Classification Of Dengue Fever Using Decision Tree

Objective To understand the epidemiologic features of an outbreak of dengue fever (DF) in Xishuangbanna prefecture of Yunnan province in 2015, with its viral serum-type and transmission source. Methods The data of DF cases in Xishuangbanna prefecture were collected. The serum samples from acute stage of these patients were collected to detect the viral nucleic acid by RT-PCR assay. The phylogenetic tree was generated and analyzed based on the nucleotide sequences of C/PrM gene fragments of dengue virus (DENV). Results A total of 1 132 cases of DF were reported in Xishuangbanna prefecture in 2015. Of them, 1 089 were indigenous cases (96.20%), 43 were imported cases (3.80%), i. e., 38 from Myanmar, 3 from Laos and 2 from Thailand. Autochthonous DF occurred in urban area and Gasa towan of Jinghong city that there was distribution of Aedes aegypti mosquitoes. Epidemic month of DF was from July to December. The majority of patients were aged from 20 to 49 years-old, with the youngest 2 years old and the eldest 93 years old. The male to female ratio was 1: 1.05. The results of virus nucleic acid detection and sequencing indicated that nucleotide sequences of C/PreM of 33 virus strains were obtained from the DF cases. Phylogenetic analysis indicated that the 33 strains belonged to DENV serotype 2 (DENV-2), and the strain from the imported cases of Thailand shared high homology with the strains from indigenous cases as well as belonged to same clade. These DENV-2 strains from Xishuangbanna had a closer genetic relationship with the strains isolated from Southeast Asia, Fujian and Guangdong provinces of China, however, distant relatives with DENV-2 strains from Ruili city of Yunnan province in 2014. Conclusions The autochthonous DF epidemic occurred in Xishuangbanna in 2015 was caused by DENV-2. The study also suggests that the transmission of DF from Thailand to Xishuangbanna of China was the main cause of the autochthonous DF epidemic, and Aedes aegypti mosquito was the main transmitting vector in the local. Should strengthen surveillance and management on the imported cases and indigenous cases of DF and mosquito control in this region is the key measures to prevent prevalence of the disease once again. Key words: Dengue fever; Dengue virus; Phylogenetic analysis; Epidemiology

Context: Dengue is an acute febrile disease transmitted by bite of Aedes aegypti mosquito. It leads to “classical” dengue fever, dengue hemorrhagic fever with/without shock. The disease is prevalent throughout India and Maharashtra recorded 5610 dengue cases in 2013 with 48 deaths and 3551 cases with 7 deaths until 29th October 2014. Aims: To study demographic and clinical spectrum of dengue patients admitted in a tertiary care hospital in Pune. Settings and Design: This was a cross-sectional record-based study. Population of Inpatients of tertiary hospital, Pune, admitted during June 1, 2016–November 31, 2016. Materials and Methods: Records of indoor patients admitted used to fill prestructured pro forma. Data were entered into Microsoft Excel to calculate percentages. Results: A total of 299 patients' records were assessed. Patients belonging to age group of 0–30 years were 70.16% (210). Out of 299 patients, 63.21%were males. The common symptoms were fever with chills in 87% patients and headache/body ache in 89% of patients. Stay in hospital for 95.29% (285) was a week. Approximately 31% (92) patients had a platelet count of 10,000–40,000 and 99.6% (269) patients did not require platelet transfusion. Ns1Ag positive were 81% patients. The most common complication was thrombocytopenia (79%). Conclusion: Age group 21–40 years was affected. Ns1Ag positive were 81% patients, blood transfusion not required by majority.

