Clinical, epidemiological and virological features of dengue virus infections in vietnamese patients presenting to primary care facilities with acute undifferentiated fever
Accepted 10 January 2010. published online 04 February 2010.
Summary
Objectives
To explore clinical and virological characteristics and describe the epidemiology of dengue in patients who presented with acute undifferentiated fever (AUF) at primary health centers (PHC) in Binh Thuan Province, Vietnam.
Methods
A prospective observational study was conducted from 2001 to 2006 to study the aetiology in AUF patients. Demographic and clinical information was obtained, and dengue polymerase chain reaction (RT-PCR) and serology were performed on a random selection of patients.
Results
Three hundred fifty-one serologically confirmed dengue patients including 68 primary and 283 secondary infections were included in this study. In 25% (86/351) dengue virus (DENV) was detected by RT-PCR among which 32 DENV-1, 16 DENV-2, 1 DENV-3 and 37 DENV-4 were identified. The predominant dengue serotype varied by year with seasonal fluctuation: DENV-4 in 2001–2002, DENV-1 and DENV-2 from 2003 to 2006. Primary dengue was more common in children. Higher viraemia levels (P=0.010) were found in primary infections compared to secondary infections. DENV-1 infected patients had higher viraemia levels than DENV-2 (P=0.003) and DENV-4 (P<0.001) infected patients. Clinical symptoms were often seen in adults. Few differences in clinical symptoms were found between primary and secondary infection and no significant differences in clinical symptoms between the serotypes were observed.
Conclusions
Our data provide insight in the epidemiology, clinical profile and virological features of mild symptomatic dengue patients who presented to PHC with AUF in Vietnam.
aDivision of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, F4-217, P.O. Box 22700, Amsterdam 1100 DE, the Netherlands
bOxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Hospital for Tropical Diseases, 190 Ben Ham Tu, District 5, Ho Chi Minh City, Viet Nam
cCenter for Infection and Immunity (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
dDivision of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
eDepartment of Virology, Cho Ray Hospital, Ho Chi Minh City, Viet Nam
fBinh Thuan Medical College, Phan Thiet City, Viet Nam
gTropical Diseases Clinical Research Center, Cho Ray hospital, Ho Chi Minh City, Viet Nam
hCenter for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Center for Clinical Vaccinology and Tropical Medicine, Oxford, UK
Corresponding author. Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, District 5, Ho Chi Minh City, Vietnam. Tel.: +84 8 9237954; fax: +84 8 9238904.
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