Clinical and laboratory profiles of dengue infection in the hospitals in North Jakarta, Indonesia

Abstract

Objectives

Indonesia is one of the dengue endemic countries. The criteria for diagnosing dengue infection are based on World Health Organization (WHO) guidelines. Chikungunya and Zika virus infections have also been reported sporadically in Indonesia. This study aimed to evaluate the clinical features of patients with dengue in a hospital setting and investigate the potential for other arboviral infections in patients with fever.

Methods

This case-control study was conducted at two hospitals in North Jakarta between August 2023 and May 2024. Patients admitted with 3 or more days of fever without any proven cause of bacterial infection or autoimmune disease were recruited. The cases were those who tested positive for Dengue, Chikunguya, Zika, and West Nile viruses by multiplex reverse transcription-quantitative polymerase chain reaction, whereas the controls were those who tested negative. Questionnaires were used to collect the signs and symptoms. Blood tests were conducted using autoanalyzers. Chi-square and Student's t-tests were used for statistical analyses.

Results

Of the 135 respondents, 70 tested positive for dengue and two tested positive for chikungunya using multiplex reverse transcription-quantitative polymerase chain reaction. Having fever with two additional two signs and symptoms, as per the WHO guidelines, is predictive of dengue infection. Leukopenia and thrombocytopenia were significantly more common in dengue cases. An increase in hematocrit was inconclusive. Serum aspartate transaminase levels are also increased in patients with dengue. The dengue virus nonstructural protein-1 antigen test is the preferred point-of-care test for the diagnosis of dengue virus infections.

Conclusions

Our investigation confirmed that the WHO guidelines for diagnosing dengue are still applicable. The Chikungunya virus also circulates in Jakarta, and physicians should be aware of this.