Dengue Virus Infection Patients Research Articles

PROFILE OF NUTRITIONAL STATUS, HEMOGLOBIN, LEUKOCYTES, PLATELET, HEMATOCRIT, ALBUMIN AND SEROLOGY TEST IN CHILDREN INFECTED WITH DENGUE VIRUS AT DR SOETOMO HOSPITAL YEAR 2015

The Dengue Virus Infection (DVI) triggers changes in the host's hematological, biochemical, and immunological aspects, affecting variables like hemoglobin (Hb), leukocytes (WBC), platelets (Plt), hematocrit (Hct), albumin (Alb), IgM, IgG, and NS1Ag Dengue. This study aims to investigate the demographic and clinical characteristics of DVI patients, considering factors such as gender, age, nutritional status, Hb, WBC, Plt, Hct, Alb, dengue serologic tests, and DVI stage. Using a cross-sectional descriptive approach, medical records of 74 subjects were analyzed. Subjects were categorized as DF (33.78%), DHF I (27.03%), DHF II (4.05%), DHF III (25.68%), and DHF IV (9.46%). Predominantly, subjects were aged 6-12 years (48.65%) and predominantly male (58.11%). Most patients had a normal nutritional status (50%), seen in both females and males (32.26%, 62.79%), with DF being dominant (14.86%, 28.92%). Over-nutrition occurred in DF, DHF without shock, and DHF with shock at rates of 12.5%, 33.33%, and 54.17%. DF prevailed in patients aged <6 years (17.57%), while DHF I, DHF II, DHF III were more common in those aged 6-12 years (14.86%, 2.70%, 16.22%), and DHF IV in those aged <6 years (8.11%). Key findings revealed increased Hb levels from DF to DHF, with 38 of 74 DVI patients exhibiting leukopenia. The DVI stage showed an inverse correlation with Plt levels. Hct levels rose in DHF patients, and they had relatively low Alb levels. Primary infections were more frequent in DF, while secondary infections were predominant in DHF with shock. The study also noted variations in over-nutrition prevalence across DVI stages among patients at Dr. Soetomo General Hospital Surabaya in 2015.

Non-structural protein 1 and hematology parameters as predictors of dengue virus infection severity in Indonesia.

Dengue virus infection (DVI) remains a significant health challenge, and diagnosis must still be considered. Non-structural protein 1 (NS1) is a potential marker of the dengue virus that can help diagnose DVI. The study aimed to assess the role of NS1 as a predictor of the severity of DVI. We utilized Dengue PCR-confirmed samples and employed semi-quantitative NS1Ag ELISA for NS1 examination, adhering to the World Health Organization South-East Asia Region (WHO-SEARO) 2011 criteria for DVI. We included DVI patients from Indonesia aged 1-65 years. Secondary infections had more severe clinical conditions than primary infections. Leukocyte and platelet levels had a more significant effect on NS1 positivity (6.19 (1.9-30.2); p<0.001; 190 (11-417); p=0.015; respectively). Multivariate analysis revealed leukocytes as a more significant predictor of NS1 values than platelets, with an odds ratio of 5.38 contributing to 30.5% of the NS1 value variation. The NS1 value could distinguish undifferentiated fever and dengue fever in the children group with a sensitivity of 76.0% and specificity of 87.5% (p=0.015). The number of NS1(-) in the severe dengue hemorrhagic fever (DHF) group was higher than NS1(+). DENV-4 type and primary infection were dominant in this study, although they did not significantly differ from the NS1 value. NS1 value can be used as a predictor to determine the severity of DVI in children but not in the adult group. The levels of leukocytes and platelets influenced the NS1 value.

