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2.
Am J Trop Med Hyg ; 73(6): 1059-62, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16354812

RESUMO

The World Health Organization (WHO) scheme for classification of dengue severity was evaluated in a three-year study of 1,671 confirmed dengue cases in three Nicaraguan hospitals. The WHO classification of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) was compared with the presence of hemorrhagic manifestations, signs of vascular permeability, marked thrombocytopenia, and shock in 114 infants, 1,211 children, and 346 adults. We found that strict application of the WHO criteria fails to detect a significant number of patients with severe manifestations of dengue, especially in adults.


Assuntos
Dengue/epidemiologia , Dengue/patologia , Guias como Assunto , Avaliação de Resultados em Cuidados de Saúde , Índice de Gravidade de Doença , Organização Mundial da Saúde , Adolescente , Adulto , Criança , Pré-Escolar , Dengue/etiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Nicarágua/epidemiologia , Dengue Grave/epidemiologia , Dengue Grave/etiologia , Dengue Grave/patologia
3.
Am J Trop Med Hyg ; 73(6): 1063-70, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16354813

RESUMO

To investigate age-related differences in dengue severity, 114 infants, 1,211 children, and 346 adults with laboratory-confirmed dengue virus (DEN) infections presenting to three hospitals in major urban centers in Nicaragua were recruited from 1999 to 2001. The age distribution of dengue cases and the circulating serotype (predominantly DEN2) were representative of national data. Similar results were obtained when either dengue hemorrhagic fever/dengue shock syndrome or its principal manifestations (vascular permeability, internal hemorrhage, marked thrombocytopenia, and/or shock) were analyzed in relation to age and immune status. The burden of disease and of severe dengue was found predominantly in infants 4-9 months of age and in children 5-9 years old, and secondary DEN infection was a risk factor for severity in children. Age-related differences were identified in the prevalence of specific clinical manifestations as well as in their association with a confirmed DEN diagnosis. This represents one of the few comprehensive studies to analyze characteristics of dengue in infants, children, and adults in the same population and highlights age-related differences in dengue severity.


Assuntos
Dengue/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Dengue/etiologia , Dengue/patologia , Feminino , Hospitais Urbanos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Nicarágua/epidemiologia , Prevalência , Fatores de Risco , Índice de Gravidade de Doença
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