Literature DB >> 17160194

Early Dengue infection and outcome study (EDEN) - study design and preliminary findings.

Jenny G H Low1, Eng-Eong Ooi, Thomas Tolfvenstam, Yee-Sin Leo, Martin L Hibberd, Lee-Ching Ng, Yee-Ling Lai, Grace S L Yap, Chenny S C Li, Subhash G Vasudevan, Adrian Ong.   

Abstract

INTRODUCTION: Dengue is a major public health problem in Singapore. Age-specific dengue morbidity rates are highest in the young adult population, unlike in many other Southeast Asian countries where dengue is mainly a paediatric disease. Hence, the World Health Organization (WHO) guidelines on dengue diagnosis and management which were developed using the paediatric experiences, may not be suitable for the management of adult dengue infections.
MATERIALS AND METHODS: The Early DENgue (EDEN) infection and outcome study is a collaborative longitudinal study to investigate epidemiological, clinical, viral and host-specific features of early dengue-infected adults, in an effort to identify new early markers for prognostication. Patients presenting with early undifferentiated fever were included in the study. We carried out an interim analysis to look for early indicators of severe disease.
RESULTS: During the period of this interim study analysis, 455 febrile patients were recruited. Of these, 133 were confirmed as acute dengue cases based on dengue-specific polymerase chain reaction (PCR) results. There were significant clinical and epidemiological differences between dengue and febrile non-dengue cases. Nine per cent of the dengue cases experienced persistent tiredness, drowsiness and loss of appetite beyond 3 weeks of illness. Quantitation of viral loads using the crossover (Ct) value of real-time RT-PCR correlated with the duration of symptoms. More than half of both primary and secondary dengue cases were hospitalised. There was no dengue-related mortality in this study.
CONCLUSION: The duration of illness and prolonged symptom duration in 9% of the subjects indicate that the burden of dengue illness is substantially different from other non-dengue febrile illness in our study cohort. Our study also highlights the paucity of early prognostic markers for dengue fever in adults.

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Year:  2006        PMID: 17160194

Source DB:  PubMed          Journal:  Ann Acad Med Singapore        ISSN: 0304-4602            Impact factor:   2.473


  74 in total

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5.  Sequential immunization induces strong and broad immunity against all four dengue virus serotypes.

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8.  Leukocyte immunoglobulin-like receptor B1 is critical for antibody-dependent dengue.

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9.  Genomic epidemiology of a dengue virus epidemic in urban Singapore.

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10.  Emergence potential of sylvatic dengue virus type 4 in the urban transmission cycle is restrained by vaccination and homotypic immunity.

Authors:  Anna P Durbin; Sandra V Mayer; Shannan L Rossi; Irma Y Amaya-Larios; Jose Ramos-Castaneda; Eng Eong Ooi; M Jane Cardosa; Jorge L Munoz-Jordan; Robert B Tesh; William B Messer; Scott C Weaver; Nikos Vasilakis
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