Originales
Indicadores tempranos de infección por dengue en niños
Early indicators of dengue infection in children
F.A. Díaz-Quijano
, L.A. Villar-Centeno, R.A. Martínez-Vega
Autor para correspondencia
fre_diazq@yahoo.com
Correspondencia: Dr. F.A. Díaz-Quijano. Centro de Investigaciones Epidemiológicas. Facultad de Salud de la Universidad Industrial de Santander. Ctra. 32 N.° 29-31, tercer piso. Bucaramanga. Colombia.
Correspondencia: Dr. F.A. Díaz-Quijano. Centro de Investigaciones Epidemiológicas. Facultad de Salud de la Universidad Industrial de Santander. Ctra. 32 N.° 29-31, tercer piso. Bucaramanga. Colombia.
Centro de Investigaciones Epidemiológicas. Universidad Industrial de Santander. Bucaramanga. Colombia
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Larrú Martínez, E. Quiroz, J.M.ª Bellón, R. Esquivel, J. Nieto Guevara, X. Sáez-Llorens" "autores" => array:6 [ 0 => array:2 [ "nombre" => "B." "apellidos" => "Larrú Martínez" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Quiroz" ] 2 => array:2 [ "nombre" => "J.M.ª" "apellidos" => "Bellón" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Esquivel" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Nieto Guevara" ] 5 => array:2 [ "nombre" => "X." "apellidos" => "Sáez-Llorens" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403306701187?idApp=UINPBA00005H" "url" => "/16954033/0000006400000006/v1_201307051503/S1695403306701187/v1_201307051503/es/main.assets" ] "es" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Originales</span>" "titulo" => "Indicadores tempranos de infección por dengue en niños" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "523" "paginaFinal" => "529" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F.A. Díaz-Quijano, L.A. Villar-Centeno, R.A. Martínez-Vega" "autores" => array:3 [ 0 => array:4 [ "nombre" => "F.A." "apellidos" => "Díaz-Quijano" "email" => array:1 [ 0 => "fre_diazq@yahoo.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "L.A." "apellidos" => "Villar-Centeno" ] 2 => array:2 [ "nombre" => "R.A." "apellidos" => "Martínez-Vega" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Centro de Investigaciones Epidemiológicas. Universidad Industrial de Santander. Bucaramanga. Colombia" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dr. F.A. Díaz-Quijano. Centro de Investigaciones Epidemiológicas. Facultad de Salud de la Universidad Industrial de Santander. Ctra. 32 N.° 29-31, tercer piso. Bucaramanga. Colombia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Early indicators of dengue infection in children" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-01-31" "fechaAceptado" => "2006-02-28" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186332" "palabras" => array:5 [ 0 => "Dengue" 1 => "Diagnóstico clínico" 2 => "Recuento de leucocitos" 3 => "Tiempo de trombina" 4 => "Tiempo parcial de tromboplastina" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186331" "palabras" => array:5 [ 0 => "Dengue" 1 => "Clinical diagnosis" 2 => "Leukocyte count" 3 => "Prothrombin time" 4 => "Partial thromboplastin time" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Identificar manifestaciones clínicas y de laboratorio útiles para el diagnóstico temprano del dengue en los niños.</p> <span class="elsevierStyleSectionTitle">Materiales y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se evaluaron 125 niños (de 5 a 12 años) con síndrome febril agudo de etiología inaparente. Mediante pruebas serológicas pareadas y/o cultivo viral, se confirmó la infección por el virus dengue en 40 pacientes y se descartó en 68 (17 indefinidos). Se compararon las manifestaciones clínicas tempranas (de los primeros 4 días de enfermedad) de los grupos con dengue y con otras causas del síndrome febril, y se determinaron los indicadores independientes de dengue en un análisis multivariado de regresión logística.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Considerando las manifestaciones clínicas y el hemograma, los indicadores independientes de dengue fueron: la ausencia de rinorrea, el eritema facial y algún recuento de leucocitos ≤ 4.500/μ1. Con al menos dos de estos hallazgos se obtiene una sensibilidad del 67,5 % y una especificidad de 72,1 % para el diagnóstico de dengue. Incluyendo las pruebas de coagulación, se obtiene un modelo diagnóstico conformado por: ausencia de rinorrea, leucocitos ≤ 4.500/μ1, tiempo de protrombina > 14 s y tiempoparcial de tromboplastina > 29 s. Con dos de estos hallazgos se sugiere el diagnóstico de dengue con una sensibilidad del 90 % y una especificidad del 52,9 %. Con al menos tres hallazgos, la especificidad aumentaría al 89,7 % y la sensibilidad disminuiría al 50 %. La presencia de los cuatro componentes de este último modelo muestra una especificidad del 100 %.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Algunas manifestaciones clínicas y pruebas de laboratorio simples podrían ayudar a detectar tempranamente el dengue en los niños.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To identify clinical manifestations and laboratory findings useful for the early diagnosis of dengue in children.</p> <span class="elsevierStyleSectionTitle">Materials and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We prospectively evaluated 125 children (aged 5 to 12 years old) with acute febrile syndrome with no apparent etiology. Paired serologic tests and/or viral culture were performed and dengue infection was confirmed in 40 patients and ruled out in 68 (17 indefinite cases). Early clinical manifestations (within the first 4 days of the disease) in the groups with dengue and other causes of febrile syndrome were compared. Independent indicators of dengue were determined in a multivariate logistic regression analysis.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">When clinical manifestations and complete blood count were considered, the independent indicators of dengue were: absence of nasal discharge, facial flushing, and leukocyte count ≤ 4,500/μl. With at least two of these findings, a sensitivity of 67 % and a specificity of 72 % for the diagnosis of dengue were obtained. When coagulation tests were considered, a model for diagnosis was composed of: absence of nasal discharge, leukocyte count ≤ 4500/μl, prothrombin time > 14 seconds, and partial thromboplastin time > 29 seconds. Two of these findings suggested a diagnosis of dengue with a sensitivity of 90 % and a specificity of 52.9 %. With at least 3 findings, specificity increased to 89.7 % and sensitivity decreased to 50 %. The presence of the four components of this latter model shows a specificity of 100 %.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Some clinical manifestations and simple laboratory tests could aid the early detection of dengue infection in children.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Este estudio está incluido en la cohorte de pacientes del proyecto 1102-04-12919, cofinanciado por COLCIENCIAS y la Universidad Industrial de Santander.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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Información del artículo
ISSN: 16954033Idioma original: Español
DOI:10.1157/13089916
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