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1.
Rev Soc Bras Med Trop ; 54: e0891 2020, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33950132

RESUMEN

INTRODUCTION: Cerebrospinal fluid analysis contributes to the diagnosis and neuropathogenesis of neuroinvasive arboviruses. Neurological complications caused by dengue, Zika, and chikungunya infections have high clinical relevance because of their high potential to cause death or neurological deficits. We aimed to evaluate the use of cerebrospinal fluid assays for diagnostic support in neurological disorders associated with dengue, chikungunya, and Zika infections. METHODS: A systematic review was carried out by searching the electronic databases LILACS, PubMed, Scopus, and Embase for articles written in English, Portuguese, or Spanish in the last 19 years. Published studies were reviewed using the terms "dengue," "Zika", "chikungunya", alone or in combination with "cerebrospinal fluid" in the period from 2000 to 2019. RESULTS: A total of 98,060 studies were identified; of these, 1.1% (1,041 studies, 58,478 cases) used cerebrospinal fluid assays for neurological investigations. The most frequent neurological disorders included encephalitis (41.4%), congenital syndromes (17%), and microcephaly associated with Zika virus infections (8.9%). Neuroinvasive disorders were confirmed in 8.03% of 58,478 cases by specific cerebrospinal fluid analyses. The main methods used were IgM-specific antibodies (66%) and reverse transcription-polymerase chain reaction (10%). The largest number of scientific papers (29%) originated from Brazil, followed by India (18.4%) and the United States (14.4%). CONCLUSIONS: Although cerebrospinal fluid analysis is of great importance for increasing neurological diagnostic accuracy and contributes to the early diagnosis of neuroinvasive dengue, chikungunya, and Zika infections, it is underused in routine laboratory investigations worldwide.


Asunto(s)
Fiebre Chikungunya , Virus Chikungunya , Virus del Dengue , Dengue , Infección por el Virus Zika , Virus Zika , Brasil , Fiebre Chikungunya/diagnóstico , Dengue/diagnóstico , Humanos , Infección por el Virus Zika/diagnóstico
2.
BMC Infect Dis ; 21(1): 311, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33794785

RESUMEN

BACKGROUND: Dengue infection is caused by an arbovirus with a wide range of presentations, varying from asymptomatic disease to unspecific febrile illness and haemorrhagic syndrome with shock, which can evolve to death. In Brazil, the virus circulates since the 1980s with many introductions of new serotypes, genotypes, and lineages since then. Here we report a fatal case of dengue associated with a Dengue virus (DENV) lineage not detected in the country until now. CASE PRESENTATION: The patient, a 58-year-old man arrived at the hospital complaining of fever and severe abdominal pain due to intense gallbladder edema, mimicking acute abdomen. After 48 h of hospital admission, he evolved to refractory shock and death. DENV RNA was detected in all tissues collected (heart, lung, brain, kidney, spleen, pancreas, liver, and testis). Viral sequencing has shown that the virus belongs to serotype 2, American/Asian genotype, in a new clade, which has never been identified in Brazil before. The virus was phylogenetically related to isolates from central America [Puerto Rico (2005-2007), Martinique (2005), and Guadeloupe (2006)], most likely arriving in Brazil from Puerto Rico. CONCLUSION: In summary, this was the first fatal documented case with systemic dengue infection associated with the new introduction of Dengue type 2 virus in Brazil during the 2019 outbreak.


Asunto(s)
Virus del Dengue/aislamiento & purificación , Dengue/diagnóstico , Encéfalo/virología , Brasil , Dengue/virología , Virus del Dengue/clasificación , Virus del Dengue/genética , Vesícula Biliar/patología , Genotipo , Corazón/virología , Humanos , Pulmón/virología , Masculino , Persona de Mediana Edad , Filogenia , ARN Viral/metabolismo
4.
Int J Mol Sci ; 22(6)2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33809042

