Epidemiology and burden of dengue fever in the United States: a systematic review.

BACKGROUND: Dengue is currently a global concern. The range of dengue vectors is expanding with climate change, yet United States of America (USA) studies on dengue epidemiology and burden are limited. This systematic review sought to characterize the epidemiology and disease burden of dengue within the USA. METHODS: Studies evaluating travel-related and endemic dengue in US states and territories were identified and qualitatively summarized. Commentaries and studies on ex-US cases were excluded. MEDLINE, Embase, Cochrane Library, Latin American and Caribbean Center of Health Sciences Information, Centre for Reviews and Dissemination and Clinicaltrials.gov were searched through January 2022. RESULTS: 116 studies were included. In US states, dengue incidence was generally low, with spikes occurring in recent years in 2013-16 (0.17-0.31 cases/100,000) and peaking in 2019 (0.35 cases/100,000). Most cases (94%, n = 7895, 2010-21) were travel related. Dengue was more common in Puerto Rico (cumulative average: 200 cases/100,000, 1980-2015); in 2010-21, 99.9% of cases were locally acquired. There were <50 severe cases in US states (2010-17); fatal cases were even rarer. Severe cases in Puerto Rico peaked in 1998 (n = 173) and 2021 (n = 76). Besides lower income, risk factors in US states included having birds in residence, suggesting unspecified environmental characteristics favourable to dengue vectors. Commonly reported symptoms included fever, headache and rash; median disease duration was 3.5-11 days. Hospitalization rates increased following 2009 World Health Organization disease classification changes (pre-2009: 0-54%; post-2009: 14-75%); median length of stay was 2.7-8 days (Puerto Rico) and 2-3 days (US states). Hospitalization costs/case (2010 USD) were$14 350 (US states),$1764-$5497 (Puerto Rico) and$4207 (US Virgin Islands). In Puerto Rico, average days missed were 0.2-5.3 (work) and 2.5 (school). CONCLUSIONS: Though dengue risk is ongoing, treatments are limited, and dengue's economic burden is high. There is an urgent need for additional preventive and therapeutic interventions.

A scoping review of Table 2 fallacy in the oral health literature.

BACKGROUND: Coined by Westreich and Greenland in 2013, Table 2 fallacy refers to the practice of reporting estimates of the primary exposure and adjustment covariates derived from a single model on the same table. This study seeks to describe the extent to which Table 2 fallacy is present in the oral health literature and provide recommendations on presenting findings from multivariable-adjusted models and/or interpretation of adjustment covariate estimates that are not the primary exposure. METHODS: We conducted a scoping review in PubMed and Scopus of human observational studies published in 4 oral health journals (JDR-CTR, CDOE, JPHD, BMC Oral Health) starting in 2013 until the end of 2018. The resulting articles were exported into Excel and were either included or excluded for full-text review based on six criteria. After categorizing the articles, we exported and summarized the results in SAS. RESULTS: A total of 1358 articles were initially screened of which 937 articles were excluded based on title or abstract for being animal studies, systematic reviews or meta-analysis, prediction models or descriptive studies. The remaining 421 articles were eligible for full text reviewed of which, 189 (45%) committed Table 2 fallacy. The prevalence of table 2 fallacy appears high in the oral health literature. CONCLUSIONS: The problem of presenting multiple effect estimates derived from a single model in the same table is that it inadvertently encourages the reader to interpret all estimates the same way, often as total effects. Implications and recommendations are discussed.