From primary care to hospitalization: clinical warning signs of severe dengue fever in children and adolescents during an outbreak in Rio de Janeiro, Brazil

Cadernos de Saúde Pública

Gerusa Gibson²  Reinaldo Souza-santos²  Patrícia Brasil¹  Antonio Guilherme Pacheco²  Oswaldo G. Cruz¹  Nildimar Alves Honório¹  Claire Kubelka¹  Marilia Sá Carvalho¹ 

[1] ,Fundação Oswaldo Cruz Rio de Janeiro ,Brazil

关键词: Dengue;    Epidemics;    Signs and Symptoms;    Dengue;    Epidemias;    Sinais e Sintomas;    Dengue;    Epidemias;    Signos y Síntomas;   

DOI  :  10.1590/S0102-311X2013000100010

来源: SciELO

【 摘 要 】

We analyzed factors associated with severe cases of dengue in children and adolescents hospitalized during the 2007/2008 epidemic in Rio de Janeiro, Brazil. This is a retrospective case-control study that covers 88 cases of severe dengue in patients admitted to four tertiary care children's hospitals. Controls consisted of 22 children with non-severe dengue living in the same neighborhood as the patients with severe dengue. Differences in prevalence of the clinical signs - abdominal pain, breathing difficulty, drowsiness or irritability - emerged on the third day after the onset of symptoms, in the febrile stage. Cases and controls received first medical care at the same clinical stage of disease. However, hospital admission of severe cases occurred later, on average between the third and fourth day after the onset of the disease. Early discharge of patients with fever whose condition could have progressed to severe dengue may have been a consequence of the type of medical assistance provided by primary care units, suggesting deficiencies both in the use of the risk classification protocol and patient triage.

【 授权许可】

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