RESUMEN

Clinical presentations of dengue fever (DF) are diverse and non-specific, causing unpredictable progression and outcomes. Its progression and severity have been associated with cytokine levels alteration. In this study, dengue patients were classified into groups following the 2009 WHO dengue classification scheme to investigate the cytokine signature at different severity of the disease: dengue without warning sign symptoms (A); dengue with warning signs (B); severe dengue (C); other fever (OF) and healthy (Healthy). We analyzed 23 different cytokines simultaneously, namely IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-33, CD14, CD54, CD62E, CD62L, CD62p, CD106, CD121b, CD154, CD178, GM-CSF, IFN-g, MIF, ST2 and TNF from patients admitted to National Cheng Kung University Hospital during the 2015 Taiwan dengue outbreak. Cytokines TNF, CD54, CD62E, CD62L, CD62P, GM-CSF, IL-1b, IL-2, IL-6, IL-8, IL-10, IL-12p70, IL-17A, INF-g and MIF were elevated while CD106, CD154, IL-4 and L-33 were decreased when compared to the control. IL-10 demonstrated to be a potential diagnostic marker for DF (H and A group; AUC = 0.944, H and OF group; AUC = 0.969). CD121b demonstrated to be predictive of the SD (A and B group; AUC = 0.744, B and C group; AUC = 0.775). Our results demonstrate the cytokine profile changes during the progression of dengue and highlight possible biomarkers for optimizing effective intervention strategies.


Asunto(s)
Virus del Dengue/aislamiento & purificación , Dengue/diagnóstico , Interleucina-10/genética , Receptores Tipo II de Interleucina-1/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/metabolismo , Citocinas/clasificación , Citocinas/genética , Dengue/genética , Dengue/patología , Dengue/virología , Virus del Dengue/genética , Virus del Dengue/patogenicidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Transcriptoma/genética , Adulto Joven
5.
Medicine (Baltimore) ; 100(14): e25311, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33832104

RESUMEN

ABSTRACT: The 2015 dengue outbreak in southern Taiwan turned into a public health emergency, resulting in a large-scale mobilization of personnel from the emergency department (ED) services operating in and near full capacity to assist with the outbreak. This study aimed to assess a rapid independent clinic-based service (RCS), which was set up and designed to relieve the overcrowding of the regular ambulatory and emergency services during an epidemic of dengue.This is a retrospective cross-sectional study.National Cheng Kung University Hospital, Tainan, Taiwan.Patients with positive test results were enrolled and reviewed to evaluate the efficacy of RCS implementation between August and October 2015. The case-treatment rates stratified by length of stay (LOS) were used to examine the performance of the RCS that was set up outside the ED and designed to relieve the overcrowding of the regular ambulatory and emergency services.Patients with dengue-like illnesses may arrive at the hospital and require optimal ED triage and management thereafter. Although the outbreak resulted in a shortage of spare space in the ED, a proper response from the hospital administration would ameliorate the work overload of the staff and would not decrease the quality of care for critical patients.An early and restrictive intensive intervention was beneficial to health care facilities during a dengue outbreak. Further planning and training of the RCS could be crucial for hospital preparedness for infectious disease outbreaks.


Asunto(s)
Instituciones de Atención Ambulatoria/organización & administración , Dengue/epidemiología , Servicio de Urgencia en Hospital/organización & administración , Cultivo de Sangre , Estudios Transversales , Dengue/diagnóstico , Dengue/tratamiento farmacológico , Diagnóstico por Imagen , Brotes de Enfermedades , Capacidad de Camas en Hospitales , Hospitales de Enseñanza , Humanos , Tiempo de Internación/estadística & datos numéricos , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , Taiwán/epidemiología , Centros de Atención Terciaria , Factores de Tiempo , Triaje/organización & administración
6.
Infez Med ; 29(1): 114-116, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33664180

RESUMEN

Dengue fever should be included in the differential diagnosis of febrile illness even if another infection such as COVID-19 has been found in returning travellers from tropical and sub-tropical area where dengue virus circulates epidemically. We describe a 40-year-old man diagnosed with laboratory-confirmed COVID-19 and dengue fever during the COVID-19 outbreak in Milan, Italy.


Asunto(s)
/diagnóstico , Coinfección/diagnóstico , Dengue/diagnóstico , Anamnesis , Adulto , Coinfección/virología , Enfermedades Transmisibles Importadas/diagnóstico , Enfermedades Transmisibles Importadas/virología , Virus del Dengue , Diagnóstico Diferencial , Humanos , Masculino , Viaje
7.
BMC Infect Dis ; 21(1): 265, 2021 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-33731022

