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孟加拉国达卡2019年登革热疫情的流行病学调查

Epidemiological Investigation of the 2019 Dengue Outbreak in Dhaka, Bangladesh.

作者信息

Yesmin Sabrina, Sarmin Shahnoor, Ahammad Alamgir Mustak, Rafi Md Abdur, Hasan Mohammad Jahid

机构信息

BIRDEM General Hospital, Dhaka, Bangladesh.

Dhaka Medical College, Dhaka, Bangladesh.

出版信息

J Trop Med. 2023 Mar 16;2023:8898453. doi: 10.1155/2023/8898453. eCollection 2023.

Abstract

INTRODUCTION

Bangladesh experienced its largest dengue epidemic in 2019. Our objective was to investigate the epidemiological, clinical, and laboratory characteristics of the hospital-admitted dengue patients during this epidemic.

METHODS

This cross-sectional study was conducted among 369 adult dengue patients admitted to two tertiary care hospitals in Dhaka, Bangladesh, from June to September 2019. The disease severity was determined according to the WHO's 2009 classification.

RESULTS

The average age of the patients was 33.3 (SD 14) years with a predominance of men. Almost 10% developed severe dengue (plasma leakage 67%, clinical bleeding 25%, and organ involvement 25%). Fever, headache, retro-orbital pain, diarrhea, and warning signs such as abdominal pain, clinical fluid accumulation, and persistent vomiting were the most common clinical presentations. Thrombocytopenia, leukopenia, elevated HCT levels, and ALT/AST were common laboratory findings.

CONCLUSIONS

Severe dengue was mostly attributable to plasma leakage with warning signs, especially abdominal pain, clinical fluid accumulation, persistent vomiting, and altered hematological parameters which might assist in the early prediction of severe dengue.

摘要

引言

2019年孟加拉国经历了有史以来最严重的登革热疫情。我们的目的是调查此次疫情期间住院登革热患者的流行病学、临床和实验室特征。

方法

本横断面研究于2019年6月至9月在孟加拉国达卡的两家三级护理医院对369例成年登革热患者进行。根据世界卫生组织2009年的分类确定疾病严重程度。

结果

患者的平均年龄为33.3(标准差14)岁,男性居多。近10%的患者发展为重症登革热(血浆渗漏67%,临床出血25%,器官受累25%)。发热、头痛、眼眶后疼痛、腹泻以及腹痛、临床积液和持续呕吐等警示体征是最常见的临床表现。血小板减少、白细胞减少、血细胞比容水平升高以及谷丙转氨酶/谷草转氨酶升高是常见的实验室检查结果。

结论

重症登革热主要归因于伴有警示体征的血浆渗漏,尤其是腹痛、临床积液、持续呕吐以及血液学参数改变,这些可能有助于早期预测重症登革热。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5961/10036172/ab0624132a8f/JTM2023-8898453.001.jpg

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