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A Simple Flow Cytometry Based Assay to Determine In Vitro Antibody Dependent Enhancement of Dengue Virus Using Zika Virus Convalescent Serum
Published on: April 10, 2018
[Early indicators of dengue infection in children]
F A Díaz-Quijano1, L A Villar-Centeno, R A Martínez-Vega
1Centro de Investigaciones Epidemiológicas, Facultad de Salud, Universidad Industrial de Santander, Ctra. 32 no. 29-31, Bucaramanga, Colombia. fre_diazq@yahoo.com
Insights
Early dengue diagnosis in children is possible using specific clinical signs like no nasal discharge and facial flushing, alongside laboratory results such as low white blood cell count. These indicators improve early detection of dengue fever.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Diagnostics
Context:
- Dengue fever poses a significant health risk to children, often presenting with non-specific febrile symptoms.
- Accurate and timely diagnosis is crucial for effective management and to prevent severe complications.
Purpose:
- To identify key clinical manifestations and laboratory findings for the early diagnosis of dengue in pediatric patients.
- To evaluate the diagnostic accuracy of specific indicators in children with acute febrile illness.
Summary:
- A prospective study of 125 children identified absence of nasal discharge, facial flushing, and leukocyte count ≤ 4,500/µL as independent indicators for dengue.
- Combining these with coagulation tests (prothrombin time > 14s, PTT > 29s) significantly improved diagnostic sensitivity and specificity, especially with three or four indicators.
Impact:
- The findings suggest that a combination of simple clinical observations and basic laboratory tests can significantly aid in the early detection of dengue in children.
- This could lead to earlier intervention and potentially better patient outcomes in endemic areas.
Objective:
To identify clinical manifestations and laboratory findings useful for the early diagnosis of dengue in children.
Materials And Methods:
We prospectively evaluated 125 children (aged 5 to 12 years old) with acute febrile syndrome with no apparent etiology. Paired serologic tests and/or viral culture were performed and dengue infection was confirmed in 40 patients and ruled out in 68 (17 indefinite cases). Early clinical manifestations (within the first 4 days of the disease) in the groups with dengue and other causes of febrile syndrome were compared. Independent indicators of dengue were determined in a multivariate logistic regression analysis.
Results:
When clinical manifestations and complete blood count were considered, the independent indicators of dengue were: absence of nasal discharge, facial flushing, and leukocyte count < or = 4,500/.l. With at least two of these findings, a sensitivity of 67 % and a specificity of 72 % for the diagnosis of dengue were obtained. When coagulation tests were considered, a model for diagnosis was composed of: absence of nasal discharge, leukocyte count < or = 4500/.l, prothrombin time > 14 seconds, and partial thromboplastin time > 29 seconds. Two of these findings suggested a diagnosis of dengue with a sensitivity of 90 % and a specificity of 52.9 %. With at least 3 findings, specificity increased to 89.7 % and sensitivity decreased to 50 %. The presence of the four components of this latter model shows a specificity of 100 %.
Conclusions:
Some clinical manifestations and simple laboratory tests could aid the early detection of dengue infection in children.
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