Dengue Research Articles

Spatial-Temporal Distribution Pattern of Dengue Fever and Spatial Relationship of the Aedes Mosquito Larvae Index in Phuket Province

Spatial-Temporal Distribution Pattern of Dengue Fever and Spatial Relationship of the Aedes Mosquito Larvae Index in Phuket Province

Serologic evidence of dengue and chikungunya among patients with acute febrile illness in Ghana, 2016 – 2018

ObjectiveThis study aimed to describe the exposure levels to Dengue and Chikungunya viruses among individuals presenting with febrile illnesses in Ghana between January 2016 to June 2018. MethodsThe study was conducted in health facilities in seven selected regions in Ghana; namely, Ashanti, Greater Accra, Northern, Upper West, Volta, and Western regions. Patients who met the case definition were enrolled in the study. A total of 1105 blood samples were collected from patients from 2016 to 2018 and serological analysis of Dengue and Chikungunya viruses were performed with ELISA IgM and IgG commercial kits (Abcam, Cambridge, UK). ResultsAnalysed results indicated that Dengue and Chikungunya viruses showed seropositivity of 62.0% and 40.0% respectively. All processed samples tested negative for Dengue and Chikungunya using the Polymerase Chain Reaction (PCR) assay. Greater Accra and Ashanti regions recorded the highest positivity for Chikungunya and Dengue fever viruses respectively. ConclusionThough no detection of Dengue and Chikungunya using molecular tools, the seropositivity suggests the need for an established surveillance for arboviruses to monitor transmission of these pathogens for epidemic preparedness and response.

Pengaruh pelatihan kader jumantik dengan ovitrap terhadap peningkatan pengetahuan demam berdarah dengue (DBD) siswa SDN 33 Jollo dan SMP 5 Satap Bungoro, Kabupaten Pangkep tahun 2023

Background: The service aims to reduce the incidence of dengue hemorrhagic fever (DHF) through basic training of Jumantik cadres using simple educational materials (Ovitrap) in Bungoro District, Pankep Regency. Methods: The target of this service consisted of students of Pangkep Regency, Bungoro District, precisely at SDN 33 Jollo and SMPN 5 SATAP Bungoro. The sample of this study consisted of students aged between 9 and 15 years and totaled 26 students. Findings: The results of this service were 3 participants (11.5%) who experienced an increase in knowledge from pre-test to post-test. In 23 participants (88.5%), there was no increase or decrease in pre-test and post-test scores. Even if knowledge increases, according to the Wilcoxon test, the p-value of 0.083 is greater than 0.05 so it can be concluded that Ha is rejected and H0 is accepted. Conclusion: There is no significant difference in improvement, pre-test and post-test knowledge can be classified as good, depending on the ability of students to apply Ovitrap production in the classroom.

Predictor effect of the Rapid Survey (LIRAa) and priority areas for Dengue surveillance in Maranhão, Brazil

Dengue fever is a serious public health problem in Brazil. However, there are still mechanisms involved in the dynamics of the disease that need to be better elucidated, especially in Maranhão. In this sense, the objective was to evaluate the predictive effect of LIRAa in relation to the incidence of dengue fever in Maranhão in 2022, and to identify priority municipalities for interventions through geospatial analysis. This is a scholastic study, carried out with data obtained from the Zoonosis Surveillance Units - UVZ of the municipalities, in the Notifiable Diseases Information System (SINAN). A simple linear regression with post-hoc analyses and the Local Moran Index (LISA) were performed. A positive effect of LIRAa on the incidence of dengue fever was observed (R2 = 0.0352; p = 0.0062). LISA indicated ten high-risk municipalities and six in a transition situation to high risk of dengue fever in the state. LIRAa has proven to be an efficient entomoepidemiological surveillance tool and the identification of priority areas for surveillance can help health authorities in developing specific strategies to contain future epidemics.

Knowledge, Attitude, and Practice (KAP) Study on Dengue Fever among Medical Students in Dera Ismail Khan, Pakistan

Knowledge, Attitude, and Practice (KAP) Study on Dengue Fever among Medical Students in Dera Ismail Khan, Pakistan

Cryptic transmission and novel introduction of Dengue 1 and 2 genotypes in Colombia.

