Comparison of dengue case classification schemes and evaluation of biological changes in different dengue clinical patterns in a longitudinal follow-up of hospitalized children in Cambodia
| Autor: | Anne-Claire Andries, Philippe Dussart, Anavaj Sakuntabhai, Saraden In, Kim Sroin Kim, Veasna Duong, Marie Flamand, Kevin Bleakley, Philippe Buchy, Tineke Cantaert, Patrich Lorn Try, Camille Fortas, Rithy Choeung |
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| Přispěvatelé: | Institut Pasteur du Cambodge, Réseau International des Instituts Pasteur (RIIP), Statistique mathématique et apprentissage (CELESTE), Inria Saclay - Ile de France, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire de Mathématiques d'Orsay (LMO), Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Kampong Cham Provincial hospital [Cambodia], Virologie Structurale - Structural Virology, Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur [Paris], GlaxoSmithKline, Glaxo Smith Kline, Génétique fonctionnelle des maladies infectieuses - Functional Genetics of Infectious Diseases, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS) |
| Rok vydání: | 2019 |
| Předmět: |
Male
Dengue hemorrhagic fever RC955-962 NS1 antigen Disease Pathology and Laboratory Medicine Severity of Illness Index Biochemistry Vascular Medicine 0302 clinical medicine Medical Conditions [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases MESH: Child Arctic medicine. Tropical medicine Prospective Studies Child dengue classification Lipids 3. Good health Cholesterol Blood Arboviral Infections Medical Microbiology Child Preschool Viral Pathogens Disease Progression MESH: Disease Progression Public aspects of medicine MESH: Triglycerides medicine.medical_specialty Classification scheme MESH: Severe Dengue Hemorrhage MESH: Child Hospitalized Dengue shock syndrome World Health Organization Microbiology Severe dengue 03 medical and health sciences MESH: Cross-Sectional Studies Signs and Symptoms MESH: Severity of Illness Index Humans Microbial Pathogens MESH: Adolescent MESH: Humans Flaviviruses MESH: Child Preschool Public Health Environmental and Occupational Health Organisms lipid markers Biology and Life Sciences Chikungunya Infection Dengue Virus medicine.disease Tropical Diseases 030104 developmental biology Cross-Sectional Studies MESH: Viral Nonstructural Proteins Clinical Medicine MESH: Female Child Hospitalized 0301 basic medicine RNA viruses Pediatrics Viral Diseases Physiology Viral Nonstructural Proteins MESH: World Health Organization Dengue fever Dengue Fever MESH: Cholesterol Medicine and Health Sciences Hematology Body Fluids Infectious Diseases Hematocrit Viruses Female RA1-1270 Pathogens Anatomy Cambodia Research Article Neglected Tropical Diseases Adolescent 030231 tropical medicine macromolecular substances World health Blood Plasma medicine In patient Severe Dengue Triglycerides business.industry MESH: Cambodia MESH: Prospective Studies MESH: Male Blood Counts [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie business |
| Zdroj: | PLoS Neglected Tropical Diseases PLoS Neglected Tropical Diseases, Vol 14, Iss 9, p e0008603 (2020) PLoS Neglected Tropical Diseases, Public Library of Science, 2020, 14 (9), pp.e0008603. ⟨10.1371/journal.pntd.0008603⟩ PLoS Neglected Tropical Diseases, 2020, 14 (9), pp.e0008603. ⟨10.1371/journal.pntd.0008603⟩ |
| ISSN: | 1935-2735 1935-2727 |
| DOI: | 10.1371/journal.pntd.0008603⟩ |
| Popis: | Background The World Health Organization (WHO) proposed guidelines on dengue clinical classification in 1997 and more recently in 2009 for the clinical management of patients. The WHO 1997 classification defines three categories of dengue infection according to severity: dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). Alternative WHO 2009 guidelines provide a cross-sectional classification aiming to discriminate dengue fever from dengue with warning signs (DWWS) and severe dengue (SD). The primary objective of this study was to perform a comparison of two dengue classifications. The secondary objective was to describe the changes of hematological and biochemical parameters occurring in patients presenting with different degrees of severity during the course of the disease, since progression to more severe clinical forms is unpredictable. Methodology/Principal findings We performed a prospective, monocentric, cross-sectional study of hospitalized children in Cambodia, aged from 2 to 15 years old with severe and non-severe dengue. We enrolled 243 patients with acute dengue-like illness: 71.2% were dengue infections confirmed using quantitative reverse transcription PCR or NS1 antigen capture ELISA, of which 87.2% and 9.0% of DF cases were respectively classified DWWS and SD, and 35.9% of DHF were designated SD using an adapted WHO 2009 classification for SD case definition. Systematic use of ultrasound at patient admission was crucial for detecting plasma leakage. No difference was observed in the concentration of secreted NS1 protein between different dengue severity groups. Lipid profiles were different between DWWS and SD at admission, characterized by a decrease in total cholesterol, HDL cholesterol, and LDL cholesterol, in SD. Conclusions/Significance Our results show discrepancies between the two classifications, including misclassification of severe dengue cases as mild cases by the WHO 1997 classification. Using an adapted WHO 2009 classification, SD more precisely defines the group of patients requiring careful clinical care at a given time during hospitalization. Author summary Dengue is a viral disease that results in various health conditions, ranging from strictly asymptomatic infections to life-threatening severe dengue. Here we have compared the two World Health Organization (WHO) dengue classification schemes from 1997 and 2009, which define different categories of dengue fever and have been at the root of much debate in the dengue research community. We enrolled a Cambodian pediatric cohort of hospitalized dengue-confirmed patients, with clinical and biological follow-up. Our findings demonstrate that (i) the WHO 1997 classification is a longitudinal dengue-case classification which uses strict prerequisite clinical and/or biological signs to move from one level of severity to another, and (ii) the WHO 2009 classification, being a transversal dengue-case classifier, is more flexible and when adapted with systematic use of ultrasound is more accurate in identifying severe dengue case for timely and appropriate clinical management of hospitalized patients. Our laboratory results found that lipid profiles exhibited changes and differences between different dengue severity groups at hospital. |
| Databáze: | OpenAIRE |
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