Dengue Hemorrhagic Fever Patients Research Articles

The alteration of NK cells phenotypes related to the functions and dengue disease outcomes

Natural killer cells (NK cells) are the front line of immune cells to combat pathogens and able to influence the subsequent adaptive immune responses. One of the factors contributing to pathogenesis in dengue hemorrhagic fever (DHF) disease is aberrant immune activation during early phase of infection. This study explored the profile of NK cells in dengue infected pediatric patients with different degrees of disease severity. DHF patients contained higher frequency of activated NK cells but lower ratio of CD56dim:CD56bright NK subsets. Activated NK cells exhibited alterations in several NK receptors. Interestingly, the frequencies of NKp30 expressing activated NK cells were more pronounced in dengue fever (DF) than in DHF pediatric patients. In vitro functional analysis indicated that degranulation of NK cells in responding to dengue infected dendritic cells (DCs) required cell-cell contact and type I IFNs. Meanwhile, Interferon gamma (IFN-γ) production initially required cell-cell contact and type I IFNs followed by Interleukin-12 (IL-12), Interleukin-15 (IL-15) and Interleukin-18 (IL-18) resulting in the amplification of IFN-γ producing NK cells over time. This study highlighted the complexity and the factors influencing NK cells responses to dengue virus. Degree of activation, phenotypes of activated cells and the crosstalk between NK cells and other immune cells, could modulate the outcome of NK cells function in the dengue disease.

HUBUNGAN IgG DAN IgM DENGUE TERHADAP JUMLAH TROMBOSIT PADA PASIEN DEMAM BERDARAH DENGUE DI RUMAH SAKIT PENDIDIKAN PROF.dr.CHAIRUDDIN PANUSUNAN LUBIS UNIVERSITAS SUMATERA UTARA

The immune responses that play a role in DHF cases are Immunoglobulin M (IgM) and Immunoglobulin G (IgG). In primary Dengue infection, IgM begins to form and is detected on the third to fifth day, whereas in secondary Dengue infection, IgG levels will increase and then remain in the human body with low titers for life. Thrombocytopenia occurs in DHF patients due to antigen-antibody reactions and activation of the complement system which causes deposition of IgM and IgG immune cells on the surface of platelet cells. This causes reticuloendothelial cells to destroy platelets so that DHF patients will experience thrombocytopenia. To find out the analysis of dengue IgG and IgM examination on the results of platelet counts in dengue hemorrhagic fever patients at Prof. Teaching Hospital. dr. Chairuddin Panusunan Lubis, University of North Sumatra. The research used is descriptive quantitative. The examination method used is Dengue IgG and IgM Dengue Rapid Test, Platelet Count Examination using a Hematology Analyzer. The number of respondents is 11 samples taken by total sampling technique. Based on the results of a study of Dengue IgG and IgM in Dengue Hemorrhagic Fever patients at Prof. Teaching Hospital. dr. Chairuddin Panusunan Lubis, University of North Sumatra who had IgG + and IgM levels - more, namely 10 (92%) patients, IgG - and IgM + as many as 1 (8%) patients. Based on the number of platelets obtained in Dengue Hemorrhagic Fever patients at Prof. Teaching Hospital. dr. Chairuddin Panusunan Lubisa, University of North Sumatra, which decreased by 9 patients, and there were some who had normal platelet counts of 2 patients. There is no relationship between Dengue IgG and IgM on platelet count in Dengue Hemorrhagic Fever patients.

Ketepatan Pengkodean Diagnosis Demam Berdarah Dengue Berdasarkan Hasil Pemeriksaan Klinis di Rumah Sakit Singaparna Medika Citrautama

One of the supporting units in the hospital, namely medical records, is a manual / electronic record carried out by health care providers such as diagnosis. One of the medical record activities is to code the disease. Coding is the provision of alphanumeric symbols carried out by the coder. The diagnosis coding provided must be correct in accordance with the codes listed in ICD-10, the correct coding will affect hospital health financing. The research was conducted at Medika Citra Utama Hospital. This study aims to describe the coding procedures and accuracy of disease diagnosis using a cross sectional design. The population of cases in this study were medical records of dengue haemorrhagic fever patients from January to December 2022. The number of samples was 98 medical records. The sampling technique used was simple random sampling. The results of the study of diagnosis coding procedures carried out by the coder have not been in accordance with the steps that have been determined by ICD-10 volume 2 due to the busyness of officers in carrying out other activities and there are 78.6% of medical records that are appropriate and in accordance with the results of clinical examinations, 21.4% of medical records that are not appropriate and do not match the results of clinical examinations resulting in pending claims at the hospital. The conclusion of this study is that coder officers are expected to do coding referring to ICD-Volume 2 and pay attention to clinical examination in order to get accurate coding so that hospital claims are claimed on time.

