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CLINICAL EVALUATION OF DENGUE AND IDENTIFICATION OF RISK FACTORS FOR SEVERE DISEASE: PROTOCOL FOR A MULTICENTRE STUDY IN 8 COUNTRIES
Adult
Asia
Child
Dengue
Dengue Virus
Diagnosis
Diagnosis, Differential
Disease Management
Female
Humans
Latin America
Male
Middle Aged
Pathogenesis
Prospective Studies
Risk Factors
Risk prediction
Young Adult
Dengue
Diagnóstico Diferencial
Gerenciamento Clínico
Feminino
Humanos
América Latina
Masculino
Meia-Idade
Patogênese Homeopática
Estudos Prospectivos
Fatores de risco
Ernesto T. A. Marques e Tereza Magalhães - Fundação Oswaldo Cruz. Centro de Pesquisas Aggeu Magalhães. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento.
1Section Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany. 2Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, District 5, Ho Chi Minh City, Vietnam. 3University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Vietnam. 4Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam. 5Children’s Hospital Number 2,Ho Chi Minh City, Vietnam. 6National Hospital for Tropical Diseases, Hanoi, Vietnam. 7Department of Medicine, Imperial College, London, UK. 8 Angkor Hospital for Children, Siem Reap, Cambodia. 9University of Malaya Medical Centre, Kuala Lumpur, Malaysia. 10Ampang Hospital, Kuala umpur, Malaysia 11Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador. 12Gadjah Mada University, Yogyakarta, Indonesia. 13James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh. 14International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh. 15Universidade Estadual Do Ceará, Fortaleza, Brazil. 16Centro de Pesquisas Aggeu Magalhaes, Fundacao Oswaldo Cruz, Recife, Pernambuco, Brazil. 17Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil. 18Secretaria Municipal de Saúde de Resende, Rio de Janeiro, Brazil. 19Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 20Facultad de Ciencias de la Salud, Universidad de Carabobo, Valencia, Venezuela. 21Institute Pedro Kouri, Havana, Cuba. 22Department of Microbiology and Immunology, The Peter Doherty Institute, University of Melbourne, Melbourne, Australia. 23Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK. 24Present address: Rwanda ilitary Hospital and the University of Rwanda in Kigali, Kigali, Rwanda. 25Present address: St. Jude Children’s Research Hospital, Memphis, TN, USA.
Author
Affilliation
Abstract
Background: The burden of dengue continues to increase globally, with an estimated 100 million clinically apparent infections occurring each year. Although most dengue infections are asymptomatic, patients can present with a wide spectrum of clinical symptoms ranging from mild febrile illness through to severe manifestations of bleeding, organ impairment, and hypovolaemic shock due to a systemic vascular leak syndrome. Clinical diagnosis of dengue and identification of which patients are likely to develop severe disease remain challenging. This study aims to improve diagnosis and clinical management through approaches designed a) to differentiate between dengue and other common febrile illness within 72 h of fever onset, and b) among patients with dengue to identify markers that are predictive of the likelihood of evolving to a more severe disease course. Method/Design: This is a prospective multi-centre observational study aiming to enrol 7–8000 participants aged ≥5 years presenting with a febrile illness consistent with dengue to outpatient health facilities in 8 countries across Asia and Latin America. Patients presenting within 72 h of fever onset who do not exhibit signs of severe disease are eligible for the study. A broad range of clinical and laboratory parameters are assessed daily for up to 6 days during the acute illness, and also at a follow up visit 1 week later. Discussion: Data from this large cohort of patients, enrolled early with undifferentiated fever, will be used to develop a practical diagnostic algorithm and a robust clinical case definition for dengue. Additionally, among patients with confirmed dengue we aim to identify simple clinical and laboratory parameters associated with progression to a more severe disease course. We will also investigate early virological and serological correlates of severe disease, and examine genetic associations in this large heterogeneous cohort. In addition the results will be used to assess the new World Health Organization classification scheme for dengue in practice, and to update the guidelines for “Integrated Management of Childhood Illness” used in dengue-endemic countries.
Keywords
AdolescentAdult
Asia
Child
Dengue
Dengue Virus
Diagnosis
Diagnosis, Differential
Disease Management
Female
Humans
Latin America
Male
Middle Aged
Pathogenesis
Prospective Studies
Risk Factors
Risk prediction
Young Adult
DeCS
Vírus da DengueDengue
Diagnóstico Diferencial
Gerenciamento Clínico
Feminino
Humanos
América Latina
Masculino
Meia-Idade
Patogênese Homeopática
Estudos Prospectivos
Fatores de risco
Citation
JAENISCH, T. et al. Clinical evaluation of dengue and identification of risk factors for severe disease: protocol for a multicentre study in 8 countries. BMC infectious diseases, v. 16, p. 1-11, Mar. 2016DOI
10.1186/s12879-016-1440-3ISSN
1471-2334Notes
Patrícia Brasil - Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Doenças Febris Agudas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento.Ernesto T. A. Marques e Tereza Magalhães - Fundação Oswaldo Cruz. Centro de Pesquisas Aggeu Magalhães. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento.
1Section Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany. 2Oxford University Clinical Research Unit, 764 Vo Van Kiet Street, District 5, Ho Chi Minh City, Vietnam. 3University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Vietnam. 4Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam. 5Children’s Hospital Number 2,Ho Chi Minh City, Vietnam. 6National Hospital for Tropical Diseases, Hanoi, Vietnam. 7Department of Medicine, Imperial College, London, UK. 8 Angkor Hospital for Children, Siem Reap, Cambodia. 9University of Malaya Medical Centre, Kuala Lumpur, Malaysia. 10Ampang Hospital, Kuala umpur, Malaysia 11Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador. 12Gadjah Mada University, Yogyakarta, Indonesia. 13James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh. 14International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh. 15Universidade Estadual Do Ceará, Fortaleza, Brazil. 16Centro de Pesquisas Aggeu Magalhaes, Fundacao Oswaldo Cruz, Recife, Pernambuco, Brazil. 17Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil. 18Secretaria Municipal de Saúde de Resende, Rio de Janeiro, Brazil. 19Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 20Facultad de Ciencias de la Salud, Universidad de Carabobo, Valencia, Venezuela. 21Institute Pedro Kouri, Havana, Cuba. 22Department of Microbiology and Immunology, The Peter Doherty Institute, University of Melbourne, Melbourne, Australia. 23Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK. 24Present address: Rwanda ilitary Hospital and the University of Rwanda in Kigali, Kigali, Rwanda. 25Present address: St. Jude Children’s Research Hospital, Memphis, TN, USA.
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