHF than DF.Current study demonstrated that DF and DHF present significantly different clinico-laboratory profile.Older age, secondary infection, diabetes mellitus, lethargy, thick gallbladder and delayed hospitalization significantly predict DHF.

View Article: PubMed Central - PubMed

Affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11800, Malaysia. tauqeer.hussain.mallhi@hotmail.com.

ABSTRACT

Background: The incidence of dengue is rising steadily in Malaysia since the first major outbreak in 1973. Despite aggressive measures taken by the relevant authorities, Malaysia is still facing worsening dengue crisis over the past few years. There is an urgent need to evaluate dengue cases for better understanding of clinic-laboratory spectrum in order to combat this disease.

Methods: A retrospective analysis of dengue patients admitted to a tertiary care teaching hospital during the period of six years (2008 - 2013) was performed. Patient's demographics, clinical and laboratory findings were recorded via structured data collection form. Patients were categorized into dengue fever (DF) and dengue hemorrhagic fever (DHF). Appropriate statistical methods were used to compare these two groups in order to determine difference in clinico-laboratory characteristics and to identify independent risk factors of DHF.

Results: A total 667 dengue patients (30.69 ± 16.13 years; Male: 56.7 %) were reviewed. Typical manifestations of dengue like fever, myalgia, arthralgia, headache, vomiting, abdominal pain and skin rash were observed in more than 40 % patients. DHF was observed in 79 (11.8 %) cases. Skin rash, dehydration, shortness of breath, pleural effusion and thick gall bladder were more significantly (P < 0.05) associated with DHF than DF. Multivariate regression analysis demonstrated presence of age > 40 years (OR: 4.1, P < 0.001), secondary infection (OR: 2.7, P = 0.042), diabetes mellitus (OR: 2.8, P = 0.041), lethargy (OR: 3.1, P = 0.005), thick gallbladder (OR: 1.7, P = 0.029) and delayed hospitalization (OR: 2.3, P = 0.037) as independent predictors of DHF. Overall mortality was 1.2 % in our study.

Conclusions: Current study demonstrated that DF and DHF present significantly different clinico-laboratory profile. Older age, secondary infection, diabetes mellitus, lethargy, thick gallbladder and delayed hospitalization significantly predict DHF. Prior knowledge of expected clinical profile and predictors of DHF/DSS development would provide information to identify individuals at higher risk and on the other hand, give sufficient time to clinicians for reducing dengue related morbidity and mortality.

No MeSH data available.


Related in: MedlinePlus

Map of top five dengue hotspots in Malaysia in 2014 (1-Kelantan, 2-Perak, 3-Selangor, 4-Kuala Lumpur, 5-Johor) and Trend of Increasing cases of dengue in Malaysia from 1998–2014
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Fig1: Map of top five dengue hotspots in Malaysia in 2014 (1-Kelantan, 2-Perak, 3-Selangor, 4-Kuala Lumpur, 5-Johor) and Trend of Increasing cases of dengue in Malaysia from 1998–2014

Mentions: Dengue viral infection (DVI) is a dangerous and debilitating disease. Alarmingly, 40 % of the world’s population is living in the areas having a risk of being infected. WHO estimates 50–100 million dengue cases with approximately 22,000 deaths each year [1]. DVI has been an important public health concern in Malaysia ever since its first reported case in 1902 [2]. According to ministry of health Malaysia, over the past few years there is an increasing incidence of DVI with maximum number of cases observed in 2014 with a mortality rate of 0.2 % (Fig. 1). Sudden drop of dengue cases in 2011 (Fig. 1) might be attributed to the methodology difference in case reporting during this year [3].Fig. 1


Clinico-laboratory spectrum of dengue viral infection and risk factors associated with dengue hemorrhagic fever: a retrospective study.

Mallhi TH, Khan AH, Adnan AS, Sarriff A, Khan YH, Jummaat F - BMC Infect. Dis. (2015)

Map of top five dengue hotspots in Malaysia in 2014 (1-Kelantan, 2-Perak, 3-Selangor, 4-Kuala Lumpur, 5-Johor) and Trend of Increasing cases of dengue in Malaysia from 1998–2014
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4590689&req=5

Fig1: Map of top five dengue hotspots in Malaysia in 2014 (1-Kelantan, 2-Perak, 3-Selangor, 4-Kuala Lumpur, 5-Johor) and Trend of Increasing cases of dengue in Malaysia from 1998–2014
Mentions: Dengue viral infection (DVI) is a dangerous and debilitating disease. Alarmingly, 40 % of the world’s population is living in the areas having a risk of being infected. WHO estimates 50–100 million dengue cases with approximately 22,000 deaths each year [1]. DVI has been an important public health concern in Malaysia ever since its first reported case in 1902 [2]. According to ministry of health Malaysia, over the past few years there is an increasing incidence of DVI with maximum number of cases observed in 2014 with a mortality rate of 0.2 % (Fig. 1). Sudden drop of dengue cases in 2011 (Fig. 1) might be attributed to the methodology difference in case reporting during this year [3].Fig. 1

Bottom Line: Skin rash, dehydration, shortness of breath, pleural effusion and thick gall bladder were more significantly (P < 0.05) associated with DHF than DF.Current study demonstrated that DF and DHF present significantly different clinico-laboratory profile.Older age, secondary infection, diabetes mellitus, lethargy, thick gallbladder and delayed hospitalization significantly predict DHF.

View Article: PubMed Central - PubMed

Affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11800, Malaysia. tauqeer.hussain.mallhi@hotmail.com.

ABSTRACT

Background: The incidence of dengue is rising steadily in Malaysia since the first major outbreak in 1973. Despite aggressive measures taken by the relevant authorities, Malaysia is still facing worsening dengue crisis over the past few years. There is an urgent need to evaluate dengue cases for better understanding of clinic-laboratory spectrum in order to combat this disease.

Methods: A retrospective analysis of dengue patients admitted to a tertiary care teaching hospital during the period of six years (2008 - 2013) was performed. Patient's demographics, clinical and laboratory findings were recorded via structured data collection form. Patients were categorized into dengue fever (DF) and dengue hemorrhagic fever (DHF). Appropriate statistical methods were used to compare these two groups in order to determine difference in clinico-laboratory characteristics and to identify independent risk factors of DHF.

Results: A total 667 dengue patients (30.69 ± 16.13 years; Male: 56.7 %) were reviewed. Typical manifestations of dengue like fever, myalgia, arthralgia, headache, vomiting, abdominal pain and skin rash were observed in more than 40 % patients. DHF was observed in 79 (11.8 %) cases. Skin rash, dehydration, shortness of breath, pleural effusion and thick gall bladder were more significantly (P < 0.05) associated with DHF than DF. Multivariate regression analysis demonstrated presence of age > 40 years (OR: 4.1, P < 0.001), secondary infection (OR: 2.7, P = 0.042), diabetes mellitus (OR: 2.8, P = 0.041), lethargy (OR: 3.1, P = 0.005), thick gallbladder (OR: 1.7, P = 0.029) and delayed hospitalization (OR: 2.3, P = 0.037) as independent predictors of DHF. Overall mortality was 1.2 % in our study.

Conclusions: Current study demonstrated that DF and DHF present significantly different clinico-laboratory profile. Older age, secondary infection, diabetes mellitus, lethargy, thick gallbladder and delayed hospitalization significantly predict DHF. Prior knowledge of expected clinical profile and predictors of DHF/DSS development would provide information to identify individuals at higher risk and on the other hand, give sufficient time to clinicians for reducing dengue related morbidity and mortality.

No MeSH data available.


Related in: MedlinePlus