Age and regional differences in clinical presentation and risk of hospitalization for dengue in brazil, 2000-2014

Age and regional differences in clinical presentation and risk of hospitalization for dengue in brazil, 2000-2014

Author Burattini, Marcelo N. Autor UNIFESP Google Scholar
Lopez, Luis F. Google Scholar
Coutinho, Francisco A. B. Google Scholar
Siqueira-, Joao B., Jr. Google Scholar
Homsani, Sheila Google Scholar
Sarti, Elsa Google Scholar
Massad, Eduardo Google Scholar
Abstract OBJECTIVES: Dengue cases range from asymptomatic to severe, eventually leading to hospitalization and death. Timely and appropriate management is critical to reduce morbidity. Since 1980, dengue has spread throughout Brazil, affecting an increasing number of individuals. This paper describes age and regional differences in dengue's clinical presentation and associated risk of hospitalization based on more than 5 million cases reported to the Brazilian Ministry of Health from 2000-2014. METHODS: We performed a retrospective analysis of similar to 5,450,000 dengue cases, relating clinical manifestations and the risk of hospitalization to age, gender, previous infection by dengue, dengue virus serotype, years of formal education, delay to first attendance and the occurrence of dengue during outbreaks and in different Brazilian regions. RESULTS: Complicated forms of dengue occurred more frequently among those younger than 10 years (3.12% vs 1.92%) and those with dengue virus 2 infection (7.65% vs 2.42%), with a delay to first attendance >2 days (3.18% vs 0.82%) and with <= 4 years of formal education (2.02% vs 1.46%). The risk of hospitalization was higher among those aged 6-10 years old (OR 4.57

95% CI 1.43-29.96) and those who were infected by dengue virus 2 (OR 6.36

95% CI 2.52-16.06), who lived in the Northeast region (OR 1.38

95% CI 1.11-2.10) and who delayed first attendance by >5 days (composite OR 3.15

95% CI 1.33-8.9). CONCLUSIONS: In Brazil, the occurrence of severe dengue and related hospitalization is associated with being younger than 10 years old, being infected by dengue virus 2 or 3, living in the Northeast region (the poorest and the second most populated) and delaying first attendance for more than 2 days.
Keywords Dengue
Morbidity
Epidemiology
Surveillance System
Hospitalization
BrazilHemorrhagic-Fever
Case Definitions
Classification
Countries
Language English
Sponsor Fundo Nacional de Saude of the Brazilian Ministry of Health (FNS) [777588/2012]
Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)
Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)
Hospital Sao Paulo (HSP)
EPM-UNIFESP
Sanofi Pasteur
Dengue TOOLS (under the health theme of the Seven Framework Program of the European Community) [282589]
[LIM 01-HCFMUSP]
Grant number FNS: 777588/2012
Seven Framework Program of the European Community: 282589
Date 2016
Published in Clinics. Sao paulo, v. 71, n. 8, p. 455-463, 2016.
ISSN 1807-5932 (Sherpa/Romeo, impact factor)
Publisher Hindawi Ltd
Extent 455-463
Origin http://dx.doi.org/10.6061/clinics/2016(08)08
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000382872200008
SciELO ID S1807-59322016000800455 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/49419

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