RESUMEN

BACKGROUND: Increasing arbovirus infections have been a global burden in recent decades. Many countries have experienced the periodic emergence of arbovirus diseases. However, information on the prevalence of arboviruses is largely unknown or infrequently updated because of the lack of surveillance studies, especially in Africa. METHODS: A surveillance study was conducted in Gabon, Central Africa, on arboviruses, which are a major public health concern in Africa, including: West Nile virus (WNV), dengue virus (DENV), Zika virus (ZIKV), yellow fever virus (YFV), chikungunya virus (CHIKV), and Rift Valley fever virus (RVFV). Serological and molecular assays were performed to investigate past infection history and the current status of infection, using serum samples collected from healthy individuals and febrile patients, respectively. RESULTS: The overall seroprevalence during 2014-2017 was estimated to be 25.3% for WNV, 20.4% for DENV, 40.3% for ZIKV, 60.7% for YFV, 61.2% for CHIKV, and 14.3% for RVFV. No significant differences were found in the seroprevalence of any of the viruses between the male and female populations. However, a focus on the mean age in each arbovirus-seropositive individual showed a significantly younger age in WNV- and DENV-seropositive individuals than in CHIKV-seropositive individuals, indicating that WNV and DENV caused a relatively recent epidemic in the region, whereas CHIKV had actively circulated before. Of note, this indication was supported by the detection of both WNV and DENV genomes in serum samples collected from febrile patients after 2016. CONCLUSIONS: This study revealed the recent re-emergence of WNV and DENV in Gabon as well as the latest seroprevalence state of the major arboviruses, which indicated the different potential risks of virus infections and virus-specific circulation patterns. This information will be helpful for public health organizations and will enable a rapid response towards these arbovirus infections, thereby preventing future spread in the country.


Asunto(s)
Arbovirus/aislamiento & purificación , Dengue/epidemiología , Infección por el Virus Zika/epidemiología , Adolescente , Animales , Infecciones por Arbovirus/diagnóstico , Infecciones por Arbovirus/epidemiología , Arbovirus/clasificación , Niño , Preescolar , Enfermedades Transmisibles Emergentes , Dengue/diagnóstico , Femenino , Fiebre/epidemiología , Fiebre/virología , Gabón/epidemiología , Humanos , Lactante , Masculino , Salud Pública , Estudios Seroepidemiológicos , Infección por el Virus Zika/diagnóstico
8.
Rev Soc Bras Med Trop ; 54: e0055-2020, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33759914

RESUMEN

INTRODUCTION: Mayaro virus (MAYV) was found in Pará state, Brazil, in 1955. Since then, sporadic outbreaks have occurred in different regions of the country. METHODS: Serum sample were collected from 49 individuals in 2016 and were initially tested for dengue virus (DENV) by real-time (RT) polymerase chain reaction (PCR). DENV-negative samples were tested for MAYV and Oropouche virus (OROV) by multiplexed RT quantitative PCR. RESULTS: All samples were negative for DENV and OROV, but MAYV was detected in four samples. CONCLUSIONS: Differential diagnoses of acute febrile syndrome are required, especially in regions where several arboviruses with similar clinical manifestations are endemic.


Asunto(s)
Alphavirus , Arbovirus , Dengue , Alphavirus/genética , Arbovirus/genética , Brasil/epidemiología , Dengue/diagnóstico , Dengue/epidemiología , Brotes de Enfermedades , Humanos , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
9.
Arch Argent Pediatr ; 119(2): 131-138, 2021 04.
Artículo en Español | MEDLINE | ID: mdl-33749212

RESUMEN

Eleven years after the first dengue outbreak in Buenos Aires, on March 20, 2020, while the mandatory quarantine for COVID-19 began dengue became the most common cause of fever consultation. The new wave of dengue cases was already among the predictions of the Pan American Health Organization based on the increase in the region of the Americas that had been occurring since the previous year. The arrival of SARS-CoV-2 at the beginning of March, added to the dengue outbreak that was already underway, made a new challenge for the health system while a new paradigm was initiated with adaptation plans to the new pandemic infection in the country. The overlapping of infections with epidemic potential such as dengue recalls the importance of not neglecting other endemic, emerging and re-emerging diseases in the shadow of the new epidemiological phenomenon.


