Clinical and Laboratory Features That Differentiate Dengue from Other Febrile Illnesses in an Endemic-Area Puerto Rico, 2007-2008
Clinical and Laboratory Features That Differentiate Dengue from Other Febrile Illnesses in an Endemic-Area Puerto Rico, 2007-2008
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DOI：
10.4269/ajtmh.2010.09-0552
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发表时间：
2010-05-01
影响因子：
3.3
通讯作者：
Tomashek, Kay M.
中科院分区：
文献类型：
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作者：
Gregory, Christopher J.;Santiago, Luis Manuel;Tomashek, Kay M.
在出现严重症状之前，在感染过程中早期诊断登革热感染可能具有挑战性，但早期诊断可以改善患者的预后并促进及时的公共卫生干预。我们开发了基于年龄的预测模型，该模型是根据波多黎各增强型登革热监测系统的 2 年数据生成的。这些模型经过内部验证，能够以中等准确度区分登革热感染和其他急性发热性疾病。该模型的准确性高于世界卫生组织当前的登革热病例定义或对该定义的拟议修改，同时需要收集的数据更少。在幼儿中，血小板减少和不咳嗽与登革热感染有关；对于成人来说，皮疹、白细胞减少和无喉咙痛与登革热感染有关；在所有年龄组中，眼眶后疼痛都与登革热感染有关。
Dengue infection can be challenging to diagnose early in the course of infection before severe manifestations develop, but early diagnosis can improve patient outcomes and promote timely public health interventions. We developed age-based predictive models generated from 2 years of data from an enhanced dengue surveillance system in Puerto Rico. These models were internally validated and were able to differentiate dengue infection from other acute febrile illnesses with moderate accuracy. The accuracy of the models was greater than either the current World Health Organization case definition for dengue fever or a proposed modification to this definition, while requiring the collection of fewer data. In young children, thrombocytopenia and the absence of cough were associated with dengue infection; for adults, rash, leucopenia, and the absence of sore throat were associated with dengue infection; in all age groups, retro-orbital pain was associated with dengue infection.