Prediction of Acute Renal Failure in Dengue Fever Patients

Background: Dengue virus (DENV) infection is caused by an arboviral strain and is transmitted by the mosquito Aedes aegypti which is found in Sudan especially Red Sea and Kassala states in the east. The disease is known to cause renal disturbances and a thorough understanding of that will potentially help in the prediction, diagnosis and treatment of the disease. Methods: This study is a prospective observational cross sectional study conducted in the Eastern Sudan College of Medical Science and Technology and Port Sudan Teaching Hospital. 200 confirmed Dengue virus infected patients along with 200 healthy appearing adults (control) were enrolled for the study. Statistical analysis was carried out after the collection of patients’ demographic, clinical, and investigational data including serum urea and creatinine values. Ethical approval was obtained from the ministry of health, Red Sea state and informed written consent was obtained from each participant. Results: The highest incidence of DENV infection was observed in individuals of the middle age group (29%). Elevated blood urea levels were detected in 10 (5%) patients while elevated creatinine levels were seen in 17 (8.5%) patients. Although fallen within reference ranges found in the literature, mean blood urea and creatinine values differed significantly between patients and controls and between different categories of the disease. Mean blood urea concentration showed a statistically significant difference between the control (22.3 mg/dl) and the test (28.4 mg/dl) (P value < 0.001). Similarly, mean serum creatinine in the control (0.70 mg/dl) differed significantly (P value < 0.001) from test (0.94 mg/dl). Clinically, fever was present in 97.5% of patients, headache in 95.5%, joints pain in 71%, lethargy in 67%, vomiting in 49%, skin rash in 40%, abdominal pain in 24% and bleeding in 17.5%. Conclusion: We strongly conclude that renal involvement is not uncommon in Dengue fever and that blood urea and creatinine evaluation should be considered in the counseling of DENV infection patients. Patients need to be subjected to necessary laboratory investigations associated with acute kidney injury to decrease the rate of morbidity and mortality associated with the disease.

Karakteristik Klinis dan Virologis Penderita Demam Berdarah Dengue di Kota Bandar Lampung

Abstract. Clinical symptoms of dengue virus (DENV) infection range from asymptomatic mild dengue fever(DF), more severe dengue hemorrhagic fever (DHF) up to dengue shock syndrome. One of the determinantsof dengue infection severity was virus virulence. This study aimed to determine the clinical and virologicalcharacteristics of dengue virus infection patients based on the severity degree. A cross-sectional study wasconducted in RSUD Dr. H. Abdul Moeloek, Lampung Province between July-November 2016 with 56 denguepatients as samples selected using purposive sampling. The serological test was done using a rapiddiagnostic test. Blood samples for DENV serotype identification were examined using reverse-transcriptionpolymerase chain reaction. Classification of DENV infection severity was obtained from the patient’s medicalrecord. The results showed that the most common clinical manifestations were fever, headache, and retroorbitalpain, appearing in all patients from every degree of severity. There were Grade I DHF patients whoexperienced Myalgia (15.6%) and petechiae (22.2%). Laboratory results showed that thrombocytopeniaappeared in every grade, even though 13.3% of grade I patients did not experience it. Secondary infectionwas found in 92.9% of samples, and all DENV serotype can be detected in 39.2%samples: DENV-1 (46.7%),DENV-2 (6.7%), DENV-3 (26.7%), and DENV-4 (20%). This study concluded that the majority of clinicalcharacteristics in DHF patients are in line with the degree of severity, with the bleeding as the dominantmanifestation in patients with grade II-IV. Virological characteristics of DENV-1 are dominant in all patientswith DHF grade I-IV.Keywords: dengue virus, serotype, severity, secondary infection, Bandar Lampung

Prevalence of Expanded Dengue Syndrome in Patients with Dengue Virus Infection at the Dr. Soetomo Hospital Surabaya in 2017 – 2018

Dengue Fever (DF) or Dengue Hemorrhagic Fever (DHF) is one of the infectious diseases that attracts much global attention, especially Indonesia because it impacts the mortality rate of the people in the world if adequate treatment is not given. Expanded Dengue Syndrome (EDS) is a clinical manifestation involving several organs such as lungs, liver, kidney, heart, and brain-related to dengue infections, with or without plasma leakage. This study aimed to determine the prevalence of expanded dengue syndrome in patients with dengue virus infection at the Dr. Soetomo Hospital in 2017–2018. Based on its purpose, the sampling technique used in this study was the total sampling of patients with DVI who admitted to Dr. Soetomo Hospital Surabaya. Every pediatric and adult patient who met the criteria were included in this study until a certain period in 2017–2018. After the data collection, only thirty samples of EDS from the 196 sample data were collected. Thirty patients with expanded dengue syndrome had a manifestation of different organs. Such as: neurological, cardiac, respiratory system, gastro-hepatic, and kidneys. The laboratory test results showed that most platelet counts of 51,000 – 100,000 were found in seventeen patients, while the range of hemoglobin and hematocrit was normal. From a total of thirty samples of dengue virus infection patients with EDS, there were only eighteen patients who did a serological test. The most found serological results were (+/-) anti-dengue IgM and (+) anti-dengue IgG (40%).