Dengue fever remains as a public health challenge in Colombia, standing as the most prevalent infectious disease in the country. The cyclic nature of dengue epidemics, occurring approximately every 3years, is intricately linked to meteorological events like El Niño Southern Oscillation (ENSO). Therefore, the Colombian system faces challenges in genomic surveillance. This study aimed to evaluate local dengue virus (DENV) transmission and genetic diversity in four Colombian departments with heterogeneous incidence patterns (department is first-level territorial units in Colombia). For this study, we processed 266 serum samples to identify DENV. Subsequently, we obtained 118 genome sequences by sequencing DENV genomes from serum samples of 134 patients infected with DENV-1 and DENV-2 serotypes. The predominant serotype was DENV-2 (108/143), with the Asian-American (AA) genotype (91/118) being the most prevalent one. Phylogenetic analysis revealed concurrent circulation of two lineages of both DENV-2 AA and DENV-1 V, suggesting ongoing genetic exchange with sequences from Venezuela and Cuba. The continuous migration of Venezuelan citizens into Colombia can contribute to this exchange, emphasizing the need for strengthened prevention measures in border areas. Notably, the time to most recent common ancestor analysis identified cryptic transmission of DENV-2 AA since approximately 2015, leading to the recent epidemic. This challenges the notion that major outbreaks are solely triggered by recent virus introductions, emphasizing the importance of active genomic surveillance. The study also highlighted the contrasting selection pressures on DENV-1 V and DENV-2 AA, with the latter experiencing positive selection, possibly influencing its transmissibility. The presence of a cosmopolitan genotype in Colombia, previously reported in Brazil and Peru, raises concerns about transmission routes, emphasizing the necessity for thorough DENV evolution studies. Despite limitations, the study underscores genomic epidemiology's crucial role in early detection and comprehension of DENV genotypes, recommending the use of advanced sequencing techniques as an early warning system to help prevent and control dengue outbreaks in Colombia and worldwide.

C-Reactive Protein (CRP) Value and Platelet Counts in Pediatric Dengue Patients at RSUP Dr. Hasan Sadikin Bandung

Plasma leakage, thrombocytopenia, and cytokines play roles in pathogenesis of dengue infection. Thrombocytopenia correlates with severity of the disease. Dengue virus infection produces cytokines that stimulate C-Reactive Protein (CRP). This study aims to describe the results of CRP and platelet counts with severity of dengue infection in paediatric inpatient at Hasan Sadikin Hospital Bandung. This is a descriptive observational study with retrospective, cross-sectional data collection in January 1-December 31, 2021 at Hasan Sadikin Hospital. From 32 total subjects, there were 24(75%) non-severe dengue infections compared to severe dengue 8(25%). Non-severe dengue 19(79.2%), had the most platelet counts of 50,000-150,000/L, while platelets count 20,000-50,000/µL was mostly in severe dengue 4/8(50%). CRP value was mostly normal (<0.3mg/dl) as many as 18/24(75%) in mild dengue, whereas in severe dengue CRP was mostly high as many as 6/8(75%). CRP examination is mostly done in critical phase, both in severe and non-severe dengue. Severe dengue infection was found mostly in platelet counts of 50,000-150,000/µL and normal CRP level as many as 14(58.3%). In severe dengue infection, platelet counts was found mostly in 20,000-50,000/µL and high CRP (≥0.3mg/dl) as many as 3(37.5%). Most cases of dengue fever infections in children at Hasan Sadikin General Hospital in 2021 were of mild severity, with platelet counts ranging from 50,000 to 150,000/µL and normal CRP levels. Examinations were typically carried out during the critical phase.

A study to assess the knowledge and practice of women regarding dengue in rural area of Meerut, Uttar Pradesh, India

Background: Dengue affects 390 million people yearly. 70% global disease burden is from Asia. Every fourth person infected with dengue get sick and about one in 20 people infected with dengue develop severe dengue. Aim of this study was to assess the knowledge and practice of women regarding dengue in rural area of Meerut, U.P. Methods: A descriptive survey was done to conduct this study. Multistage random sampling was used to select study area and participants. Data has been collected from 50 participants. Self-developed knowledge questionnaire and checklist was prepared to measure knowledge and practices of people regarding knowledge and practices. Result: Most of the participants were between age group 18-23 years and were homemakers. All participants had previous knowledge about Dengue and source of information was TV/radio/newspaper for most of the participants. In this study 74% of participants has moderately adequate knowledge level, 16% had adequate and 10% had inadequate knowledge level. In regard to practices, 72% participant have satisfactorily practices, 20% had moderately satisfactorily practices and of 8 % participant non satisfactorily practices regarding prevention and management of dengue. Conclusion: Majority of participants had adequate knowledge and satisfactorily practices but still it is needed to organize awareness campaign to disseminate knowledge regarding dengue to community people of all age groups to improve their practices in this regard.

