巴基斯坦登革热和登革热样疾病的临床特征和血清型关联。

IF 3.4 2区 医学 Q1 PARASITOLOGY
PLoS Neglected Tropical Diseases Pub Date : 2025-05-12 eCollection Date: 2025-05-01 DOI:10.1371/journal.pntd.0012978
Najeeha Talat Iqbal, Kumail Ahmed, Aqsa Khalid, Kehkashan Imtiaz, Qamreen Mumtaz Ali, Tania Munir, Syed Faisal Mahmood, Unab Khan, Badar Afzal, Farah Naz Qamar, Jesse J Waggoner, Hannah Fenelon, Helene McOwen, Erum Khan, Peter Rabinowitz, Wesley C Van Voorhis
{"title":"巴基斯坦登革热和登革热样疾病的临床特征和血清型关联。","authors":"Najeeha Talat Iqbal, Kumail Ahmed, Aqsa Khalid, Kehkashan Imtiaz, Qamreen Mumtaz Ali, Tania Munir, Syed Faisal Mahmood, Unab Khan, Badar Afzal, Farah Naz Qamar, Jesse J Waggoner, Hannah Fenelon, Helene McOwen, Erum Khan, Peter Rabinowitz, Wesley C Van Voorhis","doi":"10.1371/journal.pntd.0012978","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pakistan has been an endemic country for dengue virus since 1994, with a significant increase in cases reported in 2022 largely due to heavy rainfall and flooding. All four serotypes of the dengue virus (DENV) are present in Pakistan, with DENV 1 and DENV 2 being the most prevalent. The current study aims to explore the clinical presentations and features of dengue fever in a tertiary care hospital.</p><p><strong>Methodology: </strong>We enrolled and studied 349 cases of suspected and confirmed dengue presenting for care at the Aga Khan University Hospital in Karachi between June 2021 and November 2023. Collected data on cases included clinical symptoms and laboratory results including qRT-PCR and serotype characterization.</p><p><strong>Findings: </strong>The majority of subjects enrolled (75%) had mild disease without warning signs, while 11% exhibited warning signs, 1.4% had severe dengue, and 12.6% had no dengue diagnosis. Patients with severe dengue (SD) had significantly higher levels of liver enzymes (AST and ALT) compared to those with non-severe dengue (NSD) (AST; p = 0.024 and ALT; p = 0.047). Additionally, a higher grade of thrombocytopenia was significantly associated with hospitalization (p = 0.0008), and prolonged illness (p = 0.03). Both Platelet (p < 0.0001) and WBC counts (p = 0.001) were significantly lower in dengue PCR-positive patients in comparison to Dengue PCR-negative. Among those tested for dengue serotypes, DENV 1 (34%) and DENV 2 (45%) emerged as the predominant serotypes, with mixed infections accounting for 17%. The sensitivity of q-RT PCR was found to be 87.25% and the specificity of 68.35%. qRT-PCR detected 43.5% of cases with viral fever initially screened negative by IgM or NS1.</p><p><strong>Conclusion: </strong>The epidemiology of dengue fever during a widespread outbreak in 2022 showed a predominance of DENV 1 and DENV 2 serotypes with milder phenotype of viral illness. Screening with rapid tests requires further confirmation by molecular assay in cases with dengue and dengue-like illness. The sensitivity of q-RT PCR using gold standard.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0012978"},"PeriodicalIF":3.4000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068610/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical characteristics and serotype association of dengue and dengue like illness in Pakistan.\",\"authors\":\"Najeeha Talat Iqbal, Kumail Ahmed, Aqsa Khalid, Kehkashan Imtiaz, Qamreen Mumtaz Ali, Tania Munir, Syed Faisal Mahmood, Unab Khan, Badar Afzal, Farah Naz Qamar, Jesse J Waggoner, Hannah Fenelon, Helene McOwen, Erum Khan, Peter Rabinowitz, Wesley C Van Voorhis\",\"doi\":\"10.1371/journal.pntd.0012978\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pakistan has been an endemic country for dengue virus since 1994, with a significant increase in cases reported in 2022 largely due to heavy rainfall and flooding. All four serotypes of the dengue virus (DENV) are present in Pakistan, with DENV 1 and DENV 2 being the most prevalent. The current study aims to explore the clinical presentations and features of dengue fever in a tertiary care hospital.</p><p><strong>Methodology: </strong>We enrolled and studied 349 cases of suspected and confirmed dengue presenting for care at the Aga Khan University Hospital in Karachi between June 2021 and November 2023. Collected data on cases included clinical symptoms and laboratory results including qRT-PCR and serotype characterization.</p><p><strong>Findings: </strong>The majority of subjects enrolled (75%) had mild disease without warning signs, while 11% exhibited warning signs, 1.4% had severe dengue, and 12.6% had no dengue diagnosis. Patients with severe dengue (SD) had significantly higher levels of liver enzymes (AST and ALT) compared to those with non-severe dengue (NSD) (AST; p = 0.024 and ALT; p = 0.047). Additionally, a higher grade of thrombocytopenia was significantly associated with hospitalization (p = 0.0008), and prolonged illness (p = 0.03). Both Platelet (p < 0.0001) and WBC counts (p = 0.001) were significantly lower in dengue PCR-positive patients in comparison to Dengue PCR-negative. Among those tested for dengue serotypes, DENV 1 (34%) and DENV 2 (45%) emerged as the predominant serotypes, with mixed infections accounting for 17%. The sensitivity of q-RT PCR was found to be 87.25% and the specificity of 68.35%. qRT-PCR detected 43.5% of cases with viral fever initially screened negative by IgM or NS1.</p><p><strong>Conclusion: </strong>The epidemiology of dengue fever during a widespread outbreak in 2022 showed a predominance of DENV 1 and DENV 2 serotypes with milder phenotype of viral illness. Screening with rapid tests requires further confirmation by molecular assay in cases with dengue and dengue-like illness. The sensitivity of q-RT PCR using gold standard.</p>\",\"PeriodicalId\":49000,\"journal\":{\"name\":\"PLoS Neglected Tropical Diseases\",\"volume\":\"19 5\",\"pages\":\"e0012978\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-05-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068610/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"PLoS Neglected Tropical Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1371/journal.pntd.0012978\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"PARASITOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"PLoS Neglected Tropical Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1371/journal.pntd.0012978","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"PARASITOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:自1994年以来,巴基斯坦一直是登革热病毒的流行国家,2022年报告的病例显著增加,主要原因是强降雨和洪水。巴基斯坦存在登革热病毒的所有四种血清型,其中DENV 1和DENV 2最为流行。本研究旨在探讨登革热在三级医院的临床表现和特点。方法:我们招募并研究了2021年6月至2023年11月期间在卡拉奇阿加汗大学医院就诊的349例疑似和确诊登革热病例。收集的病例数据包括临床症状和实验室结果,包括qRT-PCR和血清型表征。结果:大多数入组受试者(75%)患有无警告信号的轻度疾病,而11%表现出警告信号,1.4%患有严重登革热,12.6%没有登革热诊断。严重登革热(SD)患者的肝酶(AST和ALT)水平明显高于非严重登革热(NSD)患者(AST;p = 0.024, ALT;p = 0.047)。此外,较高程度的血小板减少与住院治疗(p = 0.0008)和病程延长(p = 0.03)显著相关。结论:2022年登革热大范围暴发期间登革热流行病学表现为DENV 1和DENV 2血清型为主,病毒性疾病表型较轻。在登革热和登革热样疾病病例中,需要通过分子分析进一步确认快速检测筛查。用金标准品测定q-RT PCR的灵敏度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical characteristics and serotype association of dengue and dengue like illness in Pakistan.

