Le Gonidec Erwan, Maquart Marianne, Duron Sandrine, Savini Hélène, Cazajous Geraldine, Vidal Pierre-Olivier, Chenilleau Marie-Caroline, Roseau Jean-Baptiste, Benois Alain, Dehan Céline, Kugelman Jeffrey, Leparc-Goffart Isabelle, Védy Serge
Emergency Department, Bouffard Military Hospital, Djibouti, Republic of Djibouti.
French National Reference Centre for Arbovirus-Armed Forces Biomedical Research Institute, Marseille, France.
PLoS Negl Trop Dis. 2016 Jun 20;10(6):e0004755. doi: 10.1371/journal.pntd.0004755. eCollection 2016 Jun.
Dengue virus is endemic globally, throughout tropical and sub-tropical regions. While the number of epidemics due to the four DENV serotypes is pronounced in East Africa, the total number of cases reported in Africa (16 million infections) remained at low levels compared to Asia (70 million infections). The French Armed forces Health Service provides epidemiological surveillance support in the Republic of Djibouti through the Bouffard Military hospital. Between 2011 and 2014, clinical and biological data of suspected dengue syndromes were collected at the Bouffard Military hospital and analyzed to improve Dengue clinical diagnosis and evaluate its circulation in East Africa. Examining samples from patients that presented one or more Dengue-like symptoms the study evidenced 128 Dengue cases among 354 suspected cases (36.2% of the non-malarial Dengue-like syndromes). It also demonstrated the circulation of serotypes 1 and 2 and reports the first epidemic of serotype 3 infections in Djibouti which was found in all of the hospitalized patients in this study. Based on these results we have determined that screening for Malaria and the presence of the arthralgia, gastro-intestinal symptoms and lymphopenia < 1,000cell/ mm3 allows for negative predictive value and specificity of diagnosis in isolated areas superior to 80% up to day 6. This study also provides evidence for an epidemic of Dengue virus serotype 3 previously not detected in Djibouti.
登革热病毒在全球热带和亚热带地区呈地方性流行。虽然东非因四种登革热病毒血清型导致的疫情数量显著，但与亚洲（7000万例感染）相比，非洲报告的病例总数（1600万例感染）仍处于低水平。法国武装部队卫生服务局通过布法尔军事医院在吉布提共和国提供流行病学监测支持。2011年至2014年期间，布法尔军事医院收集了疑似登革热综合征的临床和生物学数据，并进行分析以改善登革热的临床诊断并评估其在东非的传播情况。通过检查出现一种或多种登革热样症状患者的样本，该研究在354例疑似病例中证实了128例登革热病例（占非疟疾性登革热样综合征的36.2%）。研究还证明了血清型1和2的传播情况，并报告了吉布提血清型3感染的首次疫情，该血清型在本研究的所有住院患者中均有发现。基于这些结果，我们确定，在第6天之前，对疟疾以及关节痛、胃肠道症状和淋巴细胞减少<1000个细胞/mm³的筛查可使偏远地区诊断的阴性预测值和特异性高于80%。本研究还为吉布提此前未检测到的登革热病毒血清型3的疫情提供了证据。