Association of Dengue Severity with Host Biomarkers

Association of Dengue Severity with Host Biomarkers

Case Report: Dengue Hemorrhagic Fever

Dengue haemorrhagic fever (DHF) is an infectious disease caused by dengue virus with clinical manifestations of fever, muscle and/or joint pain accompanied by leukopenia, rash, lymphadenopathy, thrombocytopenia and hemorrhagic diathesis. In DHF, plasma permeation is characterized by hemoconcentration (increased hematocrit) or fluid accumulation in body cavities. A case report of a 28-year-old patient came to Dr. Suhatman Hospital, MARS with complaints of continuous fever, accompanied by headache and retro orbital pain and pain in the joints. On physical examination, blood pressure was 130/90 mmHg, temperature 38.5° degree C, flushing (+), tourniquet (+), blood test was obtained. In the supporting examination, routine blood laboratory results obtained thrombocytopenia and leukocytopenia.

Clinical performance of the ImmuneMed Dengue NS1 Ag Rapid I test for the diagnosis of dengue fever: a diagnostic accuracy study

Background: Dengue virus (DENV) is transmitted by mosquitoes and is becoming a global threat owing to an increase in the number of cases and mortality, especially in low- and middle-income tropical countries. Rapid and easy-to-use diagnostic tests are required to differentiate dengue fever from other febrile illnesses. Methods: We evaluated the clinical performance of the ImmuneMed Dengue NS1 Ag Rapid I test (ImmuneMed, Inc.) using positive and negative sera collected from patients with confirmed DENV infection and healthy individuals, respectively. The AccuPower® ZIKV (DENV, CHIKV) multiplex real-time reverse transcription polymerase chain reaction (RT-PCR) assay (Bioneer) was used as the reference standard to confirm DENV infection. Results: One hundred DENV-positive and 161 DENV-negative samples were evaluated. Overall, the sensitivity and specificity were 100% (95% confidence interval [CI], 96%–100%) and 100% (95% CI, 98%–100%), respectively. The sensitivity and specificity were 100% for both DENV-1 and DENV- 2. The sensitivity was the same (100%) for sera collected < 3 days and ≥ 3 days from symptom onset. The performance of the ImmuneMed Dengue NS1 Ag Rapid I and realtime RT-PCR tests showed strong overall agreement. Conclusion: The ImmuneMed Dengue NS1 Ag Rapid I test was highly specific for DENV and as sensitive as RT-PCR. These findings suggest that the ImmuneMed Dengue NS1 Ag Rapid I test may be a useful point-of-care test for dengue fever.

Sosialisasi DBD Bentuk Upaya Pencegahan dan Penurunan Kasus Demam Berdarah di Desa Kebonadem

Socialization on the prevention of Dengue Hemorrhagic Fever (DBD) in Kebonadem Village on July 20 2024 aims to increase public awareness about the dangers of DBD and steps to prevent it. The main problem faced is the high risk of dengue fever transmission due to population density and community behavior that does not maintain environmental cleanliness, which supports the breeding of the Aedes aegypti mosquito. The urgency of this outreach is very high considering that dengue fever cases often cause Extraordinary Events (KLB) and the fatal impacts they can have. The results of this outreach show a significant increase in public understanding regarding preventive measures such as the application of 3M Plus (Draining, Covering, Burying and Sprinkling abate powder) as well as the early signs of dengue fever. Active participation in discussions and implementing new habits, such as cleaning water reservoirs, indicates the positive impact of this activity. Despite progress, consistency in implementing prevention habits and ongoing support from various parties is still needed to ensure long-term success. Regular evaluations will help assess the effectiveness of the program and reduce the number of dengue cases in the village, making it an example of success in dengue prevention in other communities.

Comparative genomics and evolutionary analysis of dengue virus strains circulating in Pakistan.