Effects of Climatic Factors on The Incidence Rate of Dengue Virus Infection in Surabaya During 2010-2013

Introduction: Dengue Virus Infection (DVI) is one of cautious mosquito-borne virus disease that transmitted by Aedes aegypti and Aedes albopictus. Surabaya has the highest incidence rate of DVI in East Java. Transmission of dengue virus were significantly affected by the change of climatic factor components (precipitation, temperature, and humidity). This study is aimed to analyze the correlation between climatic factor components with the incidence rate of DVI in Surabaya and its distribution.Methods: This is a cross-sectional study using analytic observational approach. The Incidence rate of DVI during 2010-2013 datas were taken from Surabaya Health Office. Climatic factor datas on the same years were taken from Juanda Meteorological Station. Correlation tests were performed by using Spearman Test.Results: As the result, there were 7,685 DVI patients during 2010-2013. Male patients have less proportion (51.89%). The highest DVI cases are from the age group of 5-14 years (&gt;40%). Incidence rate of DVI was increased during February to April, and highest incidence rate occured in 2010 (n=3,379). There were significant correlation between precipitation (r=0.419, p-value p=0.003) and humidity (r=0.502, p-value=0.000) with the incidence rate of DVI in Surabaya during 2010-2013.Conclusion: Therefore, precipitation and humidity are two climatic factor components that may effect the incidence rate of DVI in Surabaya.

CORRELATION OF DENGUE VIRUS SEROTYPE AND DVI SEVERITY IN ADULT PATIENTS

The clinical manifestation of dengue virus infection is often not clear, varies widely from mild to severe. Exposure of dengue virus which serotype is different from a previous infection is a risk factor for the severe manifestation of dengue virus infection. Dengue hemorrhagic fever is classified into four degrees of severity based on clinical manifestations and laboratory results. Real-time RT-PCR Dengue can detect dengue virus serotype in early dengue virus infection. The aimed of this study was to prove the correlation between dengue virus serotype and degree of severity in adult patients. This study was a cross-sectional observational design done in February until July 2016. Subjects consisted of 100 dengue virus infection patients. Serum of the patients was examined using Real-time RT-PCR Dengue (Simplexaâ„¢ Dengue). It was shown that from 46 patients with DENV-3 serotype was 63%, DENV-2 serotype 17.4%, DENV-1 serotypes 17.4% and mixed infection of DENV-1 and DENV-3 serotype 2.2%. There was not any DENV-4 serotype. Dengue Hemorrhagic Fever (DHF) stage I was 47.8%, DHF stage II was 30.4%, DHF stage III was 10.9% and Dengue Fever was 10.9%. There was not any DHF stage IV. There was not enough evidence that DENV-3 correlated with the degree of severity (p= 0.510). Based on this research, DENV-3 serotype was the dominant serotype prevalent at the Dr. Soetomo Hospital. There was no correlation between viral dengue serotype and severity in dengue adult patients in this study.

NILAI DIAGNOSTIK ANTI DENGUE IgA DAN NS1, SERTA IgM/IgG DI INFEKSI VIRUS DENGUE (The Diagnostic Value of Anti Dengue IgA and Anti Dengue IgM/IgG in Dengue Virus Infection)

The clinical manifestations of dengue virus infection are varied and thus a specific diagnostic examination is required. Usually antidengueIgM is often used, but the presence in the circulation is 3−8 months long. NS1 is sensitive in the detection of primary infection,whereas IgG is more better used in secondary infection. The examination of anti-dengue IgA as a new marker is estimated to be ableto detect the acute primary and secondary infection, however the diagnostic value of anti-dengue IgA is not much well known for theIndonesian population. This study was done at the Tropical Infectious Disease Ward of Dr. Soetomo Hospital, Surabaya during February– April 2013. The samples consisted of 37 sera from patients infected by dengue virus and 37 sera from those non one (dengue virusinfection patients). The NS1 serum, anti-dengue IgM and anti dengue IgG were examined by ELISA and anti-dengue IgA was examined byan indirect immunochromatography method using Assure@ Dengue IgA Rapid Test (MP Biomedicals Asia Pacific Pte Ltd). The diagnosticvalue was analyzed by 2x2 table with a confidence interval of (CI) 95%. The used gold standards were from the 1997th WHO criteriaand one of the positive dengue serological tests by ELISA (NS1/anti dengue IgM/anti dengue IgG). AUC and anti-dengue IgA cut-off weredetermined by ROC curve. The Diagnostic value of anti-dengue IgA showed a sensitivity and specificity of 83.8% (67.3 to 93.2) and 81.1%(64.3 to 91.4). A positive predictive value of 81.6% (65.1 to 91.7) and a negative predictive value of 83.3% (66.5 to 93.0) was found. Thepositive likelihood ratio was 4.4 times (2.2 to 8.8) and negative likelihood ratio of only 0.2 times (0.09 to 0.42). The best cut off valueof 0.2 was shown by the area under the curve of 83.5%. Based on this study, the diagnostic value of anti-dengue IgA had a good validityfor the diagnosis of dengue virus infection.