Asunto(s)
/epidemiología , Dengue/epidemiología , Argentina/epidemiología , Dengue/diagnóstico , Dengue/prevención & control , Brotes de Enfermedades , Política de Salud , Humanos , Pandemias , Cuarentena
11.
Virol J ; 18(1): 54, 2021 03 11.
Artículo en Inglés | MEDLINE | ID: mdl-33706767

RESUMEN

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic remains ongoing around the world, including in areas where dengue is endemic. Dengue and COVID-19, to some extent, have similar clinical and laboratory features, which can lead to misdiagnosis, delayed treatment and patient's isolation. The use of rapid diagnostic tests (RDT) is easy and convenient for fast diagnosis, however there may be issues with cross-reactivity with antibodies for other pathogens. METHODS: We assessed the possibility of cross-reactivity between SARS-CoV-2 and dengue antibodies by: (1) testing five brands of COVID-19 IgG / IgM RDTs on 60 RT-PCR-confirmed dengue samples; (2) testing 95 RT-PCR-confirmed COVID-19 samples on dengue RDT; and (3) testing samples positive for COVID-19 IgG and/or IgM on dengue RDT. RESULTS: We observed a high specificity across all five brands of COVID-19 RDTs, ranging from 98.3 to 100%. Out of the confirmed COVID-19 samples, one patient tested positive for dengue IgM only, another tested positive for dengue IgG only. One patient tested positive for dengue IgG, IgM, and NS1, suggesting a co-infection. In COVID-19 IgG and/or IgM samples, 6.3% of COVID-19 IgG-positive samples also tested positive for dengue IgG, while 21.1% of COVID-19 IgM-positive samples also tested positive for dengue IgG. CONCLUSION: Despite the high specificity of the COVID-19 RDT, we observed cross-reactions and false-positive results between dengue and COVID-19. Dengue and COVID-19 co-infection was also found. Health practitioners in dengue endemic areas should be careful when using antibody RDT for the diagnosis of dengue during the COVID-19 pandemic to avoid misdiagnosis.


Asunto(s)
Anticuerpos Antivirales/inmunología , Reacciones Cruzadas/inmunología , Virus del Dengue/inmunología , Dengue/diagnóstico , /inmunología , Adolescente , Adulto , Niño , Diagnóstico Diferencial , Pruebas Diagnósticas de Rutina , Reacciones Falso Positivas , Femenino , Humanos , Inmunoglobulina A/inmunología , Inmunoglobulina G/inmunología , Inmunoglobulina M/inmunología , Indonesia , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Proteínas no Estructurales Virales/inmunología , Adulto Joven
12.
Biosens Bioelectron ; 179: 113074, 2021 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-33596516

RESUMEN

On global scale, the current situation of pandemic is symptomatic of increased incidences of contagious diseases caused by pathogens. The faster spread of these diseases, in a moderately short timeframe, is threatening the overall population wellbeing and conceivably the economy. The inadequacy of conventional diagnostic tools in terms of time consuming and complex laboratory-based diagnosis process is a major challenge to medical care. In present era, the development of point-of-care testing (POCT) is in demand for fast detection of infectious diseases along with "on-site" results that are helpful in timely and early action for better treatment. In addition, POCT devices also play a crucial role in preventing the transmission of infectious diseases by offering real-time testing and lab quality microbial diagnosis within minutes. Timely diagnosis and further treatment optimization facilitate the containment of outbreaks of infectious diseases. Presently, efforts are being made to support such POCT by the technological development in the field of internet of medical things (IoMT). The IoMT offers wireless-based operation and connectivity of POCT devices with health expert and medical centre. In this review, the recently developed POC diagnostics integrated or future possibilities of integration with IoMT are discussed with focus on emerging and re-emerging infectious diseases like malaria, dengue fever, influenza A (H1N1), human papilloma virus (HPV), Ebola virus disease (EVD), Zika virus (ZIKV), and coronavirus (COVID-19). The IoMT-assisted POCT systems are capable enough to fill the gap between bioinformatics generation, big rapid analytics, and clinical validation. An optimized IoMT-assisted POCT will be useful in understanding the diseases progression, treatment decision, and evaluation of efficacy of prescribed therapy.


