Epidemiological trends and clinical manifestations of Dengue among children in one of the English-speaking Caribbean countries

Abstract

The epidemiology and clinical presentation of dengue fever among children in the Caribbean is poorly characterized. We therefore studied the epidemiology, clinical presentation, immunological characteristics, morbidity and mortality from dengue virus infection among children in Barbados, one of the English-speaking Caribbean countries. In this population-based, retrospective descriptive study, we screened all children on the island up to the age of 16 years who presented over a 10-year period (January 2000 through December 2009) with febrile illness and suspected dengue virus infection (n = 1809). We report on all the laboratory-confirmed cases of dengue (702/1809), for 545 of which we had complete clinical data. The annual incidence of dengue virus infection among children ranged between 0.29 and 2.92 cases/1000 children, with most cases seen during October through January. Children presented with undifferentiated fever (287/545, 53%), classical dengue fever (225/545, 41%), dengue hemorrhagic fever (15/545, 3%) and expanded dengue syndrome (i.e. severe involvement of liver, kidneys, brain, heart, or other unusual manifestations) (18/545, 3%). In most cases (73%), the infection was secondary. Thirty per cent of cases were diagnosed among hospitalized children and the overall crude mortality rate was 0.3%. Our study for the first time describes the epidemiology and disease characterization of dengue in Barbados, and quantifies the morbidity and mortality among children for this rapidly emerging public health problem in the Caribbean sub-region of the Americas.