Contribution of viral respiratory infections to dengue-like illness presentation at a community clinic in southern Malaysia
Document Type
Article
Publication Date
1-1-2022
Abstract
This study explored the contribution of viral respiratory infections (VRIs) in dengue-like illness (DLI) patients and their distinguishing clinicolaboratory parameters. Two hundred DLI patients were prospectively recruited (July 1- October 1, 2019) from a community clinic in Southern Malaysia. Patients >_ 18 years with acute fever and fulfilling the WHO criteria of probable dengue were recruited. They underwent blood testing: blood counts, rapid dengue tests (nonstructural antigen-1/IgM) and polymerase chain reaction (PCR) for dengue, Zika, chikungunya, and Leptospira. Nasopharyngeal swabs (NPSs) were collected for FilmArrayVR RP2plus testing. From the 200 NPSs, 58 respiratory viruses (RVs) were detected in 54 patients. Of the 96 dengue-confirmed cases, 86 had dengue mono-infection, and 10 were coinfected with RVs. Of the 104 nondengue, 44 were RV positive and 4 Leptospira positive. Zika and chikungunya virus were not detected. Overall, the etiological diagnosis was confirmed for 72% of patients. Clinicolaboratory parameters were compared between dengue mono-infection and VRI mono-infection. Patients with coinfections were excluded. Multiple logistic regression showed that recent household/neighborhood history of dengue (adjusted odds ratio aOR]: 5.9, 95% CI = 1.7-20.7), leukopenia (aOR: 12.5, 95% CI = 2.6-61.4) and thrombocytopenia (aOR: 5.5, 95% CI = 1.3-23.0) predicted dengue. Inversely, rhinorrhoea (aOR: 0.1, 95% CI = 0.01-0.3) and cough (aOR: 0.3, 95% CI = 0.1-0.9) favored VRI. Thus, VRIs comprise many infections diagnosed initially as DLIs. Early clinicolaboratory parameters can guide physicians screen patients for further testing.
Keywords
Viral respiratory infections, Dengue-like illness, Malaysia, Nasopharyngeal swabs, Zika, Chikungunya, Leptospira
Divisions
anaesthesiology
Funders
United States Naval Medical Research Unit-2 [N6264518D5058] [N6264518F0740] [SC-N6264518D5058-Monash-001],Armed Forces Health Surveillance Division (AFHSD)-Global Emerging Infections Surveillance Branch (GEIS),HRPO [HRPO.NMRCA.2018.003]
Publication Title
American Journal of Tropical Medicine and Hygiene
Volume
106
Issue
1
Publisher
Amer Soc Trop Med & Hygiene
Publisher Location
8000 WESTPARK DR, STE 130, MCLEAN, VA 22101 USA