Asunto(s)
Técnicas Biosensibles/instrumentación , Enfermedades Transmisibles/diagnóstico , Internet de las Cosas , Pruebas en el Punto de Atención , Animales , Inteligencia Artificial , Técnicas Biosensibles/métodos , Infecciones por Coronavirus/diagnóstico , Dengue/diagnóstico , Diseño de Equipo , Infecciones por VIH/diagnóstico , Fiebre Hemorrágica Ebola/diagnóstico , Humanos , Gripe Humana/diagnóstico , Malaria/diagnóstico , Infecciones por Orthomyxoviridae/diagnóstico , Infección por el Virus Zika/diagnóstico
15.
BMC Infect Dis ; 21(1): 166, 2021 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-33568111

RESUMEN

BACKGROUND: An unexpected dengue outbreak occurred in Hunan Province in 2018. This was the first dengue outbreak in this area of inland China, and 172 cases were reported. METHODS: To verify the causative agent of this outbreak and characterise the viral genes, the genes encoding the structural proteins C/prM/E of viruses isolated from local residents were sequenced followed by mutation and phylogenetic analysis. Recombination, selection pressure, potential secondary structure and three-dimensional structure analyses were also performed. RESULTS: Phylogenetic analysis revealed that all epidemic strains were of the cosmopolitan DENV-2 genotype and were most closely related to the Zhejiang strain (MH010629, 2017) and then the Malaysia strain (KJ806803, 2013). Compared with the sequence of DENV-2SS, 151 base substitutions were found in the sequences of 89 isolates; these substitutions resulted in 20 non-synonymous mutations, of which 17 mutations existed in all samples (two in the capsid protein, six in the prM/M proteins, and nine in the envelope proteins). Moreover, amino acid substitutions at the 602nd (E322:Q → H) and 670th (E390: N → S) amino acids may have enhanced the virulence of the epidemic strains. One new DNA binding site and five new protein binding sites were observed. Two polynucleotide binding sites and seven protein binding sites were lost in the epidemic strains compared with DENV-2SS. Meanwhile, five changes were found in helical regions. Minor changes were observed in helical transmembrane and disordered regions. The 429th amino acid of the E protein switched from a histamine (positively charged) to an asparagine (neutral) in all 89 isolated strains. No recombination events or positive selection pressure sites were observed. To our knowledge, this study is the first to analyse the genetic characteristics of epidemic strains in the first dengue outbreak in Hunan Province in inland China. CONCLUSIONS: The causative agent is likely to come from Zhejiang Province, a neighbouring province where dengue fever broke out in 2017. This study may help clarify the intrinsic geographical relatedness of DENV-2 and contribute to further research on pathogenicity and vaccine development.


Asunto(s)
Virus del Dengue/genética , Dengue/diagnóstico , Proteínas del Envoltorio Viral/genética , Sitios de Unión , Proteínas de la Cápside/química , Proteínas de la Cápside/genética , Proteínas de la Cápside/metabolismo , China/epidemiología , Dengue/epidemiología , Dengue/virología , Virus del Dengue/clasificación , Virus del Dengue/aislamiento & purificación , Brotes de Enfermedades , Genotipo , Humanos , Mutación , Filogenia , Estructura Terciaria de Proteína , ARN Viral/química , ARN Viral/metabolismo , Análisis de Secuencia de ARN , Proteínas del Envoltorio Viral/química , Proteínas no Estructurales Virales/genética , Proteínas no Estructurales Virales/metabolismo
16.
Rev Soc Bras Med Trop ; 54: e05192020, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33533817

RESUMEN

INTRODUCTION: Dengue presents with a variable clinical course, ranging from mild illness to potentially fatal hemorrhage and shock. We aimed to evaluate the capabilities of various hematological parameters observed early in the course of illness for predicting the clinical outcomes of illness. METHODS: We retrospectively analyzed the records of children admitted in the pediatric inpatient services of the institute with dengue between 2017 and 2019. We determined the relationships between the hematological parameters observed during the first evaluation and the various clinical outcomes. RESULTS: We evaluated data from 613 patients (age range, 26 days to 17 years). Of these, 29.85% exhibited fever with warning signs, and 8.97% had severe dengue. Lower values of hemoglobin, platelet count, mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean platelet volume, and higher values of total leukocyte count (TLC), hematocrit, and red cell distribution width variably correlated with numerous clinical outcomes-duration of hospital stay, development of complications, requirement of blood component transfusion, inotropic support, and mortality. Among the parameters, TLC ≥20,000/mL and initial platelet count ≤20,000/mL significantly associated with mortality, with odds ratios (95% confidence interval) of 11.81 (4.21-33.80) and 5.53 (1.90-16.09), respectively. CONCLUSIONS: Hematological parameters observed early during dengue infection may predict its clinical outcomes in infected children. Initial high TLC and low platelet count are potential predictors of fatal outcomes in the course of disease.