DIAGNOSIS JANGKITAN (INFEKSI) VIRUS DENGUE DENGAN UJI CEPAT (RAPID TEST) IgA ANTI-DENGUE

Dengue IgM, IgG Capture ELISAs and NS1 Ag ELISA become the most widely used serological methods for dengue diagnosis untilnow. Previous studies reported a possible use of IgA antibodies for dengue virus as a new serologic marker to make dengue infectionactive. In the present study, the performance of IgA anti-dengue rapid test as a new marker of dengue infection was assessed. In thisstudy, the sera were obtained from 30 dengue virus infection patients and 30 non dengue virus infection patients. Thirty dengue pairedsera were collected twice, at the time of hospital admission (acute) and at discharge (convalescent). All sera samples were characterizedusing dengue reference ELISAs (NS1 Ag, Dengue IgM and IgG capture ELISAs). The results of IgA anti-dengue rapid test were comparedwith the corresponding dengue reference tests. The sensitivity and specificity of IgA anti-dengue rapid test respectively were 78.3% (95%CI: 65.5–87.5%), and 73.3% (95% CI: 55,6–85,8%). Meanwhile, from acute sera, sensitivity of IgA anti-dengue rapid test was 83.3%(95% CI: 64.5–93.7), higher than IgM (73.3%, 95% CI: 53.8–87.0), IgG (66.7%, 95% CI: 47.1–82.1) and NS1 Ag ELISAs (60%,95% CI: 40.7–76.8). Positive IgA anti-dengue rapid test results in acute sera was higher in the secondary (91%) than primary infection(57%). IgA anti-dengue rapid test can be considered as a new marker for dengue infection, because it gives a high sensitivity, especiallyin the acute phase and in the secondary infections as well.

KETERKAITAN ANTIGEN NS1 INFEKSI VIRUS DENGUE DENGAN SEROTIPE VIRUS DENGUE

Dengue virus infection (DVI) currently is detected by using dengue virus NS1 antigen (NS1 Ag). The sensitivity of NS1 Ag is 27.8%–93.4%,but recent study of Kumarasamy the sensitivity of NS1 Ag is better than the virus isolation and polymerase chain reaction (PCR). This studyis focussed on the evaluation of the validity of Panbio Dengue Early Rapid for the diagnosis of DVI and the NS1 Ag sensitivity associated withdengue virus serotypes. The sera was obtained from 65 DVI patients which diagnosed by the clinicians. The resulted diagnosis was foundby serology tests (positive IgM/IgG antidengue/NS1 Ag ELISA) and 1997 WHO criteria as the gold standard, and which also found 35 nonDVI patients (typhoid fever, HAV, malaria, UTI, tuberculosis and bronchopneumonia). The samples were examined by Panbio Dengue EarlyRapid. PCR was performed on each positive serological test result to determine the dengue virus serotypes. The sensitivity and specificity ofPanbio Dengue Early Rapid was 49.2% and 100%. The PCR results of 65 sera showed positive PCR in 49.2% (positive NS1 Ag was 62.5%).Meanwhile, and negative PCR in 50.8% (positive NS1 Ag was 36.4%). The predominance of serotypes (positive NS1 Ag) were DEN-3 (37.5%),DEN-4 (28.1%), DEN-1 (21.9%) and DEN-2 (12.5%). The Panbio Dengue Early Rapid can be used as early detection of DVI, although itshould be used in conjunction with other dengue serological tests as well. Unfortunately there is still not enough evidence about the NS1 Agsensitivity associated with the dengue virus serotypes.

