Mustafa B, Hani A W Asmah, Chem Y K, Mariam M, Khairul A H, Abdul Rasid K, Chua K B
Makmal Kesihatan Awam Kebangsaan (National Public Health Laboratory), Kementerian Kesihatan, Lot 1853, Kg. Melayu, 47000 Sungai Buloh, Selangor, Malaysia.
Med J Malaysia. 2010 Dec;65(4):291-6.
Classical dengue fever is characterized by the clinical features of fever, headache, severe myalgia and occasionally rash, which can also be caused by a number of other viral and bacterial infections. Five hundred and fifty eight patients who fulfilled the criteria of clinical diagnosis of acute dengue from 4 government outpatient polyclinics were recruited in this prospective field study. Of the 558 patients, 190 patients were categorized as acute dengue fever, 86 as recent dengue and 282 as non-dengue febrile illnesses based on the results of a number of laboratory tests. Epidemiological features of febrile patients showed that the mean age of patients in the dengue fever group was significantly younger in comparison with patients in the non-dengue group. There was no significant difference between the two groups with respect to gender but there was significant ethnic difference with foreign workers representing a higher proportion in the dengue fever group. Patients with acute dengue fever were more likely to have patient-reported rash and a history of dengue in family or neighbourhood but less likely to have respiratory symptoms, sore-throat and jaundice in comparison to patients with non-dengue febrile illnesses. As with patients with dengue fever, patients in the recent dengue group were more likely to have history of patient-reported rash and a history of dengue contact and less likely to have respiratory symptoms in comparison to patients with non-dengue febrile illnesses. In contrast to patients with dengue fever, patients in the recent dengue group were more likely to have abdominal pain and jaundice in comparison to non-dengue febrile patients. The finding strongly suggests that a proportion of patients in the recent dengue group may actually represent a subset of patients with acute dengue fever at the late stage of illness.
典型登革热的临床特征为发热、头痛、严重肌痛，偶尔伴有皮疹，这些症状也可能由许多其他病毒和细菌感染引起。在这项前瞻性现场研究中，招募了558名来自4家政府门诊综合诊所、符合急性登革热临床诊断标准的患者。根据多项实验室检测结果，558名患者中，190名被归类为急性登革热，86名被归类为近期感染登革热，282名被归类为非登革热发热疾病。发热患者的流行病学特征显示，登革热组患者的平均年龄明显低于非登革热组患者。两组在性别方面无显著差异，但在种族方面存在显著差异，登革热组中外国工人所占比例更高。与非登革热发热疾病患者相比，急性登革热患者更有可能出现患者自述的皮疹以及家庭或邻里中有登革热病史，但出现呼吸道症状、喉咙痛和黄疸的可能性较小。与登革热患者一样，近期感染登革热组患者与非登革热发热疾病患者相比，更有可能出现患者自述的皮疹病史和登革热接触史，且出现呼吸道症状的可能性较小。与登革热患者不同的是，近期感染登革热组患者与非登革热发热患者相比，更有可能出现腹痛和黄疸。这一发现强烈表明，近期感染登革热组中的一部分患者可能实际上代表了疾病晚期急性登革热患者的一个亚组。
