Clinical and Virological Study of Dengue Cases and the Members of Their Households: The Multinational DENFRAME Project

被引：35

作者：

Dussart, Philippe ^{[1
]}

Baril, Laurence ^{[2
,3
]}

Petit, Laure ^{[2
]}

Beniguel, Lydie ^{[2
]}

Luong Chan Quang ^{[4
]}

Ly, Sowath ^{[5
]}

Silva Azevedo, Raimunda do Socorro ^{[6
]}

Meynard, Jean-Baptiste ^{[7
]}

Vong, Sirenda ^{[5
]}

Chartier, Loic ^{[2
]}

Diop, Aba ^{[3
]}

Sivuth, Ong ^{[8
]}

Duong, Veasna ^{[8
]}

Cao Minh Thang ^{[9
]}

Jacobs, Michael ^{[10
]}

Sakuntabhai, Anavaj ^{[11
]}

Teixeira Nunes, Marcio Roberto ^{[6
]}

Vu Ti Que Huong ^{[9
]}

Buchy, Philippe ^{[8
]}

da Costa Vasconcelos, Pedro Fernando ^{[6
]}

机构：

[1] Inst Pasteur, Virol Lab, Cayenne, French Guiana

[2] Inst Pasteur, Unite Epidemiol Malad Emergentes, Paris, France

[3] Inst Pasteur, Unite Epidemiol Malad Infect, Dakar, Senegal

[4] Inst Pasteur Ho Chi Minh Ville, Unite Epidemiol, Ho Chi Minh City, Vietnam

[5] Inst Pasteur Cambodge, Unite Epidemiol & Sante Publ, Phnom Penh, Cambodia

[6] Inst Evandro Chagas, Dept Arbovirol & Hemorrhag Fevers, Belem, Para, Brazil

[7] Inst Pasteur, Unite Epidemiol, Cayenne, French Guiana

[8] Inst Pasteur Cambodge, Virol Unit, Phnom Penh, Cambodia

[9] Inst Pasteur Ho Chi Minh Ville, Lab Arbovirus, Ho Chi Minh City, Vietnam

[10] UCL, Sch Med, Dept Infect, London W1N 8AA, England

[11] Inst Pasteur, Unite Pathogenie Virale, Paris, France

来源：

PLOS NEGLECTED TROPICAL DISEASES | 2012年 / 6卷 / 01期

关键词：

LINKED-IMMUNOSORBENT-ASSAY; PRIMARY-SCHOOL CHILDREN; VIRUS-INFECTION; PROTEIN NS1; JAPANESE ENCEPHALITIS; ANTIGEN-DETECTION; KAMPHAENG PHET; PUERTO-RICO; DIAGNOSIS; SEVERITY;

D O I：

10.1371/journal.pntd.0001482

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: Dengue has emerged as the most important vector-borne viral disease in tropical areas. Evaluations of the burden and severity of dengue disease have been hindered by the frequent lack of laboratory confirmation and strong selection bias toward more severe cases. Methodology: A multinational, prospective clinical study was carried out in South-East Asia (SEA) and Latin America (LA), to ascertain the proportion of inapparent dengue infections in households of febrile dengue cases, and to compare clinical data and biological markers from subjects with various dengue disease patterns. Dengue infection was laboratory-confirmed during the acute phase, by virus isolation and detection of the genome. The four participating reference laboratories used standardized methods. Principal Findings: Among 215 febrile dengue subjects-114 in SEA and 101 in LA-28 (13.0%) were diagnosed with severe dengue (from SEA only) using the WHO definition. Household investigations were carried out for 177 febrile subjects. Among household members at the time of the first home visit, 39 acute dengue infections were detected of which 29 were inapparent. A further 62 dengue cases were classified at early convalescent phase. Therefore, 101 dengue infections were found among the 408 household members. Adding these together with the 177 Dengue Index Cases, the overall proportion of dengue infections among the study participants was estimated at 47.5% (278/585; 95% CI 43.5-51.6). Lymphocyte counts and detection of the NS1 antigen differed significantly between inapparent and symptomatic dengue subjects; among inapparent cases lymphocyte counts were normal and only 20% were positive for NS1 antigen. Primary dengue infection and a specific dengue virus serotype were not associated with symptomatic dengue infection. Conclusion: Household investigation demonstrated a high proportion of household members positive for dengue infection, including a number of inapparent cases, the frequency of which was higher in SEA than in LA.

引用

页数：13

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[1] Enzyme-linked immunosorbent assay specific to dengue virus type 1 nonstructural protein NS1 reveals circulation of the antigen in the blood during the experiencing primary acute phase of disease in patients or secondary infections [J].