Differences in dengue severity in infants, children, and adults in a 3-year hospital-based study in Nicaragua.
To investigate age-related differences in dengue severity, 114 infants, 1,211 children, and 346 adults with laboratory-confirmed dengue virus (DEN) infections presenting to three hospitals in major urban centers in Nicaragua were recruited from 1999 to 2001. The age distribution of dengue cases and the circulating serotype (predominantly DEN2) were representative of national data. Similar results were obtained when either dengue hemorrhagic fever/dengue shock syndrome or its principal manifestations (vascular permeability, internal hemorrhage, marked thrombocytopenia, and/or shock) were analyzed in relation to age and immune status. The burden of disease and of severe dengue was found predominantly in infants 4-9 months of age and in children 5-9 years old, and secondary DEN infection was a risk factor for severity in children. Age-related differences were identified in the prevalence of specific clinical manifestations as well as in their association with a confirmed DEN diagnosis. This represents one of the few comprehensive studies to analyze characteristics of dengue in infants, children, and adults in the same population and highlights age-related differences in dengue severity.
Hammond
Samantha Nadia
SN
Division of Infectious Diseases, School of Public Health, University of California, Berkeley, California 94720-7360, USA.
Balmaseda
Angel
A
Pérez
Leonel
L
Tellez
Yolanda
Y
Saborío
Saira Indira
SI
Mercado
Juan Carlos
JC
Videa
Elsa
E
Rodriguez
Yoryelin
Y
Pérez
Maria Angeles
MA
Cuadra
Ricardo
R
Solano
Soraya
S
Rocha
Julio
J
Idiaquez
Wendy
W
Gonzalez
Alcides
A
Harris
Eva
E
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003715:Dengue / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009527:Nicaragua / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index