Objective To investigate the epidemiological characteristics of dengue fever in Shenzhen city in 2014 and to analyze the evolutional characteristics of the epidemic dengue virus (DENV) strains in order to provide scientific guidelines for the prevention and control of dengue fever. Methods Descriptive epidemiological analysis was used to analyze the prevalence of dengue fever in Shenzhen city in 2014. Immunochromatography and real-time PCR were performed to detect the specific antibodies (IgM and IgG) and DENV nucleic acids in serum samples collected from suspected cases of dengue fever. Serum samples collected from the patients at early stage of dengue fever were used to infect the C6/36 cell line for further isolation of DENV strains. The types of isolated DENV strains were determined by using real-time PCR. E genes of the isolated DENV strains were amplified by RT-PCR and then sequenced. DNAStar and Clustslx (1.83) softwares were used to analyze the homology between DENV strains isolated in Shenzhen and other areas. A phylogenetic tree based on the sequences of E genes of Shenzhen strains and other sequences of DENV reference strains downloaded from GenBank was constructed for further analysis. Results A total of 454 cases of dengue fever were reported in Shenzhen in 2014 with a male to female ratio of 1.43∶1. Local patients accounted for 76.21% and the rest 23.79% were imported cases mainly from Southeast Asian and surrounding cities. There were 441 cases reported from September to November, accounting for 97.14% of all reported cases. Most of the infected subjects were aged 20 to 50, accounting for 76.73%. Of the 270 samples positive for DENV nucleic acids, strains of DENV-1, DENV-2, DENV-3 and DENV-4 accounted for 87.41%, 8.89%, 0.37% and 2.22%, respectively. The phylogenetic tree analysis revealed that the DENV-1 strains belonged to two genotypes, which were genotypeⅠ and genotype Ⅴ. The DENV strains of genotypeⅠ were highly similar to the epidemic strain isolated in Shenzhen in 2010 and the genotype Ⅴ strains were first reported in Shenzhen. The homology analysis of the nucleotides of E genes showed that minor differences in the nucleotide sequences were found between DENV-2 strains. All of the DENV-2 strains belonged to the genotype Ⅳ as indicated by the phylogenic tree. Conclusion There were 454 cases of dengue fever (including both local and imported cases) reported in Shenzhen city in 2014, reaching an all-time high. DENV-1 was the predominant pathogen in combination with an increased infection of DENV-2. This study indicated that the prevalent DENV strains might be imported from Southeast countries and neighboring cities. Further researches should be conducted to analyze whether dengue fever is endemic in Shenzhen City. Key words: Dengue virus; Epidemiological characteristics; E gene; Evolutional analysis

Background : Dengue virus belongs to family Flaviviridae , having four serotypes that spread by the bite of infected Aedes mosquitoes. Materials and methods : Dengue positive cases from June to December of two constitutive years, 2015-2016 were obtained, total number of cases were 60. Result: Male and female were 36(60%) and 24(40%) respectively. It denotes almost all cases were primary dengue infection. They were negative for IgM and IgG. Out of total cases 28(46.6%) patients had initial presentation with thrombocytopenia, below 150,000/ul, minimum 20,000/. In first weak leucopenia with relative lymphocytosis, neutropenia, raised ALT and AST are important laboratory findings. From first weak onwards, petechial rashes due thrombocytopenia and erythematous skin patches due to increased vascular permeability are important features. The erythematous patches due to vasculopathy give a hot touch feeling. Rapid ELISA for NS1, IgM, and IgG could be false negative in 10% cases. For those dengue suspected cases ELISA, hemagglutination or PCR based investigations are warranted for diagnosis. Conclusion: The study results are relevant in the characterization of biological markers in the evolution of the disease and can be used as markers for the most severe forms thereby enabling health professionals in taking early help with the adaption of therapeutic conduct for specific patients. It could be useful for making policy regarding control and prevention of dengue fever in state like Bihar where such type study is not till now published.

This research aims to study level of knowledge, attitude and practice of Dengue Fever (DF) prevention and to identify the relationship between knowledge, attitude and practice of Dengue Fever (DF) prevention among the villagers of Moo 2 Baan Kantakian, Mitraparb Subdistrict, Muaklek District, Saraburi Province, Thailand where DF incidence has inclined. 228 respondents were purposely selected from 519 villagers with the mean age of 51 years old. Three questionnaires were used for data collection. Descriptive and Pearson product- moment correlation statistical analyses were employed. The results showed 53.9% of respondents were female, 76.8% were married; 32.0% completed elementary school; 37.3% were employee, and an average income was 18,000.00 Baht/month. Respondents had moderate level of general knowledge about DF. Majority had moderate knowledge about the cause (43.0%) and the life cycle of Aedes aegypti mosquito (53.1%), and high knowledge about transmission risk (93.4%) and the prevention (39.9%). Moreover, majority had a good level of attitude about DF regarding prevention (85.1%) plus concept and practice (69.3%); surely, majority (59.6%) had high level of practice of DF prevention. Evidently, knowledge and attitude, knowledge and practice, and attitude and practice of the respondents were positively correlated to DF prevention at statistically significant level of 0.05 (r = 0.359, p – value = < 0.000, r = 0.258, p – value = 0.000 and r = 0.372, p – value = 0.000 respectively). Recommendation on improving the knowledge and attitude of the DF to the community would be reinforce the practice for DF disease prevention remaining at high level. Meanwhile, further research investigating other factors contributing to high DF epidemic is encouraged.

