Dengue and other common causes of acute febrile illness in Asia: An active surveillance study in children
Autor(es): Capeding Maria Rosario, Chua Mary Noreen, Hadinegoro Sri Rezeki, Hussain Ismail I H M, Nallusamy Revathy, Pitisuttithum Punnee, Rusmil Kusnandi, Thisyakorn Usa, Thomas Stephen J, Huu Tran Ngoc, Wirawan Dewa Nyoman, Yoon In-Kyu, Bouckenooghe Alain, Hutagalung Yanee, Laot Thelma, Wartel Tram Anh
Resumo: Common causes of acute febrile illness in tropical countries have similar symptoms, which often mimic those of dengue. Accurate clinical diagnosis can be difficult without laboratory confirmation - disease burden is generally under-reported. Accurate, population-based, laboratory-confirmed incidence data on dengue - other causes of acute fever in dengue-endemic Asian countries are needed. This prospective, multicenter, active fever surveillance, cohort study was conducted in selected centers in Indonesia, Malaysia, Philippines, Thail- - Vietnam to determine the incidence density of acute febrile episodes (? 38 °C for ? 2 days) in 1,500 healthy children aged 2-14 years, followed for a mean 237 days. Causes of fever were assessed by testing acute - convalescent sera from febrile participants for dengue, chikungunya, hepatitis A, influenza A, leptospirosis, rickettsia, - Salmonella Typhi. Overall, 289 participants had acute fever, an incidence density of 33.6 per 100 person-years (95% CI: 30.0; 37.8); 57% were IgM-positive for at least one of these diseases. The most common causes of fever by IgM ELISA were chikungunya (in 35.0% of in febrile participants) - S. Typhi (in 29.4%). The overall incidence density of dengue per 100 person-years was 3.4 by nonstructural protein 1 (NS1) antigen positivity (95% CI: 2.4; 4.8) - 7.3 (95% CI: 5.7; 9.2) by serology. Dengue was diagnosed in 11.4% (95% CI: 8.0; 15.7) - 23.9% (95% CI: 19.1; 29.2) of febrile participants by NS1 positivity - serology, respectively. Of the febrile episodes not clinically diagnosed as dengue, 5.3% were dengue-positive by NS1 antigen testing - 16.0% were dengue-positive by serology. During the study period, the most common identified causes of pediatric acute febrile illness among the seven tested for were chikungunya, S. Typhi - dengue. Not all dengue cases were clinically diagnosed; laboratory confirmation is essential to refine disease burden estimates.
Imprenta: PLoS Neglected Tropical Diseases, v. 7, n. 7, p. e2331, 2013
Identificador do objeto digital: 10.1371/journal.pntd.0002331
Descritores: Chikungunya virus - Pathogenesis ; Chikungunya virus - Serology ; Chikungunya virus - Viral infections ; Chikungunya virus - Serology ; Chikungunya Virus - Virus ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Dengue ; Chikungunya virus - Epidemiology ; Chikungunya virus - Public health
Data de publicação: 2013