Cytokine profiles in dengue fever and dengue hemorrhagic fever: A study from Indonesia

Recent studies have demonstrated that cytokine dysregulation has a critical role in the pathogenesis of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The aim of this study was to investigate the association between tumor necrosis factor (TNF-α), interleukin 6 (IL-6), interleukin 10 (IL-10), and interleukin 17 (IL-17) with infection status, and severity of dengue. A prospective cross-sectional study was conducted at three hospitals in Gianyar regency and Denpasar municipality, Bali, Indonesia, from June to December 2022. Sixty-four dengue infected patients were involved. Patients’ serum was tested for dengue infection using NS1 antigen rapid test, dengue virus immunoglobulin M (IgM) and immunoglobulin G (IgG) test, and reverse transcription polymerase chain reaction (RT-PCR). Cytokine levels (TNF-α, IL-6, IL-10, and IL-17) were measured using enzyme-linked immunosorbent assay (ELISA). Infection status was determined by combining serological and RT-PCR results, categorizing patients into primary and secondary infections. The present study found that DF patients had lower TNF-α, IL-6, and IL-17 but higher IL-10 levels compared to DHF patients (p<0.001). Elevated TNF-α, IL-6, and IL-17 levels were higher in secondary infection, while IL-10 level was higher in primary infection (p<0.001). In conclusion, cytokines play a crucial role in the interplay between cytokine dysregulation and dengue infection dynamics.

Implementation of Fuzzy K-Nearest Neighbor Method in Dengue Disiase Classification

Dengue hemorrhagic fever (DHF) is a condition brought on by infection with the dengue virus. DHF is a severe illness with hemorrhagic clinical signs that can result in shock and death. One of the four viral serotypes of the genus Flavivirus is responsible for DHF. DHF symptoms include fever, joint pain, red skin patches, and others that are similar to those of other illnesses. So that there are no errors in illness prediction, strong accuracy and accuracy are required when classifying DHF patients or not. The Fuzzy K-Nearest Neighbor (FKNN) method is used in this study to classify dengue sickness in order to obtain the best classification outcomes. In this investigation, k was searched for eight times, with values of 3,5,7,9,11,13,15, and 20. Each K's accuracy statistics are 75.15, 75.16, 77.58%, 79.51%, 85.01%, 78.14%, and 75.20 percent. K = 13, which has an accuracy score of 85.01%, yields the highest accuracy.

THE RELATION BETWEEN THE NEUTROFIL LYMPHOCYTE RATIO (NLR) AND THE DEGREE OF DENGUE HEMORRHAGIC FEVER IN THE INPATIENT INSTALLATION OF ARI CANTI HOSPITAL FOR THE PERIOD OF APRIL 2022 – MAY 2023

Dengue Hemorrhagic Fever is caused by dengue virus infection which can cause death and cause an outbreak. Neutrophil lymphocyte ratio (NLR) is one of the cheap laboratory parameters and can predict plasma leakage in the critical period of dengue hemorrhagic fever. This study aims to determine the profile of dengue hemorrhagic fever patients and the relationship between the neutrophil lymphocyte ratio and the degree of dengue hemorrhagic fever in patients treated at Ari Canti Hospital for the period April 2022 – May 2023.  This research is a retrospective analytical study with a cross-sectional approach using secondary data from archives at the Ari Canti Hospital Inpatient Installation for the period April 2022-May 2023. Data collection in the form of gender, age, neutrophil lymphocyte ratio and degree of dengue hemorrhagic fever was carried out using the convenient purposive sampling method. This study shows that the highest age group is the 26-35-year age group 35.7%, the highest gender is male 55.3% with cases of dengue hemorrhagic fever without shock 89.2% and a neutrophil lymphocyte ratio (NLR) of >2 as much as 64.2%. The result of  Mann Whitney non-parametric test, showed that p value <0.0001. There is a significant relationship between NLR and the degree of dengue hemorrhagic fever in patients hospitalized at Ari Canti Hospital in April 2022, May 2023.
 Keywords : dengue virus., dengue hemorrhagic fever., hospitalization., neutrophil lymphocyte ratio

