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Vol. 64. Issue 6.
Pages 517-522 (1 June 2006)
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Vol. 64. Issue 6.
Pages 517-522 (1 June 2006)
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Dengue pediátrico en Panamá
Dengue infection in children and adolescents in panama
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B. Larrú Martíneza,
Corresponding author
bealarru@yahoo.es

Correspondencia: Dra. B. Larrú Martínez. Modesto Lafuente, 59, 6.° izq. 28003 Madrid. España.
, E. Quirozb, J.M.ª Bellónc, R. Esquiveld, J. Nieto Guevarad, X. Sáez-Llorensd
a Hospital Universitario La Paz. Madrid. España
b Instituto Conmemorativo Gorgas de Estudios de la Salud. Panamá
c Hospital General Universitario Gregorio Marañón. Madrid. España
d Hospital del Niño. Panamá
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Antecedentes

El dengue es una enfermedad infecciosa emergente, considerada actualmente como un problema de salud pública mundial.

Material y métodos

Se incluyeron en el estudio todos los casos positivos de dengue confirmados de pacientes menores de 18 años, durante los años 2000-2005. En las muestras recibidas en los primeros 3 días de la enfermedad se aisló el virus mediante cultivo y en las recibidas entre los días 5-30 por serología. Se analizaron las características clínicas y epidemiológicas de los pacientes.

Resultados

Se incluyeron 457 pacientes (57,6 % niñas). La mediana de edad fue de 13 años (rango interquartílico = 6). Se detectó un predominio de la infección en las zonas urbanas y en los meses de mayo-noviembre. Se registraron 2 epidemias en los años 2001 (33,9 %) y primeros 8 meses de 2005 (23,1 %). Las manifestaciones clínicas más frecuentes fueron: fiebre (95,2 %); cefalea (74,2 %); escalofríos (65,9 %); exantema (63,5 %); mialgias (51,9 %), y dolor retroorbitario (51,6 %). No se observaron diferencias significativas según el sexo pero sí al dividir a los pacientes en grupos de edad; menores de 5 años, 6-10 años y mayores de 10 años. En el 53,0 % de los pacientes se registró el antecedente de contacto con otro sujeto infectado en los 15 días previos. Se diagnosticaron 7 casos de dengue hemorrágico de los cuales cuatro murieron.

Conclusiones

En Panamá el dengue continúa siendo un importante problema de salud pública. Para conseguir un control efectivo de la infección es preciso realizar estudios epidemiológicos, que como el nuestro, contribuyan a diseñar estrategias preventivas adecuadas.

Palabras clave:
Infección virus dengue
Niños
Adolescentes
Panamá
Background

Dengue is a serious emerging infectious disease and constitutes a major international health concern.

Material and methods

All reports of confirmed dengue infection in patients aged less than 18 years old between 2000 and 2005 were included. A confirmed diagnosis was established by culture of the virus within the first 3 days of symptom onset or by serologic assays 5-30 days after symptom onset. Clinical and epidemiological features were analyzed.

Results

A total of 457 patients were included (57.6 % female). The median age was 13 years (IQR=6). A greater number of cases were detected in urban areas and during the rainy season (May-November). Two epidemics were reported in 2001 (33.9 %) and the first eight months of 2005 (23.1 %). The most prevalent symptoms were fever (95.2 %), severe headache (74.2 %), chills (65.9 %), rash (63.5 %), myalgias (51.9 %) and retro-orbital pain (51.6 %). No significant differences were found between male and female patients. Significant differences in clinical features were found when the patients were divided into 3 groups; < 5 years old, 6-10 years old and > 10 years old. Fifty-three percent of the patients had had previous contact with a dengue-infected individual. There were 7 patients with dengue hemorrhagic fever, 4 of whom died.

Conclusions

Dengue virus infection is still a major health problem in Panama. To achieve effective control of dengue, further epidemiological studies, such as our own, are needed to design appropriate preventive measures.

Key words:
Dengue virus infection
Children
Adolescents
Panama
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Copyright © 2006. Asociación Española de Pediatría
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