Asunto(s)
Dengue , Dengue Grave , Adulto , Niño , Dengue/diagnóstico , Hematócrito , Humanos , India/epidemiología , Recuento de Leucocitos , Estudios Retrospectivos , Dengue Grave/diagnóstico
17.
Mem Inst Oswaldo Cruz ; 115: e200287, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33533869

RESUMEN

BACKGROUND: The heat-labile nature of Dengue virus (DENV) in serum samples must be considered when applying routine diagnostic tests to avoid issues that could impact the accuracy of test results with direct implications for case management and disease reporting. OBJECTIVES: To check if pre-analytical variables, such as storage time and temperature, have an impact on the accuracy of the main routine diagnostic tests for dengue. METHODS: Virus isolation, reverse transcription real-time polymerase chain reaction (RT-PCR) and NS1 enzyme-linked immunosorbent assay (ELISA) were evaluated using 84 samples submitted to different pre-analytical conditions. FINDINGS: Sensitivity and negative predictive value were directly affected by sample storage conditions. RT-PCR and virus isolation showed greater dependence on well-conserved samples for an accurate diagnosis. Interestingly, even storage at -30ºC for a relatively short time (15 days) was not adequate for accurate results using virus isolation and RT-PCR tests. On the other hand, NS1 ELISA showed no significant reduction in positivity for aliquots tested under the same conditions as in the previous tests. MAIN CONCLUSIONS: Our results support the stability of the NS1 marker in ELISA diagnosis and indicate that the accuracy of routine tests such as virus isolation and RT-PCR is significantly affected by inadequate transport and storage conditions of serum samples.


Asunto(s)
Antígenos Virales/sangre , Virus del Dengue/aislamiento & purificación , Dengue/diagnóstico , Ensayo de Inmunoadsorción Enzimática/métodos , Pruebas Inmunológicas/métodos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Proteínas no Estructurales Virales/inmunología , Anticuerpos Antivirales/sangre , Antígenos Virales/inmunología , Dengue/sangre , Dengue/virología , Virus del Dengue/genética , Virus del Dengue/inmunología , Humanos , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Proteínas no Estructurales Virales/genética
18.
Aten. prim. (Barc., Ed. impr.) ; 53(1): 73-80, ene. 2021. tab, graf
Artículo en Español | IBECS | ID: ibc-200092

RESUMEN

OBJETIVO: Valorar los resultados obtenidos por una red de vigilancia epidemiológica y asistencial de arbovirosis compuesta por médicos y profesionales de enfermería de hospital y atención primaria (AP) formados en su identificación, confirmación diagnóstica y manejo clínico. Emplazamiento: Zona Sanitaria Metropolitana Norte de Barcelona (1.400.000 habitantes; Cataluña, España) durante un año natural. PARTICIPANTES: Diecisiete médicos (7 de AP y 10 hospitalarios) más 4 enfermeros/as de AP. Tipo de estudio: Estudio observacional prospectivo. Mediciones principales: Se definieron variables demográficas, epidemiológicas (caso autóctono/importado, sospechoso/probable/confirmado) y asistenciales (síntomas, perfil serológico, periodo virémico). RESULTADOS: De los 34 pacientes identificados cumplían criterios de estudio 26 (76,5%) casos; de ellos, se confirmó alguna arbovirosis en 14 (53,8%): 13 fiebres dengues más 1 chikungunya. No se registraron casos de fiebre de zika. Existían antecedentes de viaje a zonas endémicas (23; 88,4%), pero no en 3 casos (11,6%), en los que se consideró la posibilidad de una transmisión autóctona; de ellos, se confirmó un caso de dengue. La incidencia estimada de arbovirosis fue de 0,4 (IC 95%: 0,33-0,51) casos × 10.000 hab./año, que, comparada con la incidencia estimada en la misma área geográfica durante el periodo 2009-2013 (0,19 casos ×10.000hab./año; IC 95%: 0,07-0,31), mostró un incremento significativo (p = 0,044). Los pacientes en periodo de viremia al momento de la primera visita médica fueron 11 (42,3%). CONCLUSIONES: Un programa de vigilancia epidemiológica intensificada definido a nivel de AP y hospitalario es capaz de detectar significativamente más casos de arbovirosis importadas y transmitidas autóctonamente. Posiblemente asistimos a un aumento en la incidencia de arbovirosis importadas, por lo que las medidas encaminadas a su identificación y confirmación deben reforzarse