Platelet Modeling in DHF Patients Using Local Polynomial Semiparametric Regression on Longitudinal Data

Regression analysis is one of the statistical methods used to model the relationship between response variables and predictor variables. Semiparametric regression is a combination of parametric and nonparametric regression. The estimator used in estimating the semiparametric regression model in this research is the Local Polynomial. Longitudinal data can be found in the health sector, including dengue hemorrhagic fever (DHF) data. The laboratory criteria for indication of DHF is thrombocytopenia. This research aims to obtain platelets model for DHF patients that can be used for forecasting so that it is hoped that it can provide information to the medical team in treating DHF patients. The estimated model used is Local Polynomial semiparametric regression on longitudinal data. The response variables in this research were platelets of DHF patients, which were influenced by hemoglobin as parametric predictor variable and examination time while hospitalized as nonparametric predictor variable. In the local polynomial regression model, it is necessary to select the optimal bandwidth and polynomial order method, GCV. The optimum bandwidth selection based on the GCV method obtained is 1.5 and polynomial order of 2, then applied to DHF patient platelet data, producing an estimated local polynomial semiparametric regression model that follows the actual data pattern. Modeling the platelets of DHF patients obtained using a local polynomial estimator resulted in an R2 value of 84.25% and MAPE of 4.5%, indicating highly accurate forecasting, so it can be concluded that the resulting model is better at predicting.

Navigating the Haematological Maze: Unraveling the Role of NLR and PLR as Predictors of Dengue Severity- A Cross-sectional Study from Southern India

Introduction: Dengue Fever (DF) poses a critical public health threat in tropical regions, displaying a spectrum of manifestations without distinct diagnostic hallmarks. Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) are useful biomarkers of inflammation and prognostic markers in various diseases. The inflammation that occurs in dengue is due to the exaggerated response of the immune system. Aim: To assess the utility value of NLR and PLR as prognostic markers for dengue severity. Materials and Methods: A cross-sectional study was conducted on 99 admitted Dengue patients. Patients were grouped into three categories: DF, Dengue Haemorrhagic Fever (DHF), and Dengue Shock Syndrome (DSS). Various parameters of Complete Blood Count (CBC), NLR, and PLR were compared among the groups using Analysis of Variance (ANOVA) test (p-value <0.05 considered significant). Sensitivity, specificity, and accuracy were calculated using Receiver Operating Characteristic (ROC) curve. Results: Among the 99 patients, 63.6% exhibited thrombocytopenia (platelet count <1.5 lac/dL), and 7% of patients had a platelet count <20,000/dL. All DHF and DSS patients had thrombocytopenia. Leucopenia was evident in 45.45% of patients, with 6% having a Total Leukocyte Count (TLC) <2000/dL. TLC remained stable across these stages. The mean NLR in DF was 2.47 (range 0.1-15.4), in DHF it was 1.013 (range 0.2-3.2), and in DSS it was 0.41 (range 0.08- 0.65.17) with a p-value of 0.02. The PLR displayed substantial differences, with mean values of 134.4 (range 10.1-273.8) for DF, 50.57 (range 7.1-96.1) for DHF, and 10.39 (range 3.1-38.8) for DSS with a p-value of 0.003. NLR had 63% accuracy, 77.8% sensitivity, and 94.4% specificity. PLR had 81.5% accuracy, 93.3% sensitivity and 33.3% specificity. Conclusion: The specificity of NLR was higher, while PLR exhibited superior accuracy and sensitivity in detecting severe cases.

