Dengue Infection in Children in Ratchaburi, Thailand: A Cohort Study. II. Clinical Manifestations
Dengue Infection in Children in Ratchaburi, Thailand: A Cohort Study. II. Clinical Manifestations
复制标题
DOI：
10.1371/journal.pntd.0001520
复制
发表时间：
2012-02-01
影响因子：
3.8
通讯作者：
Sabchareon, Arunee
中科院分区：
文献类型：
--
作者：
Sirivichayakul, Chukiat;Limkittikul, Kriengsak;Sabchareon, Arunee
背景：登革热是一种重要的蚊媒传染病。需要更多关于疾病负担和症状性感染中每个临床谱的患病率以及临床表现的数据。本研究旨在描述2006年至2008年期间泰国儿童登革热感染的发病率和临床表现。研究设计：本研究是一项以学校为基础的前瞻性开放队列研究，对3-14岁儿童进行了9,448人年的随访。对研究受试者进行发热性疾病的主动监测。要求患有发热性疾病的受试者前往研究医院进行临床和实验室评价、治疗和登革热感染的血清学检测。结果：登革感染是12.1%的发热性疾病的病因，其中未分化热（UF）占49.8%，登革出血热（DF）占39.3%，登革出血热（DHF）占10.9%。头痛、厌食、恶心/呕吐和肌痛是半数以上患者的常见症状。更严重的登革热谱（即，DHF）体温较高，恶心/呕吐、腹痛、皮疹、腹泻、瘀点、肝肿大和血小板计数较低。DHF病例在患病第3-6天的厌食、恶心/呕吐和腹痛以及第4-6天的腹泻患病率也显著较高。无恶心/呕吐、腹痛、腹泻、瘀点、肝肿大和止血带试验阳性可预测非DHF。结论：在有症状的登革感染中，UF最常见，其次为DF和DHF。一些临床表现可能有助于预测更严重的疾病（即，DHF）。这项研究提供了症状性登革热感染临床谱的额外信息。
Background: Dengue infection is one of the most important mosquito-borne diseases. More data regarding the disease burden and the prevalence of each clinical spectrum among symptomatic infections and the clinical manifestations are needed. This study aims to describe the incidence and clinical manifestations of symptomatic dengue infection in Thai children during 2006 through 2008.Study Design: This study is a school-based prospective open cohort study with a 9,448 person-year follow-up in children aged 3-14 years. Active surveillance for febrile illnesses was done in the studied subjects. Subjects who had febrile illness were asked to visit the study hospital for clinical and laboratory evaluation, treatment, and serological tests for dengue infection. The clinical data from medical records, diary cards, and data collection forms were collected and analyzed.Results: Dengue infections were the causes of 12.1% of febrile illnesses attending the hospital, including undifferentiated fever (UF) (49.8%), dengue fever (DF) (39.3%) and dengue hemorrhagic fever (DHF) (10.9%). Headache, anorexia, nausea/vomiting and myalgia were common symptoms occurring in more than half of the patients. The more severe dengue spectrum (i.e., DHF) had higher temperature, higher prevalence of nausea/vomiting, abdominal pain, rash, diarrhea, petechiae, hepatomegaly and lower platelet count. DHF cases also had significantly higher prevalence of anorexia, nausea/vomiting and abdominal pain during day 3-6 and diarrhea during day 4-6 of illness. The absence of nausea/vomiting, abdominal pain, diarrhea, petechiae, hepatomegaly and positive tourniquet test may predict non-DHF.Conclusion: Among symptomatic dengue infection, UF is most common followed by DF and DHF. Some clinical manifestations may be useful to predict the more severe disease (i.e., DHF). This study presents additional information in the clinical spectra of symptomatic dengue infection.