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Clinical and epidemiological characteristics of yellow fever in Brazil: analysis of reported cases 1998-2002

Tuboi, Suely Hiromi; Costa, Zouraide Guerra Antunes; Vasconcelos, Pedro Fernando da Costa; Hatch, Douglas.
Trans R Soc Trop Med Hyg ; 101(2): 169 - 175, 2007. mapas, tab
Artículo en Inglés | IEC | ID: iec-2379
Yellow fever (YF), an arboviral infection of major public health importance in Brazil, is associated with high mortality and high epidemic potential. We analysed confirmed YF cases from the National Surveillance System from 1998-2002 and assessed risk factors for death among hospitalised patients. Variables assessed included age, gender, clinical signs and laboratory findings. A logistic regression model was used to identify independent predictors of death among hospitalised patients. From 1998-2002, among 2117 suspected YF cases reported to Brazil's Ministry of Health, 251 (11.9%) had confirmed YF, of whom 217 (86.5%) were hospitalised and the case fatality rate was 44.2%. Factors associated with higher mortality in univariate analysis included male gender (relative risk (RR) 1.96, 95% CI 1.17-2.28), age 40 years (RR 2.61, 95% CI 1.25-5.45), jaundice (RR 2.66, 95% CI 2.12-3.35), serum aspartate aminotransferase (AST) 1200IU/l (RR 1.84, 95% CI 1.23-2.74), alanine aminotransferase 1500IU/l (RR 2.09, 95% CI 1.38-3.17), total bilirubin 7.0mg/dl (RR 2.33, 95% CI 1.44-3.78), direct bilirubin 5.0mg/dl (RR 2.29, 95% CI 1.33-3.94) and blood urea nitrogen 100mg/dl (RR 5.77, 95% CI 1.43-23.22). In multivariate analysis, elevated AST and jaundice remained independently associated with higher mortality. These findings suggest that selected clinical and laboratory indicators may help clinicians recognise potentially fatal cases of YF...(AU)
Biblioteca responsable: BR275.1
Ubicación: PCIEC2007 / BR275.1