Dengue fever is an acute mosquito-transmitted disease caused by the dengue fever virus which had clinical manifestations range from fever to severe hemorrhage, shock, and death.1 There were 500,000 cases of dengue hemorrhagic fever and 25,000 deaths due to dengue annually worldwide. Bleeding is one of the major problems encountered in dengue fever. The reported prevalence of upper gastrointestinal bleeding in dengue patients varies from 5% to 30%. The pathogenesis of hemorrhage could be multifactor and include vasculopathy, platelet deficiency, and dysfunction, and blood coagulation defects. We presented here a case of 27 years-old male patient who had clinical manifestation of hematemesis on his third day of fever. Keywords: GI tract, bleeding, DHF

Dengue hemorrhagic fever or DHF is a disease spread through mosquitoes, often occurring in tropical and subtropical areas throughout the world. The common symptoms of dengue hemorrhagic fever (DHF) are high fever and other flu-like symptoms. One of the four types of dengue virus is the cause of dengue fever. We can get infected not because we are around people who are infected, but because this disease is transmitted through mosquito bites. Two mosquitoes that can transmit this virus are Aedes aegypti and Aedes albopictus. These two types of mosquitoes are often found around residential areas. Until now, dengue hemorrhagic fever (DHF) is still a problem in society. This research aims to find new forms of efforts or ideas related to community empowerment in efforts to prevent and control the incidence of dengue hemorrhagic fever (DHF). This research uses a literature study that examines various references that are closely related to dengue fever, with Google Scholar as a source for searching for articles that the author uses in this research. The articles that the author uses are articles from at least 2018, both articles and journals. We used 10 journals identified from Google Scholar. This literature review can provide recommendations regarding the role of the community in improving the implementation of every dengue control program in Indonesia.

Dengue fever (DF), caused by dengue viruses, presents classic dengue fever, dengue hemorrhagic fever, and dengue shock syndrome. A young man presented with 5 days history of fever, body aches, headache, vomiting and one day history of drowsiness and a generalized tonic clonic fit. He was afebrile and hypotensive with platelets count of 24 x 109/l, and serum IgM DENV positive. Computerized tomography scan of the brain revealed intracerebral haemorrhages in both cerebral hemispheres. He was managed with supportive care and 20% mannitol infusion, his headache and drowsiness rapidly improved. Platelet count rose to 60 x 109/l on 2nd day and 199 x 109/l on 7th day of admission. He remained afebrile during hospital stay and was discharged from hospital on 8th day of admission, when he was almost asymptomatic.

Background: Dengue viruses infection is increasingly recognized as one of the world's emerging infectious diseases. Dengue usually presents with subclinical or mild infection to full blown dengue fever to dengue hemorrhagic fever and dengue shock syndrome. Aim: To evaluate clinical features, disease severity, laboratory findings in serologically confirmed cases of dengue fever in Muhammad Saleh Basharahil Hospital, Madina Road, Omra Gadida, Makkah, Saudi Arabia. Methods: This study was conducted on 83 patients with clinically suspected dengue fever. Hematocrit, platelet counts and total leucocyte counts were done serially in all the cases until they normalized. Liver function tests, chest X-ray, ultrasound abdomen, RFT, CT scan. The serological assay for dengue were performed using standard kits, dengue IgG/IgM Rapid Test is a solid phase immunochromatographic assay for the rapid, qualitative and differential detection of IgG and IgM antibodies to dengue virus in human serum or plasma. Patients with positive result for IgM or IgG antibodies against dengue virus were considered suspected dengue-positive group and the samples were confirmed by RT-PCR in a higher center. Results: Among 83 patients, 32 were confimed dengue cases and the remaining 51 were considered as dengue negative and appropriate control. Among the positive dengue cases, 62.5(20/32) were male and 37.5(12/32) were female. Fever was present in all cases (100%) followed by myalgia in 93.75%. Macular, pruritic rashes was present in 28.125%. Abdominal pain was present in 25% of cases. Hemorrhagic manifestation in the form of petichae only was seen in 15.63%. Hepatomegaly was present in 12.5% and splenomegaly was present in 9.38. There was a significant difference in the total leucocyte count and platelets count, Significant differences were also seen in the liver function test and there was clear change in hematocrit value between dengue positive and dengue negative patients. Conclusion: Fever, myalgia and headache were the most common symptoms and hepatomegaly was the most common finding in the cases. Leucopenia, thrombocytopenia and hematocrit changes were significant features of dengue fever.

