Dengue: An Analysis of Epidemiological Pattern Over a Six Year Period

Study of Hepatic Dysfunction Associated with Dengue Epidemiology in a Tertiary Care Hospital, Kolkata

Dengue is a common arthropod-borne life-threatening febrile illness. This disease affects liver functions with an imbalance of liver enzymes followed by other clinical manifestations. The dengue serotypes can cause asymptomatic infection to more severe versions of hemorrhagic fever and dengue shock syndrome in West Bengal and around the globe. The main aim of this study is to establish how different liver enzymes act in identifying markers for dengue prognosis for the early detection of severe dengue fever (DF). The diagnosis of dengue patients was confirmed by enzyme-linked immunosorbent assay, and associated clinical parameters [aspartate transaminase (AST), alanine aminotransferase (ALT), alkaline phosphatase, total bilirubin, total albumin, total protein, packed cell volume, and platelet count] were analyzed. Furthermore, the viral load estimation was also carried out by RT PCR analysis. The majority of these patients had elevated AST and ALT levels; ALT levels were higher than AST levels, which were partially observed in all non-structural protein 1 antigen- and dengue immunoglobulin M antibody-reactive patients. Almost 25% of patients had very low platelet count or thrombocytopenia. Furthermore, the viral load shows a significant association with all the clinical parameters with a p-value of <0.0001. All these liver enzymes are significantly correlated with an increased level of T.BIL, ALT, and AST. This study depicts that the intensity of hepatic involvement may play a critical role in the morbidity and mortality of DF patients. As a result, all of these liver parameters can be useful early markers for determining the severity of the disease, allowing for early detection of high-risk cases.

Dengue virus infection and pregnancy outcomes during the 2017 outbreak in Ouagadougou, Burkina Faso: A retrospective cohort study

Introduction

Dengue fever is a re-emerging pathology in Burkina Faso. It affects everyone and pregnant women are not left out. The objective of this study was to estimate the burden of dengue fever and to assess its effects on pregnancy outcomes in hospitalized pregnant women during the 2017 outbreak in Ouagadougou, Burkina Faso.

Method

This was a retrospective cohort study including febrile pregnant women from five health facilities in Ouagadougou. The study was carried out from July 1st to December 31st, 2017. A logistic stepwise regression was performed to identify the pregnancy adverse outcomes risk factors.

Results

Our study included 424 pregnant women at a mean age of 27.1 years old (Standard deviation: 6.23 years). Overall 28.54% (121/424) were infected with dengue virus. During follow-up, 29.01% (123/424) presented an adverse pregnancy outcome. Adjusted for gestational age and clinical symptoms, the risk of adverse pregnancy outcome was twice as high among dengue infected women as compared to uninfected women with an adjusted Odds Ratio (aOR) = 2.09 (1.08–4.05). The risk of the adverse pregnancy outcome was higher in the third trimester of pregnancy with aOR = 1.66 (1.02–2.72) in dengue fever infected women.

Conclusion

Dengue fever is a risk factor for adverse pregnancy outcomes, especially in the third trimester in Burkina Faso. The implementation of effective anti-vectorial control interventions and better management of dengue fever during pregnancy are needed to improve pregnancy outcomes.

Risk Factors and Predictors of Severe Dengue in Saudi Population in Jeddah, Western Saudi Arabia: A Retrospective Study

This study was performed to determine the risk factors and predictors of severe dengue fever (SDF) in Saudi population in Jeddah, Western Saudi Arabia. This 7-year retrospective study included children and adults with confirmed dengue from 2010 to 2016. Demographic, clinical, laboratory, serological, and virologic data were collected. Comparative analyses were performed between pediatric and adult SDF cases defined according to the WHO 2009 dengue classification. During the study period, dengue was confirmed in 17,646 cases with predominant infection of adults (6.5 times that of children) and males (3.8 times that of females). May and June were associated with 43.9% of total dengue cases. All 56 pediatric and 187 adult SDF cases were hospitalized. At least one warning sign of severe illness was present in 92.2% of total SDF cases. Mortality rates were 8.9% and 10.7% of pediatric and adult SDF cases, respectively. Multiple logistic regression detected that the most significant risk factors and predictors of SDF in adults versus children were significantly more secondary dengue infection (adjusted odds ratio [AOR]: 2.20, 95% CI: 1.09-4.44, P = 0.02), significantly less clinical fluid accumulation (AOR: 0.17, 95% CI: 0.07-0.44, P < 0.001) and significantly less neutropenia (AOR: 0.41, 95% CI: 0.17-0.97, P = 0.04). This was the first large multicenter study evaluating SDF in Saudi population and considering the WHO 2009 dengue classification, which showed predominant infection of adults and males with dengue, few SDF cases with low mortality and highlighted predictors of SDF in adults versus children. Consideration of warning signs for severe dengue may result in hospital admission, prompting closer monitoring, timely and proper interventions and reduced mortality in SDF cases.