PEMODELAN JUMLAH KASUS DEMAM BERDARAH DENGUE DENGAN MENGGUNAKAN MODEL AUTOREGRESSIVE DISTRIBUTED LAG

This study aims to model dengue hemorrhagic fever (DHF) cases with an autoregressive distributed lag (ARDL) model to investigate significant predictor variables in Bojonegoro Regency. The selected predictor variables are the percentage of poverty, population, health facilities, and health workers. A research design with a quantitative approach was used to investigate the predictor variables in dengue cases with the ARDL model and the help of EViews. Stationarity, cointegration, classical assumptions, parameter significance, and model goodness assessment, namely R-square, MSE, AIC, and SBC, were tested. The research data source is secondary data, namely annual data from the reports of the Central Bureau of Statistics and the Health Office in Bojonegoro Regency from 2008 to 2022. The test results show only cointegration in the response variable, so the ARDL model is applied, but the lag distribution is only done on the response variable. In testing the significance of the parameters, it was found that an increase in the health workforce significantly affected the decrease in the number of DHF patients. At the same time, the other predictor variables were not significant

Comparison of Neutrophil-Lymphocyte Ratio in Patients with COVID-19 and Dengue Hemorrhagic Fever

Coronavirus Disease-19 (COVID-19) and Dengue Hemorrhagic Fever (DHF) can be found together in patients and are difficult to distinguish because they have the same antigenic viral structure, symptoms, and laboratory findings. Neutrophil-Lymphocyte Ratio (NLR) is one of the inflammatory markers that are both easy and have fast results, so it is considered adequate for managing both diseases. This study aimed to compare NLR values and cut-off based on degrees in COVID-19 and DHF patients. The study used data from medical records of 459 COVID-19 patients and 95 DHF patients treated at UNHAS RSPTN and Sayang Rakyat Hospital from July 2020 to August 2021. They had routine hematological examination results when they were first admitted. COVID-19 samples were grouped into severe and moderate degrees, and DHF samples were grouped into DHF without shock and DHF in shock. Mann-Whitney test, independent T-test, and ROC curve were used to compare the two groups (significant if the p-value was <0.05). There was a difference in NLR median between moderate COVID-19 (2.57) and severe COVID-19 (6.39) (p<0.001); between DHF without-shock (0.49) and DHF in-shock (0.43) (p<0.001). Neutrophil lymphocyte ratio cut-off between moderate and severe COVID-19 based on ROC curve was 5.66 (sensitivity 79.6%, specificity 73.5%), and between DHF without-shock and DHF in-shock was 0.39 (sensitivity 93.2%, specificity 83.3%). Neutrophil lymphocyte ratio values in COVID-19 are different from DHF. Neutrophil-lymphocyte ratio values are higher in severe COVID-19 than moderate, while NLR values are lower in DHF in shock rather than without shock.

Analisis Jumlah Trombosit Dan Leukosit Pada Pasien Dengue Hemorrhagic Fever (DHF) Di Rumah Sakit Umum Daerah Kabupaten Barru

Dengue hemorrhagic fever (DHF) is a chronic fever disease caused by infection with the dengue virus which is transmitted through the bite of the Aedes aegypti and Aedes albopictus mosquitoes. Laboratory abnormalities that are often found in DHF patients are thrombocytopenia and leukopenia. This study aims to determine the results of examination of platelet and leukocyte counts in dengue hemorrhagic fever (DHF) patients. This study used a descriptive design with the population being all dengue hemorrhagic fever (DHF) patients at the Barru District General Hospital. The sample consisted of 30 DHF patients whose platelet and leukocyte counts were checked using a hematology analyzer for 3 consecutive days of hospitalization. The sampling technique in this research is the purposive sampling method. The results of the study showed that there were 30 DHF patients consisting of 14 (47%) men and 16 (53%) women with the highest age found `DHF being 8 - 12 years old, 10 people (33.33%). On the first day of hospitalization, 29 people experienced thrombocytopenia and 1 person had normal platelets. On the second day of hospitalization, 25 people experienced thrombocytopenia and 5 people had normal platelets. On the third day of hospitalization, 11 people experienced thrombocytopenia and 19 people had normal platelets. On the first day of hospitalization, 17 people experienced leukopenia, 11 people had normal leukocytes and 2 people had leukocytosis. On the second day of hospitalization, 8 people experienced leukopenia and 22 people had normal leukocytes. On the third day of hospitalization, 3 people experienced leukopenia and 27 people had normal leukocytes. This study shows that the majority of DHF patients experience thrombocytopenia while the platelet count tends to be normal.

