Dengue-specific serotype related to clinical severity during the 2012/2013 epidemic in centre of Brazil
Abstract Multilingual abstracts Please see Additional file 1 for translations of the abstract into the five official working languages of the United Nations. Background Currently, in Brazil, there is a co-circulation of the four dengue (DENV-1 to DENV-4) serotypes. This study aimed to assess whether...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | Infectious Diseases of Poverty |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40249-017-0328-9 |
| _version_ | 1819120073626877952 |
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| author | Benigno A. M. Rocha Adriana O. Guilarde Angela F. L. T. Argolo Marianna Peres Tassara Lucimeire A. da Silveira Isabela C. Junqueira Marília D. Turchi Valéria C. R. Féres Celina M. T. Martelli |
| author_facet | Benigno A. M. Rocha Adriana O. Guilarde Angela F. L. T. Argolo Marianna Peres Tassara Lucimeire A. da Silveira Isabela C. Junqueira Marília D. Turchi Valéria C. R. Féres Celina M. T. Martelli |
| author_sort | Benigno A. M. Rocha |
| collection | DOAJ |
| description | Abstract Multilingual abstracts Please see Additional file 1 for translations of the abstract into the five official working languages of the United Nations. Background Currently, in Brazil, there is a co-circulation of the four dengue (DENV-1 to DENV-4) serotypes. This study aimed to assess whether different serotypes and antibody response patterns were associated with the severity of the disease during a dengue outbreak, which occurred in 2012/2013 in centre of Brazil. Methods We conducted a prospective study with 452 patients with laboratory confirmed dengue in central Brazil, from January 2012 to July 2013. The clinical outcome was the severity of cases: dengue, dengue with warning signs, and severe dengue. The patients were evaluated at three different moments. Blood sampling for laboratory testing and confirmatory tests for dengue infection were performed. We performed a multinomial analysis considering the three categories of the dependent variable, as outlined above. The odds ratios (ORs) were calculated. A multinomial logistic regression model was applied for variables with a P-value <0.20. Statistical analysis was performed with STATA 12.0 software. Results Four hundred fifty-two patients (452/632, 71.5%) were diagnosed with dengue. The dengue virus (DENV) serotypes were identified in 243 cases. DENV-4 was detected in 135 patients (55.6%), DENV-1 in 91 (37.4%), DENV-3 in 13 (5.3%), and DENV-2 in 4 (1.6%). Patients with the DENV-1 serotype were more prone to present with several clinical and laboratory features as compared with DENV-4 patients, including spontaneous bleeding (P = 0.03), intense abdominal pain (P = 0.004), neurological symptoms (P = 0.09), and thrombocytopenia (P = 0.01). Secondary infection was more predominant among DENV-4 cases (80.0%) compared with DENV-1 cases (62.3%) (P = 0.03). The univariate analysis showed that females (OR = 2.12; 95% CI: 1.44–3.13; P < 0.01) had a higher risk of having dengue with warning signs. The multinomial analysis showed that severe dengue cases with secondary infection had an adjusted OR of 2.80 (95% CI: 0.78–10.00; P = 0.113) as compared with dengue fever with primary infection when adjusted for age and sex. Conclusion The current data show that 5.8% of patients recruited for treatment in healthcare centres and hospitals during the study period had severe dengue. DENV-4 was the predominant serotype, followed by DENV-1, in a large outbreak of dengue in central Brazil. Our findings contribute to the understanding of clinical differences and immune status related to the serotypes DENV-1 and DENV-4 in central of Brazil. |
| first_indexed | 2024-12-22T06:14:52Z |
| format | Article |
| id | doaj.art-4ff632b579cc46c1a314183fe92c8a23 |
| institution | Directory Open Access Journal |
| issn | 2049-9957 |
| language | English |
| last_indexed | 2024-12-22T06:14:52Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Diseases of Poverty |
