Department of Laboratory Medicine, Kolkata, West Bengal, India.
Department of Tropical Medicine, Kolkata, West Bengal, India.
J Med Virol. 2022 Feb;94(2):540-548. doi: 10.1002/jmv.27430. Epub 2021 Nov 11.
For the past several decades, dengue fever has been emerging in epidemic proportions in several regions of the world. During August-September 2019, an increasing number of fever cases were being reported from some areas of North 24 Parganas district of West Bengal, India. Accordingly, outbreak investigation of fever cases from these affected areas of Bongoan, Barasat, and Habra was carried out. To characterize clinical and biochemical features of fever cases as well as to investigate the utility of CRP as a Dengue severity marker in resource-limited settings. We systematically enrolled 108 patients from the affected region of North 24 Parganas. Standard diagnostic assays along with routine serological and biochemical parameters were performed. Of the 108 patients, 77 (71%) were confirmed with Dengue infection followed by 22 (20%) DENV seronegative and 9 (8%) coinfected DENV cases. Among the 77 confirmed Dengue patients, 53 (69%) had primary infection while 24 (31%) had secondary infection. Among the DENV clinical symptoms, fever (r = 0.50; p = 0.004), headache (r = 0.40; p = 0.03) and abdominal pain (r = -0.40; p = 0.02) were found to bear significant correlation with DENV viral load. The predominant circulating serotype was found to be DENV2. CRP Dengue severity cut-off level of 10.15 mg/L (AUC: 0.85; 86% sensitivity, 77% specificity) was obtained. CRP had correlation with viral load (r = 0.4, p = 0.05) within febrile phase of infection. The performance of biomarkers can be influenced by local epidemiology, geography, and several patient factors, therefore, CRP Dengue severity cut-off value may be region-specific. This study for the first time attempts to estimate CRP Dengue severity cut-off value based on routine immunoturbidometric evaluation from Dengue Hyperendemic zones of North 24 Parganas, West Bengal, Eastern India.
在过去的几十年中，登革热在世界上的几个地区以流行的比例出现。2019 年 8 月至 9 月，来自印度西孟加拉邦北 24 帕尔干纳地区的一些地区报告了越来越多的发热病例。因此，对来自邦加安、巴拉萨特和哈布拉受影响地区的发热病例进行了暴发调查。为了描述发热病例的临床和生化特征，并研究 CRP 作为资源有限环境中登革热严重程度标志物的效用。我们系统地从受影响的北 24 帕尔干纳地区招募了 108 名患者。进行了标准诊断检测以及常规血清学和生化参数检测。在 108 名患者中，77 名（71%）确诊为登革热感染，22 名（20%）DENV 血清阴性，9 名（8%）合并感染 DENV。在 77 例确诊的登革热患者中，53 例（69%）为原发性感染，24 例（31%）为二次感染。在 DENV 临床症状中，发热（r=0.50；p=0.004）、头痛（r=0.40；p=0.03）和腹痛（r=-0.40；p=0.02）与 DENV 病毒载量有显著相关性。主要循环血清型为 DENV2。获得了 10.15mg/L 的 CRP 登革热严重程度截断值（AUC：0.85；86%敏感性，77%特异性）。CRP 在感染发热期与病毒载量呈正相关（r=0.4，p=0.05）。生物标志物的性能可能受到当地流行病学、地理位置和几个患者因素的影响，因此，CRP 登革热严重程度截断值可能是特定于地区的。这项研究首次尝试根据印度东部西孟加拉邦北 24 帕尔干纳登革热高度流行地区的常规免疫比浊法评估来估计 CRP 登革热严重程度截断值。
