Clinical Features and Outcomes of Dengue and Scrub Typhus in Hospitalized Adults in the Maldives.

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES
Rajib Kumar Dey, Fernando Mosler, Rifau Adam, Isha Ali, Aishath Sausan, Zaidhoon Jaleel, Rashda Mahir, Izza Abdul Habeeb, Aishath Maeesha, Nihla Ali Rasheed, Aminath Aroosha, Wasin Matsee, Hisham Ahmed Imad
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Abstract

Background: Dengue and scrub typhus are common causes of acute undifferentiated febrile illness in the Maldives.

Methods: This retrospective study compared the clinical characteristics of 184 hospitalized adults diagnosed with dengue (n = 94) or scrub typhus (n = 90) at a national referral hospital in the Maldives. Clinical data were collected from 2013 to 2021 for scrub typhus and from 2018 to 2021 for dengue, identified using ICD-10 codes from both physical and electronic records. National dengue and scrub typhus data from 2015 to 2024 were obtained from the Health Protection Agency of the Maldives.

Results: Scrub typhus patients were generally older, with a median age of 42.5 years compared to 27 years in dengue, were more often locals, and tended to present later in the course of illness, on day 10 compared to day 4. Furthermore, scrub typhus patients experienced more complications, 23.9% compared to 3.2% in dengue, which resulted in longer hospital stays. An eschar was observed in 63.1% of scrub typhus cases, serving as a useful diagnostic clue. In contrast, dengue patients more often presented with chills, myalgia, arthralgia, bleeding, and thrombocytopenia. There were no fatalities in this cohort.

Conclusions: In acute undifferentiated febrile illness in the Maldives, certain clinical indicators, including eschar for scrub typhus and bleeding with severe thrombocytopenia can aid in bedside diagnosis. Identifying these features can help clinicians in resource-limited settings provide timely and appropriate care.

马尔代夫住院成人登革热和恙虫病的临床特征和结局
背景:登革热和恙虫病是马尔代夫急性未分化发热性疾病的常见病因。方法:本回顾性研究比较了184名在马尔代夫一家国家转诊医院诊断为登革热(n = 94)或恙虫病(n = 90)的住院成人的临床特征。收集了2013年至2021年恙虫病的临床数据和2018年至2021年登革热的临床数据,使用来自物理和电子记录的ICD-10代码进行识别。2015年至2024年的全国登革热和丛林斑疹伤寒数据来自马尔代夫卫生保护局。结果:恙虫病患者一般年龄较大,中位年龄为42.5岁,而登革热患者的中位年龄为27岁,多为当地人,且往往在病程较晚出现,第10天出现,而第4天出现。此外,恙虫病患者出现更多并发症(23.9%),而登革热患者为3.2%,这导致住院时间更长。63.1%的恙虫病病例有瘢痕,可作为诊断恙虫病的有效线索。相比之下,登革热患者更常表现为寒战、肌痛、关节痛、出血和血小板减少。该队列中没有死亡病例。结论:在马尔代夫的急性未分化发热性疾病中,某些临床指标,包括恙虫病的焦痂和严重血小板减少的出血,可以帮助床边诊断。识别这些特征可以帮助资源有限的临床医生提供及时和适当的护理。
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来源期刊
Travel Medicine and Infectious Disease
Travel Medicine and Infectious Disease PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-INFECTIOUS DISEASES
CiteScore
19.40
自引率
1.70%
发文量
211
审稿时长
49 days
期刊介绍: Travel Medicine and Infectious Disease Publication Scope: Publishes original papers, reviews, and consensus papers Primary theme: infectious disease in the context of travel medicine Focus Areas: Epidemiology and surveillance of travel-related illness Prevention and treatment of travel-associated infections Malaria prevention and treatment Travellers' diarrhoea Infections associated with mass gatherings Migration-related infections Vaccines and vaccine-preventable disease Global policy/regulations for disease prevention and control Practical clinical issues for travel and tropical medicine practitioners Coverage: Addresses areas of controversy and debate in travel medicine Aims to inform guidelines and policy pertinent to travel medicine and the prevention of infectious disease Publication Features: Offers a fast peer-review process Provides early online publication of accepted manuscripts Aims to publish cutting-edge papers
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