Clinical profile of dengue hemorrhagic fever cases in Mexico

Dengue hemorrhagic fever is a public health problem in Mexico since 1994. With four serotypes circulating the risk of epidemic dengue hemorrhagic fever is increasing. We describe the clinical features of confirmed cases in the social security health system (IMSS) from 1995 to 2003. Clinical picture...

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Bibliographic Details
Published in:Salud pública de México 2005-05, Vol.47 (3), p.193-200
Main Authors: Navarrete-Espinosa, Joel, Gómez-Dantés, Héctor, Celis-Quintal, Juan Germán, Vázquez-Martínez, José Luis
Format: Article
Language:English
Subjects:
Adult
Ascites - epidemiology
Ascites - etiology
Dengue - complications
Dengue - diagnosis
Dengue - epidemiology
Dengue - mortality
Disease Progression
Female
Follow-Up Studies
Hematemesis - epidemiology
Hematemesis - etiology
Humans
Incidence
Male
Melena - epidemiology
Melena - etiology
Mexico - epidemiology
Prognosis
Retrospective Studies
Risk
Risk Factors
Serologic Tests
Severe Dengue - complications
Severe Dengue - diagnosis
Severe Dengue - epidemiology
Severe Dengue - mortality
Thrombocytopenia - epidemiology
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Summary:Dengue hemorrhagic fever is a public health problem in Mexico since 1994. With four serotypes circulating the risk of epidemic dengue hemorrhagic fever is increasing. We describe the clinical features of confirmed cases in the social security health system (IMSS) from 1995 to 2003. Clinical picture and epidemiological features were compared and a multivariate model was fitted to evaluate associations. Cases were divided into two groups: 438 patients with dengue fever, including 109 cases with hemorrhagic manifestations without thrombocytopenia, and 977 cases with dengue hemorrhagic fever, including 79 deaths. The main risk factors associated with mortality were hematemesis (RR 2.6; CI 95% 1.4-4.6) and melena (RR 2.2; Cl 95% 1.2-3.7). Our results characterize the clinical profile of dengue hemorrhagic fever cases in Mexico and identify prognostic factors to alert clinician for the prevention of a fatal evolution.
ISSN:0036-3634
0036-3634
DOI:10.1590/S0036-36342005000300002