The Early Clinical Features of Dengue in Adults: Challenges for Early Clinical Diagnosis
2011

Early Clinical Features of Dengue in Adults

Sample size: 2129 publication 10 minutes Evidence: high

Author Information

Author(s): Low Jenny G. H., Ong Adrian, Tan Li Kiang, Chaterji Shera, Chow Angelia, Lim Wen Yan, Lee Koon Wui, Chua Robert, Chua Choon Rong, Tan Sharon W. S., Cheung Yin Bun, Hibberd Martin L., Vasudevan Subhash G., Ng Lee-Ching, Leo Yee Sin, Ooi Eng Eong

Primary Institution: Duke-NUS Graduate Medical School, Singapore

Hypothesis

How do the clinical features of dengue in adults differ by age group?

Conclusion

Early clinical diagnosis of dengue is challenging in older adults due to reduced sensitivity of symptom classification schemes.

Supporting Evidence

  • Dengue cases presented with high rates of symptoms listed in WHO classification schemes.
  • Older adults reported fewer symptoms, reducing the sensitivity of classification schemes.
  • Hospitalization rates for dengue were significantly higher in older adults.
  • Leukopenia was more pronounced in older adults with dengue.
  • Symptoms like myalgia and arthralgia decreased with age.

Takeaway

Dengue can be hard to diagnose in older people because they don't show the usual symptoms as much as younger people do.

Methodology

A prospective study of adults presenting with acute febrile illness was conducted, with follow-up over 3-4 weeks.

Potential Biases

Potential over-hospitalization of dengue cases due to national guidelines.

Limitations

The study had a small number of severe dengue cases, limiting analysis of predictive parameters for severe illness.

Participant Demographics

Median age of dengue cases was 39 years; 60.8% were male.

Statistical Information

P-Value

p<0.0001

Confidence Interval

95% CI

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pntd.0001191

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