OBJECTIVE: To evaluate the results obtained by a surveillance network on arbovirosis composed by doctors and nurses located at hospitals and Primary Care trained in their identification, diagnostic confirmation and clinical management. LOCATION: North Metropolitan Area of Barcelona (1,400,000 inhabitants; Catalonia; Spain) during a calendar year. PARTICIPANTS: Seven Primary Care and 10 hospital physicians plus 4 Primary Care nurses. Type of study: A prospective observational study. MAIN MEASUREMENTS: Demographic, epidemiological (autochthonous/imported, suspect/probable/confirmed case) and healthcare variables (symptoms, serological profile, viral period) were defined. RESULTS: Of the 34 patients identified, 26 (76.5%) met study criteria. Among them, any arbovirosis was confirmed in 14 (53.8%): 13 dengue plus 1 chikungunya fever. There were no cases of Zika fever. There was a history of travel to endemic areas 23 (88.4%), but not in 3 cases (11.6%) in which the possibility of an indigenous transmission was considered; of them, a case of dengue was confirmed. The estimated incidence of arbovirosis was 0.4 (95% CI: 0.33-0.51) cases × 10,000 hab/year which, when compared to the estimated incidence in the same geographical area during the period 2009-2013 (0.19 cases × 10,000 hab/year; 95% CI: 0.07-0.31), a significant increase was found (P = .044). Patients within viremia period at the time of their first medical visit were 11 (42.3%). CONCLUSIONS: An intensified epidemiological surveillance program defined at Primary Care and hospital levels is able to detect significantly more cases of imported and autochthonous arbovirosis. Possibly we are witnessing an increase in the incidence of imported arbovirosis and, thus, measures aimed at their identification and confirmation should be reinforced


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Monitoreo Epidemiológico , Infecciones por Arbovirus/epidemiología , Infecciones por Arbovirus/diagnóstico , Atención Primaria de Salud , Estudios Prospectivos , Infecciones por Arbovirus/terapia , Dengue/diagnóstico , Dengue/epidemiología , Dengue/terapia , Reacción en Cadena de la Polimerasa , España/epidemiología
20.
BMC Infect Dis ; 21(1): 104, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33482756

RESUMEN

BACKGROUND: Dengue virus (DENV) infection is increasingly common in southern China and can be transmitted through blood transfusion but is not currently part of donor screening throughout the region. We assessed DENV prevalence among donors at the Xishuangbanna Blood Center, Yunnan, to support development of DENV screening strategies. METHODS: Blood samples were collected randomly between June 2019 and August 2019. These were screened for anti-DENV IgG and IgM using enzyme-linked immunosorbent assay (ELISA). Then, all reactive samples and some randomly-chosen non-reactive samples were used to detect DENV RNAs using real-time polymerase-chain-reaction (RT-PCR) assays. After RT-PCR, samples were further tested for soluble nonstructural protein 1 (NS1) using the colloidal gold method. Donors demographics were also collected and assessed. RESULTS: Over the study period, 2254 donor samples were collected and tested for anti-DENV IgG and IgM by ELISA. This revealed 598 anti-DENV IgG and/or IgM reactive samples, a serological prevalence of 26.53%. Of these, 26 were RT-PCR positive and/or NS1 positive. Significant differences in DENV prevalence were noted by occupation (P = 0.001), education (P < 0.001), and ethnicity (P = 0.026). CONCLUSION: The prevalence of DENV in Xishuangbanna Blood Center was higher than most other blood centers that have implemented DENV donor screening. Our study provides first-hand data about the prevalence of DENV and allows the development of a screening strategy for clinical use.


Asunto(s)
Donantes de Sangre , Virus del Dengue/aislamiento & purificación , Dengue/diagnóstico , Dengue/epidemiología , Tamizaje Masivo/métodos , Adulto , Anticuerpos Antivirales/sangre , China/epidemiología , Dengue/sangre , Virus del Dengue/genética , Virus del Dengue/inmunología , Femenino , Humanos , Masculino , Tamizaje Masivo/estadística & datos numéricos , Persona de Mediana Edad , Prevalencia , ARN Viral/genética , Proteínas no Estructurales Virales/genética , Adulto Joven
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