Background: Pakistan has been an endemic country for dengue virus since 1994, with a significant increase in cases reported in 2022 largely due to heavy rainfall and flooding. All four serotypes of the dengue virus (DENV) are present in Pakistan, with DENV 1 and DENV 2 being the most prevalent. The current study aims to explore the clinical presentations and features of dengue fever in a tertiary care hospital.

Methodology: We enrolled and studied 349 cases of suspected and confirmed dengue presenting for care at the Aga Khan University Hospital in Karachi between June 2021 and November 2023. Collected data on cases included clinical symptoms and laboratory results including qRT-PCR and serotype characterization.

Findings: The majority of subjects enrolled (75%) had mild disease without warning signs, while 11% exhibited warning signs, 1.4% had severe dengue, and 12.6% had no dengue diagnosis. Patients with severe dengue (SD) had significantly higher levels of liver enzymes (AST and ALT) compared to those with non-severe dengue (NSD) (AST; p = 0.024 and ALT; p = 0.047). Additionally, a higher grade of thrombocytopenia was significantly associated with hospitalization (p = 0.0008), and prolonged illness (p = 0.03). Both Platelet (p < 0.0001) and WBC counts (p = 0.001) were significantly lower in dengue PCR-positive patients in comparison to Dengue PCR-negative. Among those tested for dengue serotypes, DENV 1 (34%) and DENV 2 (45%) emerged as the predominant serotypes, with mixed infections accounting for 17%. The sensitivity of q-RT PCR was found to be 87.25% and the specificity of 68.35%. qRT-PCR detected 43.5% of cases with viral fever initially screened negative by IgM or NS1.

Conclusion: The epidemiology of dengue fever during a widespread outbreak in 2022 showed a predominance of DENV 1 and DENV 2 serotypes with milder phenotype of viral illness. Screening with rapid tests requires further confirmation by molecular assay in cases with dengue and dengue-like illness. The sensitivity of q-RT PCR using gold standard.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases PARASITOLOGY-TROPICAL MEDICINE
自引率
10.50%
发文量
723
期刊介绍: PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy. The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability. All aspects of these diseases are considered, including: Pathogenesis Clinical features Pharmacology and treatment Diagnosis Epidemiology Vector biology Vaccinology and prevention Demographic, ecological and social determinants Public health and policy aspects (including cost-effectiveness analyses).
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信