Dengue fever virus (DENV) poses a significant public health risk in tropical and subtropical regions across the world. Although the dengue fever virus (DENV) exhibits significant genetic diversity and has the potential to evolve, there is a lack of comprehensive research on the comparative genomics and evolutionary dynamics of the virus in Pakistan. Phylogenetic analysis demonstrated the circulation of all four dengue virus serotypes (DENV-1, -2, -3, and -4) with prevalent genotypes III and V within DENV-1, cosmopolitan genotype within DENV-2, genotype III within DENV-3, and genotype I within DENV-4 during 2006-2014. Based on the complete envelope region, genome-wide residue signature and genetic diversity indicate that there is a high level of genetic diversity among DENV-1 strains, while DENV-3 strains exhibit the least genetic diversity. Comparative analysis of all four DENV serotypes revealed that certain codons in DENV-2 and -4 were subject to strong purifying selection, while a few codon sites in the envelope region showed evidence of positive selection. These findings provided valuable insights into the comparative genomics and evolutionary pattern of DENV strains reported from Pakistan. Whether those characteristics conferred a fitness advantage to DENV-1 genotypes within a specific geography and time interval warrants further investigations. The findings of the current study will contribute to tracking disease dynamics, understanding virus transmission and evolution, and formulating effective disease control strategies.

The Role of Community Health Nurses in Handling Dengue Fever Outbreaks in Residential Areas

Controlling Dengue Hemorrhagic Fever (DHF) outbreaks is a complex public health challenge that requires collaboration from various stakeholders, including community health nurses. This study aims to assess the role of these nurses in managing DHF outbreaks in residential areas. Using a descriptive qualitative approach, the research involved in-depth interviews with community health nurses and direct field observations to gather comprehensive data. The findings revealed that community health nurses are crucial in preventing and controlling DHF outbreaks. Their responsibilities include educating the community about DHF prevention, identifying and managing mosquito breeding sites, and implementing environmental interventions. They also play a vital role in early detection of DHF cases and coordinate with government and health institutions for effective prevention and control measures. Furthermore, community health nurses provide counseling and training to raise awareness about DHF dangers and promote preventive actions. They are instrumental in encouraging community participation in environmental management to reduce mosquito habitats. This study emphasizes the need for ongoing support and capacity building for community health nurses to enhance their effectiveness. In conclusion, collaboration among health workers, communities, and stakeholders is essential to control dengue outbreaks and minimize the disease's impact.

A febrile thrombocytopenia is it always dengue

Dengue is tropic infectious disease which concentrated in tropical and subtropical regions. Human immunodeficiency virus (HIV) is an infection that attacks the body’s immune system. A 29-year-old female admitted to hospital with history of febrile thrombocytopenia with HIV infection on highly active anti-retroviral therapy (HAART). First, the patient was assessed with dengue hemorrhagic fever, but anti-dengue immunoglobulin G (IgG) and IgM were negative. Febrile thrombocytopenia occurs not only in dengue, but also in other conditions. Person with HIV experience a wide range of hematological abnormalities, the most prevalent of which are cytopenias, which can be anemia, leukopenia, thrombocytopenia, or a combination of these. Fever and thrombocytopenia are closely related to dengue infection, but this condition can also be caused by various factors.

Immunopathogenesis of dengue virus and Salmonella typhi coinfection

Typhoid, malaria, leptospirosis, dengue virus (DENV), and other arboviruses are endemic in Indonesia. Therefore, it is more likely that DENV and other infectious diseases could be coinfected. More severe symptoms, delayed identification, and ineffective treatment of the illness can all result from Salmonella typhi coinfection. To serve as a principle for clinicians’ considerations while diagnosing and prescribing, we aim to examine the immunopathogenesis of dengue associated with Salmonella typhi coinfection. Dengue virus has the potential to increase both susceptibility and incidence of this coinfection, leading to dengue haemorrhagic fever (DHF) with more severe clinical symptoms. This is explained by regulating impact of coinfection in the presence of gram-negative membrane endotoxin, DENV replication, and lipopolysaccharide (LPS). If Salmonella typhi coinfection is not treated promptly, both dengue and Salmonella typhi can affect several organs and result in significant morbidity and death. Dengue and typhoid immunopathogenesis coinfection are unclear. When dengue monoinfection compared with Salmonella dengue dual infections are related to higher fatality and morbidity rates.

Harnessing Natural Resources for Advancements in Dengue Virus Treatment.

Dengue fever, caused by the Dengue virus (DENV) and transmitted by Aedes aegypti mosquitoes, has become endemic in over 100 countries. Despite considerable research, there is a lack of specific drugs for clinical use against dengue. Hence, further exploration to identify anti-- dengue compounds is essential. In recent years, natural products have gained attention for their antiviral properties. Plant-based medicines are particularly appealing due to their safety and low toxicity. This review summarizes natural compounds with potential antiviral activity against DENV, highlighting their mechanisms of action. Various compounds, from traditional herbal remedies to novel plant isolates, show promise against dengue, targeting crucial viral proteins like the envelope protein, proteases, and RNA polymerase. Exploring natural sources of antiviral agents against dengue is crucial. These compounds offer hope for effective treatments and mitigating dengue's global impact.

