Dataset Information

Risk prediction for severe disease and better diagnostic accuracy in early dengue infection; the Colombo dengue study.

ABSTRACT:

Background

A major challenge in dengue management in resource limited settings is the confirmation of diagnosis. Clinical features of dengue often overlap with other infections and molecular diagnostic tools are not readily accessible to clinicians at hospitals. In addition, the prediction of plasma leakage in dengue is also difficult. Hematocrit level and ultrasound scans (combined with clinical parameters) are helpful to detect plasma leakage once it has happened, not before.

Methods

Colombo Dengue Study (CDS) is a prospective cohort study of clinically suspected adult dengue patients recruited from the National hospital of Sri Lanka (within the first 3?days of fever) that aimed to a) identify clinical and basic laboratory test parameters to differentiate dengue from non-dengue fever, b) evaluate the comparative efficacy of loop-mediated isothermal amplification (LAMP) for dengue diagnosis (vs. NS1 antigen test and RT-qPCR) and c) identify early associations that are predictive of plasma leakage or severe dengue. The basic laboratory tests considered here included hematological parameters, serum biochemistry and inflammatory markers.

Results

Only 70% of clinically suspected patients were confirmed as having dengue by either the NS1 antigen test or RT-qPCR. On a Bayesian latent class model which assumes no "gold standard", LAMP performed equally or better than RT-qPCR and NS1 antigen test respectively. When confirmed dengue patients were compared with others, the earlier group had significantly lower lymphocyte counts and higher aspartate aminotransferase levels (AST) within the first 3?days of fever. Confirmed dengue patients with plasma leakage had a lower mean age and a higher median baseline AST level compared to those without plasma leakage (p?ConclusionClinical suspicion overestimates the true number of dengue patients. RT-LAMP is a potentially useful low-cost diagnostic tool for dengue diagnosis. Confirmed dengue patients had significantly higher AST levels and lower lymphocyte counts in early disease compared to others. In confirmed dengue patients, younger age and a higher AST level in early infection were associated with subsequent plasma leakage.

SUBMITTER: Sigera PC

PROVIDER: S-EPMC6676631 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Risk prediction for severe disease and better diagnostic accuracy in early dengue infection; the Colombo dengue study.

Sigera Ponsuge Chathurani PC Amarasekara Ranmalee R Rodrigo Chaturaka C Rajapakse Senaka S Weeratunga Praveen P De Silva Nipun Lakshita NL Huang Chun Hong CH Sahoo Malaya K MK Pinsky Benjamin A BA Pillai Dylan R DR Tissera Hasitha A HA Jayasinghe Saroj S Handunnetti Shiroma S Fernando Sumadhya D SD

BMC infectious diseases 20190801 1

<h4>Background</h4>A major challenge in dengue management in resource limited settings is the confirmation of diagnosis. Clinical features of dengue often overlap with other infections and molecular diagnostic tools are not readily accessible to clinicians at hospitals. In addition, the prediction of plasma leakage in dengue is also difficult. Hematocrit level and ultrasound scans (combined with clinical parameters) are helpful to detect plasma leakage once it has happened, not before.<h4>Method ...[more]

PMID: 31370795

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Dataset Information

Risk prediction for severe disease and better diagnostic accuracy in early dengue infection; the Colombo dengue study.

Background

Methods

Results

Publications

Risk prediction for severe disease and better diagnostic accuracy in early dengue infection; the Colombo dengue study.

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