PENGETAHUAN, KUALITAS HIDUP DAN BIAYA SAKIT PASIEN DENGUE DI RS PKU MUHAMMADIYAH GAMPING

The incidence of dengue virus infection in the D.I. Yogyakarta reached 3,618 cases in 2020. Based on its clinical manifestations, dengue virus infection is divided into Dengue Fever (DF), Dengue Haemorrhagic Fever (DHF), and Dengue Shock Syndrome (DSS). This study aims to identify the level of knowledge, quality of life, and costs of dengue patients at PKU Muhammadiyah Gamping Hospital from March 2021 to October 2021. This study used a cross-sectional design. The measurement of the patient's knowledge level used a questionnaire knowledge of dengue, while the quality of life was assessed using EQ-5D-5L for adult patients and EQ-5D-Y for pediatric patients. The cost of illness data from the hospital finance database. This study involved 31 respondents with the characteristics aged 16-40 years (54.84%), male (87.1%), using BPJS insurance (80.65%), and an average length of stay of 4 days (51.61%). The patient's level of knowledge about dengue, knowledge of dengue prevention, and dengue prevention behavior reached 74.20% (sufficient), 74.20% (sufficient), and 77.42% (sufficient) respectively. The quality of life of dengue patients reached 100% and 85.2% in DF patients, while the DHF patients felt a few anxious/depressed (sad). The average cost of illness in DF patients was Rp. 2,796,386 and Rp. 3,378,537 in DHF patients.

The implementation of digital application in reducing Dengue Hemorrhagic Fever (DHF) infection rate from an economic loss perspective as an effort to achieve the Sustainable Development Goals

Background: Dengue Hemorrhagic Fever (DHF) is a disease caused by the dengue virus transmitted through the Aedes aegypti mosquito and is most commonly found in tropical regions. In contemporary society, there is significant emphasis on infectious diseases. DHF is a tropical disease that falls under the third indicator of the Sustainable Development Goals (SDGs). DHF poses a significant global public health problem. Currently, its prevalence is spread across more than 100 countries worldwide. Over three decades, the severity of DHF has shown a significant increase across the Southeast Asian region. In 2021, Indonesia recorded a total of 73,518 DHF cases with 705 fatalities. In 2022, there were 143,266 reported cases resulting in 1,237 deaths. As of March 2023, there have been a total of 17,434 reported cases with 141 fatalities. These DHF case incidence figures indicate a considerable increase.Purpose: To reduce DHF cases in South Tangerang City by creating an innovative digital application which is called “Pakar” from an economic loss perspective.Method: This research adopts a mixed-method approach with exploratory research. The research begins with a qualitative phase to design the application, followed by a quantitative phase to assess the effectiveness of the developed application. The study commences with a Focus Group Discussion (FGD) involving various stakeholders, including the South Tangerang City Health Office, public health centers, and community health workers. Subsequently, the application is developed and tested in selected pilot areas as an initial project. Further testing is conducted using a one-group pre-test post-test design. The experimental procedure includes a pre-test as an initial observation, followed by the intervention, and concludes with a post-test as a final observation.Results: During the pre-test, it was observed that DHF patients had a moderate level of knowledge, with a cumulative percentage of 46%. In contrast, the majority of respondents in the post-test had a high level of knowledge regarding DHF diagnosis, with a percentage of 76%. The paired t-test showed a t-value of -6.306 and the corresponding probability or significance value of 0.000 (p < 0.005).Conclusion: The expert system application, as an innovative approach for DHF mitigation and the experimental assessment of economic impact, is effective as indicated by the pre-post test. Furthermore, it is crucial to consider the economic impact of the costs incurred by DHF patients by placing greater emphasis on improving environmental cleanliness efforts.

The Relationship of Fever Onset with NS1 Examination Results, IgM, and IgG in Dengue Hemorrhagic Fever Patients

Fever onset represents the average number of days from the beginning of fever symptoms to the time when IgM and IgG examinations are conducted. Determining the right timing for these examinations can significantly impact their accuracy. In November 2021, there was a notable surge in cases of Dengue Hemorrhagic Fever at the Karawang Health Center, Sukabumi. This study aimed to investigate the relationship between the duration of fever and the results of dengue antigen and antibody tests. The research employed a descriptive analysis with a cross-sectional approach, and a sample of 50 individuals was gathered through consecutive sampling. The data was then analyzed using the Chi-Square test. The study revealed a positive correlation between the duration of fever and the outcomes of the NS1 and IgG Dengue examinations (p<0.05), highlighting the significance of timing when conducting these tests. NS1 was predominantly detected within the first three days of fever, while IgG showed reactivity after more than five days of fever. These findings underscore the importance of timing when conducting these tests and interpreting their results.