Knowledge and Perceptions about Diagnosis, Clinical Management, and Prevention of Dengue Fever among Physicians during the 2023 Outbreak: A Cross-Sectional Study in Peru.

The objective of this study was to evaluate the knowledge level and perception of dengue fever management among Peruvian physicians and to determine the factors associated with higher knowledge. We conducted an analytical cross-sectional study based on an online survey. To evaluate the factors associated with a high level of knowledge (≥70% of correct answers), we used crude (cPR) and adjusted (aPR) prevalence ratios by the Poisson regression model. Of 359 respondents (median age: 33 years; male: 56.5%), 78.8% achieved a high level of knowledge. Multivariable analysis showed an independent association with having read the Peruvian clinical practice guidelines for dengue management (aPR: 1.29; 95% CI: 1.12-1.49), having experience in treating patients (aPR: 1.32; 95% CI: 1.03-1.68), and having treated cases frequently (aPR: 1.22; 95% CI: 1.02-1.46). Residing in the eastern macroregion (aPR: 0.83; 95% CI: 0.71-0.97) was associated with a low level of knowledge. In conclusion, Peruvian physicians had a high level of knowledge about dengue fever. This was associated with having clinical experience in dengue management. However, given the low level of knowledge in the eastern macroregion, educational campaigns are necessary in this area.

Effects of the oxoaporphine alkaloid hernandonine on dengue virus. Evidence for its mechanisms of action

BackgroundDengue, caused by the dengue virus (Orthoflavivirus dengue, encompassing DENV types 1-4), is a member of the Flaviviridae family. The symptoms of dengue range from subclinical or mild manifestations to potentially fatal complications. The management of severe dengue is exceptionally challenging due to the absence of effective antiviral medications. In this context, natural products, whether in the form of pure compounds or standardized plant extracts, have emerged as a promising source for the development of novel antiviral therapeutics. Hernandonine, an oxoaporphine alkaloid found in Hernandia nymphaeifolia (C. Presl) Kubitzki. serves both as a metabolite and an inhibitor of human immunodeficiency virus type 1 (HIV-1) integrase. PurposeThis study investigated the ability of hernandonine to inhibit DENV infection and explored its potential mechanisms. Study designTo assess the in vitro anti-DENV activity, cells or induced pluripotent stem cell (iPSC)-derived cerebral organoids were exposed to hernandonine before or after infection with DENV. Along with hernandonine, the endocytosis modulators, genistein, wortmannin, Methyl-β-cyclodextrin (MβCD) and lovastatin, were used in the assays. MethodsThe DENV infectivity and virion production in cells or cerebral organoids treated with compounds were determined. Various methods, including cell and cerebral organoids imaging, protein and gene detection were conducted to explore their antiviral mechanisms. ResultsThe results revealed notable antiviral properties of hernandonine, particularly in inhibiting DENV during the early stages of infection. Mechanistic analysis demonstrated that, akin to genistein, wortmannin, methyl-β-cyclodextrin (MβCD), and lovastatin, hernandonine exerted an influence on cholesterol-rich lipid rafts. It also restrained the pseudopodial movement ability of cells, potentially through the downregulation of cytoskeleton and endocytosis regulatory genes or protein expression. Moreover, hernandonine's virucidal activity was demonstrated. Hernandonine's inhibition of DENV infection was further validated in a disease-relevant iPSC-derived cerebral organoids model, a novel DENV-2 infection system worthy of further application. ConclusionThis study evidenced the potential of hernandonine as a novel candidate in the fight against DENV infection.

Application of spatial scan statistics on retrospective data to detect outbreaks of dengue hemorrhagic fever in Hai An and Duong Kinh districts, Hai Phong, 2020 - 2023

Dengue fever is an endemic disease that can lead to major outbreaks in Vietnam. This study aims to describe application of spatial scan statistics on retrospective data to detect outbreaks of dengue hemorrhagic fever in Hai An and Duong Kinh districts, Hai Phong, 2020 - 2023. The study analyzed aggregate dengue data covering 177 weeks (from Week 1/2020 to Week 20/2023). During the retrospective data period, 360 cases were reported from 14 wards of Hai An and Duong Kinh districts, of which 74 cases formed 5 clusters, with the remaining cases being sporadic. The clusters mainly occurred in November each year. Scan statistics should be systematically applied in monitoring dengue fever outbreaks, as the study results demonstrate that scan techniques can effectively detect clusters in the community.