Dengue Early Warning System as Outbreak Prediction Tool: A Systematic Review.

Early warning system (EWS) for vector-borne diseases is incredibly complex due to numerous factors originating from human, environmental, vector and the disease itself. Dengue EWS aims to collect data that leads to prompt decision-making processes that trigger disease intervention strategies to minimize the impact on a specific population. Dengue EWS may have a similar structural design, functions, and analytical approaches but different performance and ability to predict outbreaks. Hence, this review aims to summarise and discuss the evidence of different EWSs, their performance, and their ability to predict dengue outbreaks. A systematic literature search was performed of four primary databases: Scopus, Web of Science, Ovid MEDLINE, and EBSCOhost. Eligible articles were evaluated using a checklist for assessing the quality of the studies. A total of 17 studies were included in this systematic review. All EWS models demonstrated reasonably good predictive abilities to predict dengue outbreaks. However, the accuracy of their predictions varied greatly depending on the model used and the data quality. The reported sensitivity ranged from 50 to 100%, while specificity was 74 to 94.7%. A range between 70 to 96.3% was reported for prediction model accuracy and 43 to 86% for PPV. Overall, meteorological alarm indicators (temperatures and rainfall) were the most frequently used and displayed the best performing indicator. Other potential alarm indicators are entomology (female mosquito infection rate), epidemiology, population and socioeconomic factors. EWS is an essential tool to support district health managers and national health planners to mitigate or prevent disease outbreaks. This systematic review highlights the benefits of integrating several epidemiological tools focusing on incorporating climatic, environmental, epidemiological and socioeconomic factors to create an early warning system. The early warning system relies heavily on the country surveillance system. The lack of timely and high-quality data is critical for developing an effective EWS.

Prediction of annual dengue incidence by hydro-climatic extremes for southern Taiwan.

Dengue is one of the most rapidly spreading mosquito-borne viral diseases in the world. An increase in the incidence of dengue is commonly thought to be a consequence of variability of weather conditions. Taiwan, which straddles the Tropic of Cancer, is an excellent place to study the relationship between weather conditions and dengue fever cases since the island forms an isolated geographic environment. Therefore, clarifying the association between extreme weather conditions and annual dengue incidence is one of important issues for epidemic early warning. In this paper, we develop a Poisson regression model with extreme weather parameters for prediction of annual dengue incidence. A leave-one-out method is used to evaluate the performance of predicting dengue incidence. Our results indicate that dengue transmission has a positive relationship with the minimum temperature predictors during the early summer while a negative relationship with all the maximum 24-h rainfall predictors during the early epidemic phase of dengue outbreaks. Our findings provide a better understanding of the relationships between extreme weather and annual trends in dengue cases in Taiwan and it could have important implications for dengue forecasts in surrounding areas with similar meteorological conditions.

Combinaciones más frecuentes y características clínicas y de estudios complementarios de pacientes pediátricos con dengue / Most common symptom combinations, clinical features and supplementary test characteristics of pediatric

Introducción: el dengue es una enfermedad viral, con un amplio espectro clínico. Objetivos: describir las características clínicas y de laboratorio, y determinar las combinaciones de síntomas y signos más frecuentes halladas en pacientes pediátricos con sospecha de dengue, internados en el Hospital Docente Pediátrico del Cerro. Métodos: se realizó un estudio analítico, transversal, retrospectivo, a un universo de 1 300 pacientes ingresados entre enero y diciembre de 2012, con una muestra de 260 enfermos. Se estudiaron las variables síntomas y signos, además se hallaron las medianas de los valores de laboratorio hematócrito, conteo leucocitario y plaquetario. Se establecieron asociaciones predictivas de tener dengue según grupo de edades, para lo cual se determinó odds ratio (OR). Resultados: los síntomas más frecuente estuvieron representados por: cefalea, artromialgias, dolor retroocular y rash; los complementarios solo mostraron tendencia a la leucopenia. Las combinaciones predictivas de dengue halladas fueron: fiebre, exantema y prueba del lazo positiva en todas las edades. La fiebre, exantema y artromialgias para adolescentes (OR= 28,7; IC 95 por ciento 3,98-58,3; p= 0,0001) y escolares (OR= 13,32; IC 95 por ciento 1,74-28,0; p= 0,0001); mientras que la fiebre, cefalea, dolor retroocular y exantema en el grupo adolescentes (OR= 9,57; IC 95 por ciento; 3,63-26,85; p= 0,00001). Conclusiones: en este estudio la clínica varía con la edad, sin incluir síntomas respiratorios, no así los análisis. La asociación de síntomas y signos deben ser tenidas en cuenta de acuerdo con los grupos de edad, y resultaron semejantes los encontrados en los adolescentes con lo reportado en adultos(AU)

