Patterns of signs, symptoms, and laboratory values associated with Zika, dengue, and undefined acute illnesses in a dengue endemic region: Secondary analysis of a prospective cohort study in southern Mexico
Por:
Hunsberger S., Ortega-Villa A.M., Powers J.H., III, Rincón León H.A., Caballero Sosa S., Ruiz Hernández E., Nájera Cancino J.G., Nason M., Lumbard K., Sepulveda J., Guerra de Blas P.D.C., Ruiz-Palacios G., Belaunzarán-Zamudio P.F.
Publicada:
1 ene 2020
Resumen:
Objectives: Dengue and Zika infections cause illnesses with overlapping clinical manifestations. The aim of this study was to explore the association of each of these infections with single or grouped clinical and laboratory parameters. Methods: Clinical and laboratory data were collected prospectively from a cohort of patients seeking care for symptoms meeting the Pan American Health Organization's modified case-definition criteria for probable Zika virus infection. Zika and dengue were diagnosed with RT-PCR. The relationship of clinical characteristics and laboratory data with Zika, dengue, and undefined acute illness (UAI) was examined. Results: In the univariate models, localized rash and maculopapular exanthema were associated with Zika infection. Generalized rash, petechiae, and petechial purpuric rash were associated with dengue. Cough and confusion/disorientation were associated with UAI. Platelets were significantly lower in the dengue group. A conditional inference tree model showed poor sensitivity and positive predictive value for individual viral diagnoses. Conclusions: Clusters of signs, symptoms, and laboratory values evaluated in this study could not consistently differentiate Zika or dengue cases from UAI in the clinical setting at the individual patient level. We identified symptoms that are important to Zika and dengue in the univariate analyses, but predictive models were unreliable. Low platelet count was a distinctive feature of dengue. © 2020 The Authors
Filiaciones:
Hunsberger S.:
National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
Ortega-Villa A.M.:
National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
Powers J.H.:
Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, United States
III:
Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, United States
Rincón León H.A.:
Instituto Mexicano del Seguro Social, Delegación Estatal, Tapachula, Chiapas, Mexico
Caballero Sosa S.:
Clínica Hospital Dr. Roberto Nettel Flores, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, Mexico
Ruiz Hernández E.:
Hospital General de Tapachula, Tapachula, Chiapas, Mexico
Nájera Cancino J.G.:
Hospital Regional de Alta Especialidad Ciudad Salud, Tapachula, Mexico
Nason M.:
National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
Lumbard K.:
Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, United States
Sepulveda J.:
Hospital Regional de Alta Especialidad Ciudad Salud, Tapachula, Mexico
Guerra de Blas P.D.C.:
The Mexican Emerging Infectious Diseases Clinical Research Network (LaRed), Mexico City, Mexico
Ruiz-Palacios G.:
Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Belaunzarán-Zamudio P.F.:
National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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