Víctor Manuel Alvarado-Castro1, Elizabeth Ramírez-Hernández2, Sergio Paredes-Solís3, José Legorreta Soberanis1, Vianey Guadalupe Saldaña-Herrera1, Liliana Sarahí Salas-Franco1, Jorge Alberto Del Castillo-Medina4, Neil Andersson5. 1. Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, México. 2. Servicio de Urgencias Pediátricas, Hospital General Dr. Raymundo Abarca Alarcón, Servicios Estatales de Salud, Chilpancingo, Guerrero, México. 3. Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, México. Electronic address: sparedes@ciet.org. 4. Jefatura de Posgrado del Hospital Juárez de México, Secretaría de Salud, Ciudad de México, México. 5. Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, México; Departamento de Medicina Familiar, Universidad de McGill, Montreal, Canadá.
Abstract
BACKGROUND: Dengue continues to increase globally. Currently, the highest incidence of first infection occurs in paediatric population, where severe dengue fever is potentially lethal. This study characterizes the clinical profile of paediatric patients with dengue fever in the South of Mexico. METHODS: We undertook a series case study of 133 paediatric inpatients who presented clinical diagnosis of non-severe dengue and severe dengue fever. We described univariate analysis as means or percentages, using 0.05 as significance level. We estimated the prediction of severe dengue considering clinical signs and symptoms only using GLMM (Generalised Linear Mixed Models). RESULTS: 58% (77/133) patients had severe dengue. There were significant differences among the dengue groups, in the following signs and symptoms: Fever, abdominal pain, epistaxis and platelet count. Children older than four years old had a higher proportion of severe dengue (p<0.05). GLMM identified a group of four clinical signs and symptoms (fever ≥39°C, myalgia, arthralgia and abdominal pain) as predictors of severe dengue. CONCLUSIONS: The results of this exploratory study suggest changes in the frequency of clinical signs and symptoms among paediatric inpatients. Paediatric patients with a presumptive diagnosis of dengue, showing fever of ≥39° C, myalgia, arthralgia and abdominal pain should be considered as potential cases of severe dengue.
BACKGROUND: Dengue continues to increase globally. Currently, the highest incidence of first infection occurs in paediatric population, where severe dengue fever is potentially lethal. This study characterizes the clinical profile of paediatric patients with dengue fever in the South of Mexico. METHODS: We undertook a series case study of 133 paediatric inpatients who presented clinical diagnosis of non-severe dengue and severe dengue fever. We described univariate analysis as means or percentages, using 0.05 as significance level. We estimated the prediction of severe dengue considering clinical signs and symptoms only using GLMM (Generalised Linear Mixed Models). RESULTS: 58% (77/133) patients had severe dengue. There were significant differences among the dengue groups, in the following signs and symptoms: Fever, abdominal pain, epistaxis and platelet count. Children older than four years old had a higher proportion of severe dengue (p<0.05). GLMM identified a group of four clinical signs and symptoms (fever ≥39°C, myalgia, arthralgia and abdominal pain) as predictors of severe dengue. CONCLUSIONS: The results of this exploratory study suggest changes in the frequency of clinical signs and symptoms among paediatric inpatients. Paediatric patients with a presumptive diagnosis of dengue, showing fever of ≥39° C, myalgia, arthralgia and abdominal pain should be considered as potential cases of severe dengue.
Authors: Oliver Mendoza-Cano; Pedro Rincón-Avalos; Verity Watson; Abdou Khouakhi; Jesús López-de la Cruz; Angelica Patricia Ruiz-Montero; Cynthia Monique Nava-Garibaldi; Mario Lopez-Rojas; Efrén Murillo-Zamora Journal: Int J Environ Res Public Health Date: 2021-04-16 Impact factor: 3.390
Authors: Catalina Tovar Acero; Javier Ramírez-Montoya; María Camila Velasco; Paula A Avilés-Vergara; Dina Ricardo-Caldera; Miquel Duran-Frigola; Gustavo Quintero; Myriam Elena Cantero; Juan Rivera-Correa; Ana Rodriguez; María Fernanda Yasnot-Acosta Journal: PLoS Negl Trop Dis Date: 2022-09-30