| spelling | doaj.art-4ff632b579cc46c1a314183fe92c8a232022-12-21T18:36:07ZengBMCInfectious Diseases of Poverty2049-99572017-08-016111110.1186/s40249-017-0328-9Dengue-specific serotype related to clinical severity during the 2012/2013 epidemic in centre of BrazilBenigno A. M. Rocha0Adriana O. Guilarde1Angela F. L. T. Argolo2Marianna Peres Tassara3Lucimeire A. da Silveira4Isabela C. Junqueira5Marília D. Turchi6Valéria C. R. Féres7Celina M. T. Martelli8Institute of Tropical Pathology and Public Health, Federal University of GoiásInstitute of Tropical Pathology and Public Health, Federal University of GoiásInstitute of Tropical Pathology and Public Health, Federal University of GoiásInstitute of Tropical Pathology and Public Health, Federal University of GoiásInstitute of Tropical Pathology and Public Health, Federal University of GoiásInstitute of Tropical Pathology and Public Health, Federal University of GoiásInstitute of Tropical Pathology and Public Health, Federal University of GoiásFaculty of Pharmacy, Federal University of GoiásInstitute of Tropical Pathology and Public Health, Federal University of GoiásAbstract Multilingual abstracts Please see Additional file 1 for translations of the abstract into the five official working languages of the United Nations. Background Currently, in Brazil, there is a co-circulation of the four dengue (DENV-1 to DENV-4) serotypes. This study aimed to assess whether different serotypes and antibody response patterns were associated with the severity of the disease during a dengue outbreak, which occurred in 2012/2013 in centre of Brazil. Methods We conducted a prospective study with 452 patients with laboratory confirmed dengue in central Brazil, from January 2012 to July 2013. The clinical outcome was the severity of cases: dengue, dengue with warning signs, and severe dengue. The patients were evaluated at three different moments. Blood sampling for laboratory testing and confirmatory tests for dengue infection were performed. We performed a multinomial analysis considering the three categories of the dependent variable, as outlined above. The odds ratios (ORs) were calculated. A multinomial logistic regression model was applied for variables with a P-value <0.20. Statistical analysis was performed with STATA 12.0 software. Results Four hundred fifty-two patients (452/632, 71.5%) were diagnosed with dengue. The dengue virus (DENV) serotypes were identified in 243 cases. DENV-4 was detected in 135 patients (55.6%), DENV-1 in 91 (37.4%), DENV-3 in 13 (5.3%), and DENV-2 in 4 (1.6%). Patients with the DENV-1 serotype were more prone to present with several clinical and laboratory features as compared with DENV-4 patients, including spontaneous bleeding (P = 0.03), intense abdominal pain (P = 0.004), neurological symptoms (P = 0.09), and thrombocytopenia (P = 0.01). Secondary infection was more predominant among DENV-4 cases (80.0%) compared with DENV-1 cases (62.3%) (P = 0.03). The univariate analysis showed that females (OR = 2.12; 95% CI: 1.44–3.13; P < 0.01) had a higher risk of having dengue with warning signs. The multinomial analysis showed that severe dengue cases with secondary infection had an adjusted OR of 2.80 (95% CI: 0.78–10.00; P = 0.113) as compared with dengue fever with primary infection when adjusted for age and sex. Conclusion The current data show that 5.8% of patients recruited for treatment in healthcare centres and hospitals during the study period had severe dengue. DENV-4 was the predominant serotype, followed by DENV-1, in a large outbreak of dengue in central Brazil. Our findings contribute to the understanding of clinical differences and immune status related to the serotypes DENV-1 and DENV-4 in central of Brazil.http://link.springer.com/article/10.1186/s40249-017-0328-9DengueSecondary infectionSevere dengueDengue type 4Brazil |
| spellingShingle | Benigno A. M. Rocha Adriana O. Guilarde Angela F. L. T. Argolo Marianna Peres Tassara Lucimeire A. da Silveira Isabela C. Junqueira Marília D. Turchi Valéria C. R. Féres Celina M. T. Martelli Dengue-specific serotype related to clinical severity during the 2012/2013 epidemic in centre of Brazil Infectious Diseases of Poverty Dengue Secondary infection Severe dengue Dengue type 4 Brazil |
| title | Dengue-specific serotype related to clinical severity during the 2012/2013 epidemic in centre of Brazil |
| title_full | Dengue-specific serotype related to clinical severity during the 2012/2013 epidemic in centre of Brazil |
| title_fullStr | Dengue-specific serotype related to clinical severity during the 2012/2013 epidemic in centre of Brazil |
| title_full_unstemmed | Dengue-specific serotype related to clinical severity during the 2012/2013 epidemic in centre of Brazil |
| title_short | Dengue-specific serotype related to clinical severity during the 2012/2013 epidemic in centre of Brazil |
| title_sort | dengue specific serotype related to clinical severity during the 2012 2013 epidemic in centre of brazil |
| topic | Dengue Secondary infection Severe dengue Dengue type 4 Brazil |
| url | http://link.springer.com/article/10.1186/s40249-017-0328-9 |
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