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Trop Med Int Health. 2018 Nov;23(11):1231-1241. doi: 10.1111/tmi.13147. Epub 2018 Sep 19.

Burden of dengue among febrile patients at the time of chikungunya introduction in Piedecuesta, Colombia.

Author information

1
Global Dengue and Aedes-transmitted Diseases Consortium, International Vaccine Institute, Seoul, Korea.
2
McGill University, Montreal, QC, Canada.
3
Universidad Industrial de Santander, Bucaramanga, Colombia.

Abstract

OBJECTIVE:

To estimate the age-specific incidence of symptomatic dengue and chikungunya in Colombia.

METHOD:

A passive facility-based fever surveillance study was conducted among individuals with undifferentiated fever. Confirmatory diagnostics included serological and molecular tests in paired samples, and surveillance's underreporting was assessed using capture-recapture methods.

RESULTS:

Of 839 febrile participants 686 completed the study. There were 33.2% (295/839) dengue infections (51% primary infections), and 35.9% (191/532) of negative dengue cases there were chikungunya cases. On average, dengue cases were younger (median = 18 years) than chikungunya cases (median = 25 years). Thrombocytopaenia and abdominal pain were the main dengue predictors, while presence of rash was the main predictor for chikungunya diagnosis. Underreporting of dengue was 31%; the estimated expansion factors indicate an underreporting rate of dengue cases of threefold for all cases and of almost sixfold for inpatients.

CONCLUSIONS:

These findings highlight the ongoing coexistence of both arboviruses, a distinct clinical profile of each condition in the study area that could be used by clinicians to generate a differential diagnosis, and the presence of underreporting, mostly among hospitalised cases.

KEYWORDS:

Colombia; Colombie; caractérisation clinique; chikungunya; clinical characterisation; dengue; disease incidence; fever surveillance; incidence de la maladie; sous-déclaration; surveillance de la fièvre; underreporting

PMID:
30176107
PMCID:
PMC6334506
DOI:
10.1111/tmi.13147
[Indexed for MEDLINE]
Free PMC Article

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