Associated risk factors of severe dengue in Reunion Island: A prospective cohort study.
Journal
PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
received:
20
09
2022
accepted:
21
03
2023
revised:
27
04
2023
medline:
1
5
2023
pubmed:
18
4
2023
entrez:
17
4
2023
Statut:
epublish
Résumé
Since 2018, a dengue epidemic has been raging annually in Reunion Island, which poses the major problem of its morbidity and mortality. However, there is no consensus in the literature on factors associated with severity of illness. The objective of this study was to identify the factors associated with the occurrence of severe dengue (SD) according to the criteria adopted in 2009 by the World Health Organization (WHO), during the 2019 epidemic. A total of 163 patients with RT-PCR-confirmed dengue were included in a multicenter prospective cohort study in Reunion Island between January and June 2019. Of these, 37 (23%) were classified as SD, which involves presentation dominated by at least one organ failure, and 126 (77%) classified as non-SD (of which 90 (71%) had warning signs). Confusion, dehydration, and relative hypovolemia were significantly associated with SD in bivariate analysis (p < 0.05). The factors associated with SD in multivariate analysis were a time from first symptom to hospital consultation over 2 days (OR: 2.46, CI: 1.42-4.27), a history of cardiovascular disease (OR: 2.75, 95%CI: 1.57-4.80) and being of Western European origin (OR: 17.60, CI: 4.15-74). This study confirms that SD is a frequent cause of hospitalization during dengue epidemics in Reunion Island. It suggests that cardiovascular disease, Western European origin, and delay in diagnosis and management are risk factors associated with SD fever, and that restoration of blood volume and correction of dehydration must be performed early to be effective. NCT01099852; clinicaltrials.gov.
Sections du résumé
BACKGROUND
Since 2018, a dengue epidemic has been raging annually in Reunion Island, which poses the major problem of its morbidity and mortality. However, there is no consensus in the literature on factors associated with severity of illness. The objective of this study was to identify the factors associated with the occurrence of severe dengue (SD) according to the criteria adopted in 2009 by the World Health Organization (WHO), during the 2019 epidemic.
METHODOLOGY/PRINCIPAL FINDINGS
A total of 163 patients with RT-PCR-confirmed dengue were included in a multicenter prospective cohort study in Reunion Island between January and June 2019. Of these, 37 (23%) were classified as SD, which involves presentation dominated by at least one organ failure, and 126 (77%) classified as non-SD (of which 90 (71%) had warning signs). Confusion, dehydration, and relative hypovolemia were significantly associated with SD in bivariate analysis (p < 0.05). The factors associated with SD in multivariate analysis were a time from first symptom to hospital consultation over 2 days (OR: 2.46, CI: 1.42-4.27), a history of cardiovascular disease (OR: 2.75, 95%CI: 1.57-4.80) and being of Western European origin (OR: 17.60, CI: 4.15-74).
CONCLUSIONS/SIGNIFICANCE
This study confirms that SD is a frequent cause of hospitalization during dengue epidemics in Reunion Island. It suggests that cardiovascular disease, Western European origin, and delay in diagnosis and management are risk factors associated with SD fever, and that restoration of blood volume and correction of dehydration must be performed early to be effective.
TRIAL REGISTRATION
NCT01099852; clinicaltrials.gov.
Identifiants
pubmed: 37068115
doi: 10.1371/journal.pntd.0011260
pii: PNTD-D-22-01199
pmc: PMC10138848
doi:
Banques de données
ClinicalTrials.gov
['NCT01099852']
Types de publication
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0011260Informations de copyright
Copyright: © 2023 Carras et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist
Références
PLoS One. 2020 Jul 1;15(7):e0235166
pubmed: 32609737
Rev Med Virol. 2018 Jul;28(4):e1979
pubmed: 29691914
PLoS One. 2017 Oct 4;12(10):e0183544
pubmed: 28977019
Emerg Infect Dis. 2003 Aug;9(8):1003-6
pubmed: 12967502
Circ Genom Precis Med. 2022 Apr;15(2):e003489
pubmed: 35133173
Arch Virol. 2007;152(3):533-42
pubmed: 17106622
Science. 2017 Nov 17;358(6365):929-932
pubmed: 29097492
BMC Infect Dis. 2015 Sep 30;15:399
pubmed: 26423145
EClinicalMedicine. 2021 Jan 06;32:100712
pubmed: 33681736
Nat Rev Cardiol. 2022 Feb;19(2):133-143
pubmed: 34497402
Lancet Infect Dis. 2021 Jul;21(7):1014-1026
pubmed: 33640077
Diabetes Res Clin Pract. 2005 Mar;67(3):234-42
pubmed: 15713356
J Microbiol Immunol Infect. 2020 Feb;53(1):69-78
pubmed: 30146413
PLoS Negl Trop Dis. 2020 Mar 12;14(3):e0007327
pubmed: 32163420
Nat Rev Dis Primers. 2016 Aug 18;2:16055
pubmed: 27534439
Blood Press. 2017 Feb;26(1):39-47
pubmed: 27195533
Expert Rev Anti Infect Ther. 2015 Jan;13(1):29-40
pubmed: 25399556
Lancet Infect Dis. 2016 Jun;16(6):712-723
pubmed: 26874619
Front Cell Infect Microbiol. 2017 Jul 12;7:317
pubmed: 28748176
PLoS One. 2017 Feb 14;12(2):e0172267
pubmed: 28196111