Patterns of signs, symptoms, and laboratory values associated with Zika, dengue, and undefined acute illnesses in a dengue endemic region: Secondary analysis of a prospective cohort study in southern Mexico

International Journal of Infectious Diseases

Ana M. Ortega-Villa¹  Jesús Sepulveda²  Héctor Armando Rincón León³  Emilia Ruiz Hernández⁴  Pablo F. Belaunzarán-Zamudio⁵  José Gabriel Nájera Cancino⁶  Martha Nason⁷  Paola del Carmen Guerra de Blas⁷  Sandra Caballero Sosa⁸  Sally Hunsberger⁹  John H. Powers, III⁹  Keith Lumbard⁹  Guillermo Ruiz-Palacios^1,10 

[1]Corresponding author at: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.

[2]Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA

[3]Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA

[4]Clínica Hospital Dr. Roberto Nettel Flores, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, Mexico

[5]Departamento de Infectologia, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City, Mexico

[6]Hospital General de Tapachula, Tapachula, Chiapas, Mexico

[7]Hospital Regional de Alta Especialidad Ciudad Salud, Tapachula, Mexico

[8]Instituto Mexicano del Seguro Social, Delegación Estatal, Tapachula, Chiapas, Mexico

[9]National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

[10]The Mexican Emerging Infectious Diseases Clinical Research Network (LaRed), Mexico City, Mexico

关键词: Arbovirus infections;    Signs;    Symptoms;    Laboratory values;    Diagnosis;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objectives: Dengue and Zika infections cause illnesses with overlapping clinical manifestations. The aim of this study was to explore the association of each of these infections with single or grouped clinical and laboratory parameters. Methods: Clinical and laboratory data were collected prospectively from a cohort of patients seeking care for symptoms meeting the Pan American Health Organization’s modified case-definition criteria for probable Zika virus infection. Zika and dengue were diagnosed with RT-PCR. The relationship of clinical characteristics and laboratory data with Zika, dengue, and undefined acute illness (UAI) was examined. Results: In the univariate models, localized rash and maculopapular exanthema were associated with Zika infection. Generalized rash, petechiae, and petechial purpuric rash were associated with dengue. Cough and confusion/disorientation were associated with UAI. Platelets were significantly lower in the dengue group. A conditional inference tree model showed poor sensitivity and positive predictive value for individual viral diagnoses. Conclusions: Clusters of signs, symptoms, and laboratory values evaluated in this study could not consistently differentiate Zika or dengue cases from UAI in the clinical setting at the individual patient level. We identified symptoms that are important to Zika and dengue in the univariate analyses, but predictive models were unreliable. Low platelet count was a distinctive feature of dengue.

【 授权许可】

Unknown