Malavige G N, Velathanthiri V G N S, Wijewickrama E S, Fernando S, Jayaratne S D, Aaskov J, Seneviratne S L
Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayawardanapura, Sri Lanka.
QJM. 2006 May;99(5):299-305. doi: 10.1093/qjmed/hcl039. Epub 2006 Apr 7.
Recent years have seen an increase in dengue infections among adults in Sri Lanka, with similar trends seen in many other countries. Data on the natural history and outcome of dengue in adults are quite limited.
To study clinical and laboratory findings in adult dengue patients hospitalized in Sri Lanka during a recent major dengue epidemic.
Prospective observational study.
Clinical, laboratory and demographic information were collected from adult patients with confirmed dengue infections (n = 108) treated in a general medical ward in Sri Lanka from 24 April to 31 July 2004.
There were 68 male and 40 female patients, mean age 26.6 years. Dengue fever (DF) was seen in 33 (30.6%) and dengue haemorrhagic fever (DHF) in 75 (69.4%). Of the 37 (34.3%) with primary dengue infections, 19 (51.4%) developed DF and 18 (48.6%) developed DHF. Overall, 42 patients (38.9%) had bleeding manifestations. These adults showed differences in clinical and laboratory findings, disease severity and mortality, compared to children seen during the same epidemic. Secondary dengue infections were significantly associated with development of severe disease (OR 5.0, 95%CI 1.9-13.5, p < 0.001). Mortality was 3.7%.
Pooling data on adult dengue patients from different regions should help us to understand the natural history of disease in this group. It would also help in developing evidence-based treatment guidelines and allocating limited and scarce health resources. Our data contribute towards this goal.
近年来，斯里兰卡成年人登革热感染病例有所增加，许多其他国家也出现了类似趋势。关于成年人登革热自然病史和转归的数据非常有限。
研究近期斯里兰卡一次重大登革热疫情期间住院的成年登革热患者的临床和实验室检查结果。
前瞻性观察性研究。
收集了2004年4月24日至7月31日在斯里兰卡一家普通内科病房接受治疗的确诊登革热感染成年患者（n = 108）的临床、实验室和人口统计学信息。
共有68名男性和40名女性患者，平均年龄26.6岁。登革热（DF）患者33例（30.6%），登革出血热（DHF）患者75例（69.4%）。在37例（34.3%）原发性登革热感染患者中，19例（51.4%）发展为DF，18例（48.6%）发展为DHF。总体而言，42例患者（38.9%）有出血表现。与同一疫情期间的儿童相比，这些成年人在临床和实验室检查结果、疾病严重程度和死亡率方面存在差异。继发性登革热感染与严重疾病的发生显著相关（比值比5.0，95%置信区间1.9 - 13.5，p < 0.001）。死亡率为3.7%。
汇总不同地区成年登革热患者的数据应有助于我们了解该群体疾病的自然病史。这也将有助于制定基于证据的治疗指南以及分配有限且稀缺的卫生资源。我们的数据有助于实现这一目标。
