Reference Center for Dengue, Campos dos Goytacazes, Rio de Janeiro, RJ 28030-582, Brazil.
Braz J Infect Dis. 2013 Jan-Feb;17(1):27-31. doi: 10.1016/j.bjid.2012.08.020. Epub 2013 Jan 11.
Over the past several years, the epidemiological profile of dengue has been changing progressively and is currently characterized by an increase in the number of cases in children under 15 years of age. This study was aimed at comparing the clinical and laboratory features between adults and children with dengue; therefore, we performed a cross-sectional analysis of 5686 individuals with laboratory-confirmed dengue who sought treatment at a healthcare facility in Rio de Janeiro, Brazil from 2010 to 2011. A multivariate analysis indicated that myalgia (OR=2.58; CI 95%=2.08-3.18), retro-orbital pain (OR=1.36; CI 95%=1.15-1.62), nausea (OR=1.92; CI 95%=1.60-2.30), and arthralgia (OR=3.64; CI 95%=2.72-4.89) were the most frequent clinical symptoms in adults, whereas vomiting (OR=0.52; CI 95%=0.43-0.61) and skin rash (OR=0.46; CI 95%=0.25-0.85) were the most prevalent symptoms in children. Adults exhibited a higher hemoconcentration (OR=3.04; CI 95%=2.53-3.65), thrombocytopenia (OR=2.17; CI 95%=1.80-2.60), increased erythrocyte sedimentation rate (OR=1.81; CI 95%=1.53-2.14), and increased ALT (OR=3.13; CI 95%=2.44-4.02) than did children. In addition, adults exhibited a higher frequency of the severe forms of the disease (OR=1.74; CI 95%=1.12-2.72) and hospitalization (OR=2.21; CI 95%=1.59-3.06) relative to children. Based on these results, this study demonstrated significant differences in the clinical and laboratory presentations and disease severity between adults and children affected by dengue.
在过去的几年中，登革热的流行病学特征一直在逐渐变化，目前的特点是 15 岁以下儿童病例数增加。本研究旨在比较成人和儿童登革热的临床和实验室特征；因此，我们对 2010 年至 2011 年在巴西里约热内卢一家医疗机构就诊的 5686 例实验室确诊登革热患者进行了横断面分析。多变量分析表明，肌痛（OR=2.58；95%CI=2.08-3.18）、眼眶后疼痛（OR=1.36；95%CI=1.15-1.62）、恶心（OR=1.92；95%CI=1.60-2.30）和关节痛（OR=3.64；95%CI=2.72-4.89）是成人中最常见的临床症状，而呕吐（OR=0.52；95%CI=0.43-0.61）和皮疹（OR=0.46；95%CI=0.25-0.85）是儿童中最常见的症状。与儿童相比，成人表现出更高的血液浓缩（OR=3.04；95%CI=2.53-3.65）、血小板减少症（OR=2.17；95%CI=1.80-2.60）、红细胞沉降率升高（OR=1.81；95%CI=1.53-2.14）和 ALT 升高（OR=3.13；95%CI=2.44-4.02）。此外，与儿童相比，成人患疾病严重程度更高（OR=1.74；95%CI=1.12-2.72）和住院率（OR=2.21；95%CI=1.59-3.06）更高。基于这些结果，本研究表明成人和儿童登革热患者的临床和实验室表现以及疾病严重程度存在显著差异。
