1. Clinical Survey of Dengue Virus Circulation in the Republic of Djibouti between 2011 and 2014 Identifies Serotype 3 Epidemic and Recommends Clinical Diagnosis Guidelines for Resource Limited Settings
- Author
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Jean-Baptiste Roseau, Erwan Le Gonidec, Isabelle Leparc-Goffart, S. Duron, Celine Dehan, Marie-Caroline Chenilleau, Jeffrey R. Kugelman, Hélène Savini, Geraldine Cazajous, Marianne Maquart, Serge Védy, Alain Benois, and Pierre-Olivier Vidal
- Subjects
Serotype ,RNA viruses ,Viral Diseases ,Physiology ,Suspected dengue ,Fevers ,Dengue virus ,medicine.disease_cause ,Pathology and Laboratory Medicine ,Communicable Diseases, Emerging ,Dengue fever ,Geographical Locations ,Dengue ,White Blood Cells ,0302 clinical medicine ,Animal Cells ,Medicine and Health Sciences ,030212 general & internal medicine ,Lymphocytes ,lcsh:Public aspects of medicine ,Hematology ,Arthralgia ,Body Fluids ,Infectious Diseases ,Blood ,Medical Microbiology ,Arboviral Infections ,Viral Pathogens ,Viruses ,Djibouti ,RNA, Viral ,Pathogens ,Cellular Types ,Anatomy ,Research Article ,Platelets ,lcsh:Arctic medicine. Tropical medicine ,lcsh:RC955-962 ,Immune Cells ,030231 tropical medicine ,Immunology ,Microbiology ,03 medical and health sciences ,Signs and Symptoms ,Diagnostic Medicine ,Environmental health ,Lymphopenia ,medicine ,East africa ,Pain Management ,Humans ,Lymphocyte Count ,Serotyping ,Microbial Pathogens ,Blood Cells ,Biology and life sciences ,Flaviviruses ,business.industry ,Platelet Count ,Public Health, Environmental and Occupational Health ,Organisms ,lcsh:RA1-1270 ,Cell Biology ,Dengue Virus ,medicine.disease ,Virology ,Clinical diagnosis ,People and Places ,Africa ,business ,Limited resources ,Malaria - Abstract
Dengue virus is endemic globally, throughout tropical and sub-tropical regions. While the number of epidemics due to the four DENV serotypes is pronounced in East Africa, the total number of cases reported in Africa (16 million infections) remained at low levels compared to Asia (70 million infections). The French Armed forces Health Service provides epidemiological surveillance support in the Republic of Djibouti through the Bouffard Military hospital. Between 2011 and 2014, clinical and biological data of suspected dengue syndromes were collected at the Bouffard Military hospital and analyzed to improve Dengue clinical diagnosis and evaluate its circulation in East Africa. Examining samples from patients that presented one or more Dengue-like symptoms the study evidenced 128 Dengue cases among 354 suspected cases (36.2% of the non-malarial Dengue-like syndromes). It also demonstrated the circulation of serotypes 1 and 2 and reports the first epidemic of serotype 3 infections in Djibouti which was found in all of the hospitalized patients in this study. Based on these results we have determined that screening for Malaria and the presence of the arthralgia, gastro-intestinal symptoms and lymphopenia < 1,000cell/ mm3 allows for negative predictive value and specificity of diagnosis in isolated areas superior to 80% up to day 6. This study also provides evidence for an epidemic of Dengue virus serotype 3 previously not detected in Djibouti., Author Summary Dengue virus is emerging worldwide, however, little is known about the burden of Dengue in Africa. Effectively, only sporadic cases and few epidemics have been reported in the last 30 years. This descriptive study reports clinical and biological data of Dengue-suspected cases analyzed in the Bouffard military hospital of Djibouti from 2011–2014. It also confirms the circulation of Dengue virus serotypes 1 and 2 and reports the first epidemic of Dengue virus serotype 3 infections in Djibouti. Directions for diagnosis are offered to practitioners working in resource limited settings and dealing with a Dengue-like syndrome of less than seven days and negative for malaria.
- Published
- 2016