Dengue virus infection-enhancement activity in neutralizing antibodies of healthy adults before dengue season as determined by using Fc\u03b3R-expressing cells

BackgroundAntibodies are critical responses to protect the host from dengue virus(DENV) infection. Antibodies target DENV by two pathologic mechanisms: virus neutralization and infection enhancement. In dengue patients, the absence of neutralizing activity in the presence of FcγR implies that infection-enhancing activity hampers the neutralizing activity of antibodies, which could potentially lead to symptomatic presentations and severe clinical outcomes.MethodsA total of 100 pair serum samples from adult healthy volunteers were obtained during the dengue season in Ha Noi in 2015 for evaluation of neutralizing and infection-enhancing activity. Additionally, 20 serum samples from acute secondary DENV infection patients were also used as the patient group in this study. PRNT was performed on BHK cells and FcγR-expressing BHK cell lines for all serum samples.ResultsOut of 100 residents, positive neutralizing antibodies (N.A) were found in 44.23 and 76.92% for DENV-1; 38.46 and 75% for DENV-2; 19.23 and 15.38% for DENV-3; and 1.92 and 9.62% for DENV-4 for pre and post-dengue season respectively. The percentage of post-exposure residents having positive responses against single, two, or more than three DENV serotypes were 38.46, 44.23 and 15.38%, respectively. A total of 34 residents were DENV seropositive before the dengue season and these individuals demonstrated further elevation of IgG antibodies after the dengue season. At the end of the season, 18 residents were confirmed to be new asymptomatic DENV infection cases. In both groups, N.A titers determined on BHK cells were higher than that on FcγR-expressing BHK cells. In heterotypic N.A responses, N.A titers to the infecting serotype from the samples obtained from pre-exposure group were significantly higher than those of the patient group. However, fold enhancement to the infecting serotypes from the samples in the pre-exposure group was substantially lower as compared to that of the patient group.ConclusionBefore and after the dengue season, serum samples from healthy volunteers demonstrated high levels of neutralizing antibodies and low or absence of infection-enhancement activity. The results suggest that while infection-enhancement activity hampers neutralizing activity of antibodies, high levels of DENV neutralizing antibodies set a critical threshold in facilitating the prevention of disease progression.

Application of log-linear models to dengue virus infection patients in Thailand

Application of log-linear models to dengue virus infection patients in Thailand

Diagnosis of dengue virus infection with IgA anti Dengue rapid tests

Background: Dengue IgM, IgG Capture ELISAs and NS1 Ag ELISA have become the most widely used serological methods for dengue diagnosis until now. Previous studies reported a possible use of IgA antibodies for dengue virus as a new serologic marker to make dengue infection active. In the present study, the performance of IgA anti-dengue rapid test as a new marker of dengue infection was assessed. Methods: In this study, sera were obtained from 70 dengue virus infection patients and 30 non dengue virus infection patients. Seventy dengue paired sera were collected twice, at the time of hospital admission (acute) and discharge (convalescent). All sera samples were characterized using dengue reference ELISAs (NS1 Ag, Dengue IgM and IgG capture ELISAs). All of the dengue and non dengue samples were evaluated by Dengue IgA Rapid Test. Results: The results of IgA anti-dengue rapid test were compared with the coresponding dengue reference tests. The sensitivity and specificity of IgA anti-dengue rapid test respectively were 82.9% (95%CI:72.4-89.9), and 73.3%(95%CI: 55.6%-85.8%). Meanwhile, from acute sera, sensitivity of IgA anti-dengue rapid test was 83.3%(95%CI:64.5-93.7), higher than IgM (73.3%,95%CI:53.8-87.0), IgG (66.7%,95%CI:47.1-82.1) and NS1 Ag ELISAs (60%,95%CI:40.7-76.8). Based on the day of fever, sensitivity of IgA anti-dengue from day 1-2 was 66.7%, day 3-4 was 84.8%, day 5-7 was 76.2% respectively. Positive IgA anti-dengue rapid test results in acute sera was higher in secondary (84.6%) than primary infection (77.7%). Conclusion: IgA anti-dengue rapid test can be considered as a new marker of dengue infection, because it gives a high sensitivity, especially in the acute phase and in the secondary infections as well.