[Clinical and epidemiologic characteristics of dengue cases: the experience of a general hospital in Culiacan, Sinaloa, Mexico].
OBJECTIVE
To document the clinical and epidemiological characteristics present in dengue patients served by a hospital in Culiacan, Sinaloa, Mexico.


METHODS
A cross-sectional, observational, and analytical study was carried out at the Hospital General Dr. Bernardo J. Gastélum de Culiacan from 1 October to 2 December 2003. Associations between the independent variables (the patients' clinical and epidemiological characteristics) and the dependent variable (confirmed hemorrhagic dengue) were determined through simple regression analysis. The variables that were significantly associated (P < 0.05) were submitted to multifactorial logistic regression analysis.


RESULTS
Of the only 241 cases that met the study's inclusion criteria (207 dengue and 34 hemorrhagic dengue), the mean age was 34.7 +/- 15.1 years. According to the results of the multifactorial analysis (adjusted by age, sex, and the presence of dengue cases at the geographic location), the variables predictive of major complications of the disease were: the presence of ascites (odds ration [OR] = 22.12; 95% confidence interval [95%CI]: 5.00-97.87), gingivorrhagia (OR = 7.35; 95%CI: 2.11-25.61), hematemesis (OR = 7.40; 95%CI: 1.04-52.42), thrombocytopenia (platelets from 40,001/mm(3)-60,000/mm(3)) (OR = 5.43; 95%CI: 1.58-18.72), conjunctival hyperemia (OR = 4.27; 95%CI: 1.37-13.28), persistent vomiting (OR = 3.04; 95%CI: 1.05-8.80), and the absence of nasal congestion (OR = 0.015; 95%CI: 0.0004-0.473).


CONCLUSIONS
The presence of ascites, gingivorrhagia, hematemesis, thrombocytopenia (with platelet values from 40,001/mm(3)-60,000/mm(3)), and persistent vomiting were confirmed as warning signs of an imminent dengue attack. Platelet counts of > 100,000/mm(3) were confirmed in cases with acute clinical symptoms (capillary leak) that were not classified as hemorrhagic dengue due to falling short of the criteria established by WHO.
Ramírez-Zepeda
María Guadalupe
MG
Dirreción Investigación en Políticas para la Salud, y Facultad de Medicina, Universidad Autónoma de Sinaloa, Sinaloa, México. graze75@uas.uasnet.mx
Velasco-Mondragón
Héctor Eduardo
HE
Ramos
Celso
C
Peñuelas
Javier E
JE
Maradiaga-Ceceña
Marco Antonio
MA
Murillo-Llanes
Joel
J
Rivas-Llamas
Ramón
R
Chaín-Castro
Ricardo
R