Geographic Accessibility to Primary Healthcare: Study Case Dengue Fever in Purwosari Sub-District, Gunungkidul Regency, Yogyakarta, Indonesia

Distribution and spatial analysis of public healthcare in Indonesia are rarely discussed. Most of the research tell about quantity and quality which do not mention the spatial aspect. This research purposes to know the relationship between health facilities selection and geographic conditions by combining medical facilites data, number of doctor and spatial analysis approach. The selected study areas are referral health facilities chosen by DHF (Dengue Hemorrhagic Fever) patients in Purwosari District, Gunungkidul Regency. Information was collected by interviews and field measurements (altitude and location plotting) and also secondary data collection (hospital accreditation data, number of doctors, and number of beds). GPS, Altimeter, ArcGIS, and SPSS used for data collection and analysis. The spatial analysis method in this research were kernel density, buffer, ruler, and altitude of each facility. Meanwhile, the medical analysis approach used Pearsons' correlation and multinomial logistic regression in SPSS. The results of the spatial analysis show that the DHF patients in Purwosari dominantly choose health facilities in Bantul Regency because of having closer distance, relatively short travel time, lower elevation, and many health facilities centers. At the same time, Puskesmas Purwosari (Sub-district level Health center) was only chosen as an early reference and a place for treating mild dengue patients. In addition, distance, duration of travel time, and the number of doctors had a strong correlation based on the Pearson's correlation. These three variables have the greatest linear relationship with the response variable. Meanwhile, some variables; elevation, number of doctors, accreditation, and number of beds were considered by patients in choosing a hospital based on multinomial logistic regression analysis.

Leucocytes, thrombocytes and immature platelets in patients with dengue hemorrhagic fever

Diagnosis of Dengue Hemorrhagic Fever (DHF) is based on clinical and supporting examinations, including leukocytes and platelets examinations and antigen and antibody tests for the dengue virus. Examining leucocytes, thrombocytes, and immature platelets is a routine protocol in DHF patients. Leucocytes, thrombocytes, and immature platelets in dengue hemorrhagic fever have their characteristics and roles in relation to the disease severity. Prompt and early diagnosis will reduce the risk of disease severity. This review described the characteristics and role of leucocytes, thrombocytes, and immature platelets in dengue hemorrhagic fever.

Characterization of soluble TLR2 and CD14 levels during acute dengue virus infection

Dengue virus infection results in a broad spectrum of diseases ranging from mild dengue fever (DF) to severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Hitherto, there is no consensus biomarker for the prediction of severe dengue disease in patients. Yet, early identification of patients who progress to severe dengue is pivotal for better clinical management. We have recently reported that an increased frequency of classical (CD14 ++CD16−) monocytes with sustained high TLR2 expression in acutely infected dengue patients correlates with severe dengue development. Here, we hypothesized that the relatively lower TLR2 and CD14 expression in mild dengue patients is due to the shedding of their soluble forms (sTLR2 and sCD14) and that these could be used as indicators of disease progression. Therefore, using commercial sandwich ELISAs, we evaluated the release of sTLR2 and sCD14 by peripheral blood mononuclear cells (PBMCs) in response to in vitro dengue virus (DENV) infection and assessed their levels in acute-phase plasma of 109 dengue patients. We show that while both sTLR2 and sCD14 are released by PBMCs in response to DENV infection in vitro, their co-circulation in an acute phase of the disease is not always apparent. In fact, sTLR2 was found only in 20% of patients irrespective of disease status. In contrast, sCD14 levels were detected in all patients and were significantly elevated in DF patients when compared to DHF patients and age-matched healthy donors. Altogether, our results suggest that sCD14 may help in identifying patients at risk of severe dengue at hospital admittance.

Simulation of Hemorrhage Pathogenesis in Mice through Dual Stimulation with Dengue Envelope Protein Domain III-Coated Nanoparticles and Antiplatelet Antibody.

