Age and regional differences in clinical presentation and risk of hospitalization for dengue in Brazil, 2000-2014
Age and regional differences in clinical presentation and risk of hospitalization for dengue in Brazil, 2000-2014
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DOI：
10.6061/clinics/2016(08)08
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发表时间：
2016-08-01
期刊：
影响因子：
2.7
通讯作者：
Massad, Eduardo
中科院分区：
文献类型：
--
作者：
Burattini, Marcelo N.;Lopez, Luis F.;Massad, Eduardo
登革热病例从无症状到严重，最终导致住院和死亡。及时和适当的管理对于降低发病率至关重要。自1980年以来，登革热在巴西各地蔓延，影响到越来越多的人。本文根据2000- 2014年向巴西卫生部报告的500多万例病例，描述了登革热临床表现和相关住院风险的年龄和地区差异。我们对545万例登革热病例进行了回顾性分析，将临床表现和住院风险与年龄、性别、既往登革热感染、登革热病毒血清型、正规教育年限、首次就诊延迟和登革热暴发期间和巴西不同地区的发生率。10岁以下儿童更容易患上复杂的登革热（3.12%vs1.92%）和登革病毒2型感染者（7.65% vs 2.42%），首次就诊延迟>2天（3.18% vs 0.82%）和5天（复合OR 3.15; 95% CI 1.33-8.9）。在巴西，严重登革热和相关住院治疗的发生与10岁以下、感染登革热病毒2或3、居住在东北部地区（最贫穷和人口第二多），并推迟首次就诊超过2天。
OBJECTIVES: Dengue cases range from asymptomatic to severe, eventually leading to hospitalization and death. Timely and appropriate management is critical to reduce morbidity. Since 1980, dengue has spread throughout Brazil, affecting an increasing number of individuals. This paper describes age and regional differences in dengue's clinical presentation and associated risk of hospitalization based on more than 5 million cases reported to the Brazilian Ministry of Health from 2000-2014.METHODS: We performed a retrospective analysis of similar to 5,450,000 dengue cases, relating clinical manifestations and the risk of hospitalization to age, gender, previous infection by dengue, dengue virus serotype, years of formal education, delay to first attendance and the occurrence of dengue during outbreaks and in different Brazilian regions.RESULTS: Complicated forms of dengue occurred more frequently among those younger than 10 years (3.12% vs 1.92%) and those with dengue virus 2 infection (7.65% vs 2.42%), with a delay to first attendance >2 days (3.18% vs 0.82%) and with 5 days (composite OR 3.15; 95% CI 1.33-8.9).CONCLUSIONS: In Brazil, the occurrence of severe dengue and related hospitalization is associated with being younger than 10 years old, being infected by dengue virus 2 or 3, living in the Northeast region (the poorest and the second most populated) and delaying first attendance for more than 2 days.