Introduction: dengue is a viral disease of broad clinical spectrum. Objectives: to describe the clinical and laboratory characteristics, and to determine the most common sign and symptom combinations found in pediatric patients suspected of dengue, who had been admitted to the teaching pediatric hospital in Cerro municipality. Methods: a retrospective, cross-sectional and analytical study was conducted in a sample of 260 patients from a universe of 1 300 patients admitted to hospital from January to December 2012. The study variables were symptoms and signs in addition to estimating the medians of hematocrit, leukocyte and platelet count values at lab. Predictive associations of having dengue were set according to age groups for which odds ratios were determined. Results: the most frequent symptoms were headache, arthromyalgias, retroocular pain and rash whereas the supplementary tests just showed tendency to leucopenia. The predictive combinations for dengue were fever, exanthema and positive tourniquet test at all ages; fever, exanthema and arthromyalgias for adolescents(OR= 28.7; 95 percent CI 3.98-58,3; p= 0.0001) and schoolchildren (OR= 13.32; 95 percent CI 1.74-28.0; p= 0.0001) and fever, headache, retroocular pain and exanthema for the adolescent group (OR= 9.57; IC 95 percent; 3.63-26.85; p= 0.00001). Conclusions: in this study, the clinical characteristics vary with the age, excluding the respiratory symptoms, but it is not the same in the supplementary tests. The associations of symptoms and signs should be taken into account depending on the age group and those found in adolescents were similar to the ones reported in adults(AU)

Combinaciones más frecuentes y características clínicas y de estudios complementarios de pacientes pediátricos con dengue / Most common symptom combinations, clinical features and supplementary test characteristics of pediatric patients with dengue

Introducción: el dengue es una enfermedad viral, con un amplio espectro clínico.Objetivos: describir las características clínicas y de laboratorio, y determinar las combinaciones de síntomas y signos más frecuentes halladas en pacientes pediátricos con sospecha de dengue, internados en el Hospital Docente Pediátrico del Cerro.Métodos: se realizó un estudio analítico, transversal, retrospectivo, a un universo de 1 300 pacientes ingresados entre enero y diciembre de 2012, con una muestra de 260 enfermos. Se estudiaron las variables síntomas y signos, además se hallaron las medianas de los valores de laboratorio hematócrito, conteo leucocitario y plaquetario. Se establecieron asociaciones predictivas de tener dengue según grupo de edades, para lo cual se determinó odds ratio (OR).Resultados: los síntomas más frecuente estuvieron representados por: cefalea, artromialgias, dolor retroocular y rash; los complementarios solo mostraron tendencia a la leucopenia. Las combinaciones predictivas de dengue halladas fueron: fiebre, exantema y prueba del lazo positiva en todas las edades. La fiebre, exantema y artromialgias para adolescentes (OR= 28,7; IC 95 por ciento 3,98-58,3; p= 0,0001) y escolares (OR= 13,32; IC 95 por ciento 1,74-28,0; p= 0,0001); mientras que la fiebre, cefalea, dolor retroocular y exantema en el grupo adolescentes (OR= 9,57; IC 95 por ciento; 3,63-26,85; p= 0,00001).Conclusiones: en este estudio la clínica varía con la edad, sin incluir síntomas respiratorios, no así los análisis. La asociación de síntomas y signos deben ser tenidas en cuenta de acuerdo con los grupos de edad, y resultaron semejantes los encontrados en los adolescentes con lo reportado en adultos(AU)