Dengue hemorrhagic fever (DHF) is a severe form of dengue virus (DENV) infection that can lead to abnormal immune responses, endothelial vascular dysfunction, and hemorrhage pathogenesis. The virion-associated envelope protein domain III (EIII) is thought to play a role in the virulence of DENV by damaging endothelial cells. However, it is unclear whether EIII-coated nanoparticles simulating DENV virus particles could cause a more severe pathogenesis than soluble EIII alone. This study aimed to investigate whether EIII-coated silica nanoparticles (EIII-SNPs) could elicit greater cytotoxicity in endothelial cells and hemorrhage pathogenesis in mice compared to EIII or silica nanoparticles alone. The main methods included in vitro assays to assess cytotoxicity and in vivo experiments to examine hemorrhage pathogenesis in mice. EIII-SNPs induced greater endothelial cytotoxicity in vitro than EIII or silica nanoparticles alone. Two-hit combined treatment with EIII-SNPs and antiplatelet antibodies to simulate DHF hemorrhage pathogenesis during secondary DENV infections resulted in higher endothelial cytotoxicity than either treatment alone. In mouse experiments, two-hit combined treatment with EIII-SNPs and antiplatelet antibodies resulted in more severe hemorrhage pathogenesis compared to single treatments of EIII, EIII-SNPs, or antiplatelet antibodies alone. These findings suggest that EIII-coated nanoparticles are more cytotoxic than soluble EIII and could be used to develop a tentative dengue two-hit hemorrhage pathogenesis model in mice. Additionally, our results indicated that EIII-containing DENV particles could potentially exacerbate hemorrhage pathogenesis in DHF patients who have antiplatelet antibodies, highlighting the need for further research on the potential role of EIII in DHF pathogenesis.

The effect of water storage and humidity on the incidence of dengue hemorrhagic fever in the work area of the Kebayakan Health Center, Central Aceh Regency

Background: Dengue Hemorrhagic Fever (DHF) is an acute febrile disease found in the tropics with a geographic distribution like malaria. Dengue fever is spread to humans by the Aedes aegypti mosquito. More than 100 tropical and subtropical countries have experienced dengue eruptions and dengue hemorrhagic fever; approximately 50,000 cases each year are hospitalized, with thousands of people dying. Objective: This study aims to determine the effect of water storage and humidity on the incidence of Dengue Hemorrhagic Fever (DHF) in the work area of the Kebayakan Health Centre, Central Aceh Regency. Materials and Methods: This research is an analytic survey research with a case-control research design. In this case, there were 55 DHF patients consisting of children and the elderly as respondents. Controls were 55 DHF patients consisting of children and the elderly. The analysis used a chi-square test. Result: The results showed that the factors that significantly affected the incidence of DHF were humidity (P=0.002 OR=4.571 95% CI=1.752-11928) and water reservoirs (P=0.004 OR=3.328 95% CI=1.521–7.282). Conclusions: it is hoped that the community will participate in efforts to eradicate dengue hemorrhagic fever (PSN-DHF), and water reservoirs should be cleaned at least once a week to prevent the presence of mosquito larvae and pay more attention to environmental sanitation.

Diagnosis of Acute Dengue Virus Infection Using Enzyme-Linked Immunosorbent Assay and Real-Time PCR.

Dengue fever is a viral infection caused by the dengue virus and is a growing concern for public health worldwide, particularly in tropical and subtropical regions. This study aimed to assess the diagnostic accuracy of a commercially available NS1 ELISA kit for dengue fever in Pakistan using multiplex qRT-PCR as the gold standard. The study recruited 1236 suspected cases of dengue fever admitted to public sector hospitals in Lahore, Pakistan. Of the suspected cases, 610 (49.3%) were confirmed positive for DENV infection through qRT-PCR, with all four serotypes detected. DENV-2 was the most prevalent serotype, detected in 95.7% of cases. The NS1 ELISA kit detected 71.1% of the positive cases. However, the diagnostic accuracy of the NS1 ELISA kit was found to be only 64.89%. Of the 610 confirmed cases, 68% were male and 32% were female, with a median age of 30 years. Dengue fever was diagnosed in 91.8% of cases, while 8.2% were diagnosed with dengue hemorrhagic fever (DHF). DHF patients had a higher prevalence of abdominal pain, hemorrhagic manifestations, and thrombocytopenia. The cocirculation of all four DENV serotypes in Lahore is concerning and could lead to more severe forms of the disease, such as DHF or dengue shock syndrome, in the future. The study highlights the low diagnostic accuracy of commercially available NS1 ELISA kits and emphasizes the importance of using molecular methods to confirm acute dengue infections. Given the increasing prevalence of dengue fever in developing countries like Pakistan, more accurate and reliable diagnostic tools are needed for effective disease management and control.