Ali Soegianto, Kaisar Maria Mardalena Martini, Hengestu Anastasia, Teguh Angeline Imelda, Janova Angelica Michelle, Chriestya Febie, Loe Luse, Wijaya Jullyany Waty
Department of Medical Biology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
IJID Reg. 2025 Feb 23;14:100612. doi: 10.1016/j.ijregi.2025.100612. eCollection 2025 Mar.
Indonesia is one of the dengue endemic countries. The criteria for diagnosing dengue infection are based on World Health Organization (WHO) guidelines. Chikungunya and Zika virus infections have also been reported sporadically in Indonesia. This study aimed to evaluate the clinical features of patients with dengue in a hospital setting and investigate the potential for other arboviral infections in patients with fever.
This case-control study was conducted at two hospitals in North Jakarta between August 2023 and May 2024. Patients admitted with 3 or more days of fever without any proven cause of bacterial infection or autoimmune disease were recruited. The cases were those who tested positive for Dengue, Chikunguya, Zika, and West Nile viruses by multiplex reverse transcription-quantitative polymerase chain reaction, whereas the controls were those who tested negative. Questionnaires were used to collect the signs and symptoms. Blood tests were conducted using autoanalyzers. Chi-square and Student's -tests were used for statistical analyses.
Of the 135 respondents, 70 tested positive for dengue and two tested positive for chikungunya using multiplex reverse transcription-quantitative polymerase chain reaction. Having fever with two additional two signs and symptoms, as per the WHO guidelines, is predictive of dengue infection. Leukopenia and thrombocytopenia were significantly more common in dengue cases. An increase in hematocrit was inconclusive. Serum aspartate transaminase levels are also increased in patients with dengue. The dengue virus nonstructural protein-1 antigen test is the preferred point-of-care test for the diagnosis of dengue virus infections.
Our investigation confirmed that the WHO guidelines for diagnosing dengue are still applicable. The Chikungunya virus also circulates in Jakarta, and physicians should be aware of this.
印度尼西亚是登革热流行国家之一。登革热感染的诊断标准基于世界卫生组织(WHO)指南。印度尼西亚也偶有基孔肯雅热和寨卡病毒感染的报告。本研究旨在评估医院环境中登革热患者的临床特征,并调查发热患者感染其他虫媒病毒的可能性。
本病例对照研究于2023年8月至2024年5月在雅加达北部的两家医院进行。招募了发热3天及以上且无任何确诊细菌感染或自身免疫性疾病病因的患者。病例为通过多重逆转录定量聚合酶链反应检测登革热、基孔肯雅热、寨卡病毒和西尼罗河病毒呈阳性的患者,而对照为检测呈阴性的患者。使用问卷收集体征和症状。使用自动分析仪进行血液检测。采用卡方检验和t检验进行统计分析。
在135名受访者中,70人通过多重逆转录定量聚合酶链反应检测登革热呈阳性,2人检测基孔肯雅热呈阳性。根据WHO指南,出现发热并伴有另外两种体征和症状可预测登革热感染。白细胞减少和血小板减少在登革热病例中明显更为常见。血细胞比容升高的情况尚无定论。登革热患者的血清天冬氨酸转氨酶水平也会升高。登革热病毒非结构蛋白-1抗原检测是诊断登革热病毒感染的首选即时检测方法。
我们的调查证实,WHO的登革热诊断指南仍然适用。基孔肯雅病毒也在雅加达传播,医生应予以关注。