Alanine Substitution Inactivates Cross-Reacting Epitopes in Dengue Virus Recombinant Envelope Proteins

The expansion of the habitat of mosquitoes belonging to the Aedes genus puts nearly half of the world's population at risk of contracting dengue fever, and a significant fraction will develop its serious hemorrhagic complication, which can be fatal if not diagnosed properly and treated in a timely fashion. Although several diagnostic methods have been approved for dengue diagnostics, their applicability is limited in rural areas of developing countries by sample preparation costs and methodological requirements, as well as cross-reactivity among the different serotypes of the Dengue virus and other flavivirus, such as the Zika virus. For these reasons, it is necessary to generate more specific antigens to improve serological methods that could be cheaper and used in field operations. Here, we describe a strategy for the inactivation of cross-reacting epitopes on the surface of the Dengue virus envelope protein through the synthetic generation of recombinant peptide sequences, where key amino acid residues from Dengue virus serotype 1 (DENV-1) and 2 (DENV-2) are substituted by alanine residues. The proteins thus generated are recognized by 88% of sera from Dengue NS1+ patients and show improved serotype specificity because they do not react with the antibodies present in seroconverted, PCR-serotyped DEN-4 infected patients.

Epidemiological scenario of dengue in the state of Manipur during the last 3 years

Background

The study of disease transmission of dengue fever (DF) is perplexing in the Indian subcontinent as all the four serotypes are circling. Also, there is no efficient epidemiological examination done on dengue cases in Manipur, a north-eastern territory of India.

Method

We utilized the dengue information extricated from the lab register of Viral Research and Diagnostic Laboratory (VRDL) from 2016 to 2018. All presumed outpatient and inpatients dengue cases from open and private health-care facilities are incorporated into the VRDL database whose informed consent were gotten.

Results

A sum of 1689 instances of associated patients with dengue infection was tried for dengue ELISA test and 272 (16.10%) samples were seen as seropositive. The month-wise conveyance of dengue cases is very intriguing as the three years of study demonstrates a variation design in perception. In all the three years dengue seropositive cases were seen higher in the male populace. Be that as it may, there is no noteworthy incentive to the inspiration of dengue seropositive towards male than female.

Conclusion

Our examination exhibits a comparative epidemiological investigation on seroprevelance of dengue in the province of Manipur for three years. This is an endeavour to show epidemiological dengue seroprevelance in the territory of Manipur which in future would be a reference from general wellbeing worries for making up essential move intend to shorten the spread of dengue.

Distribution of and associated factors for dengue burden in the state of Odisha, India during 2010-2016

This study is aimed to estimate the epidemiological burden of dengue in Odisha, India using the disability adjusted life year (DALY) methods and to explore the associated factors in the year 2010-2016. During the period of 2010-2016, 27 772 cases (68.4% male) were reported in the state. Mean age (years) of male and female was 31.63 and 33.82, respectively. Mean district wise disability adjusted life years (DALY) per 100 000 people was higher in the year 2016 (0.45) and mean DALY lost per person was highest in the year 2015 (34.90 years). Adjusted regression model indicates, every unit increase in humidity and population density increases DALY by 1.05 and 1.02 units respectively. Whereas, unit change in sex ratio (females per 1000 males) and forest coverage increases the DALY by 0.98 units. Our results indicate geographical variation of DALY in Odisha, which is associated with population density, humidity and forest cover. Discrepancies identified between standard incidence and DALY maps suggests, latter can be used to present disease burden more effectively. More prevalence among young males suggests the need of strengthening the targeted prevention and control measures.