The timing setting in kinetic dengue studies: A systematic review

Area of Science:

• Virology
• Epidemiology
• Infectious Diseases

Background:

• Dengue fever is an endemic infectious disease transmitted by Aedes mosquitoes.
• Kinetic studies monitoring viral load are crucial for dengue control.
• Standardization of timing systems in these studies is lacking.

Purpose of the Study:

• To systematically evaluate the diverse timing systems employed in dengue kinetic studies.
• To identify inconsistencies in the definition of key time points like illness onset and defervescence.
• To assess the impact of these inconsistencies on research findings and treatment guidelines.

Main Methods:

• A comprehensive search of nine electronic databases and manual reference/citation list searches was conducted.
• Eighty-seven relevant studies were included in the systematic evaluation.
• Quality assessment was performed using National Institute of Health tools for observational and cross-sectional studies.

Main Results:

• The majority of studies (81.6%) used illness onset as the reference day, with 60 studies (type 1B) defining it as 'day 1' and 11 (type 1A) as 'day 0'.
• Only 11.5% of studies used defervescence as 'day 0'.
• Other timing systems included hospital admission (4.6%), hemorrhagic manifestation (2.3%), and pharmacological treatment (2.3%).

Conclusions:

• The most common timing system in dengue kinetic studies defines illness onset as 'day 1'.
• Significant inconsistencies exist in defining 'day 0' and 'day 1' across studies.
• These variations can lead to disparities in results and hinder the implementation of effective treatment guidelines.