Transmission of dengue virus is more prevalent in the home, so that the home environmental affects the morbidity of dengue hemorrhagic fever, although still dependent on other factors. This study aims to determine the relationship of the household density, abiotic environment and the presence of larvae of house mosquito Aedes spp against dengue virus infection. The study was conducted in Cirebon regency with cross sectional design. Respondents were asked the wide of house and number of occupants, then calculated the house density. Subsequently measured lighting, temperature and humidity inside the house and observed the presence of water containers are not covered as well as the presence of mosquito larvae of Aedes spp. The number of respondents was 200 persons consisting of 86 men ans 114 women. Known, respondents with not normal nutritional status is 68 respondents (34%) and normal categories was 132 (66%); in age group <5 years in 193 respondents (96,50%) and 161 respondents (80,50%) is negatif. Bivariate analysis showed the nutritional status and age groups are each associated with dengue virus infection status, the most influential is the age group. In addition, it was examined the blood samples using a rapid diagnostic test to find out the status of dengue virus transmission. The resulting data, analysed to determine the relationship between the independent variables with the dependent variable. It was concluded, the density of the household, home lighting, and humidity shown to be associated with dengue virus infection status. Dense homes and homes with optimal light for the development of Aedes spp is a risk factor for the occurrence of dengue virus infection.

Aedes aegypti and Aedes albopictus mosquitoes are responsible for the transmission of diseases such as dengue fever, yellow fever, chikungunya fever, zika virus fever, some of which can cause irreversible central nervous system problems and death. This study investigates what technologies are being used for combatting and monitoring the Aedes mosquitoes and to propose joining these technologies into a single and complete solution using the Smart Cities concept. A search for newscasts on Google and mobile apps in app stores were performed to identify technological solutions for combat to Aedes mosquitoes. Also, a model for joint technology was proposed. Results identified the following technologies: 170 software, two sensors, two drones, one electronic device, ten mosquito traps/lures, seven biological tools, six biotechnologies, and eight chemical formulations. Technological resources and adoption of preventive measures by the population could be a useful method for the mosquito control. Examples include a georeferenced model for identification and examination of larvae, application of chemical/biological products, real-time mapping, sending of educational materials via email or social media for the population, and alerts to health professionals in the zones of combat/risk. In combination, these technologies may indicate a better solution to the current problem.

Dengue fever and dengue hemorrhagic fever are the most important re-emergent arbovirus diseases of human, transmitted with four viral serotypes, dengue virus 1, 2, 3 and 4. Gastrointestinal bleeding is the most common complication of severe dengue hemorrhagic fever. The incidence of upper gastrointestinal (UGI) bleeding in patients with dengue fever varied from 8.4% to 58.5% in Taiwan. Adequate blood transfusion to correct the bleeding tendency, coagulation disorder and hypovolemia is the mainstay of medical treatment of UGI bleeding in dengue patients. However, the role of endoscopic treatment in UGI bleeding of dengue patients is still unknown. We report a serologically confirmed dengue patient with UGI bleeding. Successful hemostasis was achieved after application of endoscopic hemoclip. Our experience on this dengue-related UGI bleeding patient may suggest that endoscopic hemoclipping is helpful for similar cases.

BackgroundElevation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) is prominent in acute dengue illness. The World Health Organization (WHO) 2009 dengue guidelines defined AST or ALT≥1000 units/liter (U/L) as a criterion for severe dengue. We aimed to assess the clinical relevance and discriminatory value of AST or ALT for dengue hemorrhagic fever (DHF) and severe dengue.Methodology/Principal FindingsWe retrospectively studied and classified polymerase chain reaction positive dengue patients from 2006 to 2008 treated at Tan Tock Seng Hospital, Singapore according to WHO 1997 and 2009 criteria for dengue severity. Of 690 dengue patients, 31% had DHF and 24% severe dengue. Elevated AST and ALT occurred in 86% and 46%, respectively. Seven had AST or ALT≥1000 U/L. None had acute liver failure but one patient died. Median AST and ALT values were significantly higher with increasing dengue severity by both WHO 1997 and 2009 criteria. However, they were poorly discriminatory between non-severe and severe dengue (e.g., AST area under the receiver operating characteristic [ROC] curve = 0.62; 95% confidence interval [CI]: 0.57–0.67) and between dengue fever (DF) and DHF (AST area under the ROC curve = 0.56; 95% CI: 0.52–0.61). There was significant overlap in AST and ALT values among patients with dengue with or without warning signs and severe dengue, and between those with DF and DHF.ConclusionsAlthough aminotransferase levels increased in conjunction with dengue severity, AST or ALT values did not discriminate between DF and DHF or non-severe and severe dengue.

Dengue—a viral disease that can refer to both dengue fever and the more severe dengue hemorrhagic fever (DHF)—swept away records again this past spring as it raged across Brazil, infecting more than 160,000 people and killing more than 100. The reports were similar to those out of Southeast Asia in the summer of 2007, South America the previous spring, and India the fall before that. Although it may not be the most devastating of the mosquito-borne diseases—malaria strikes 10 times more people and yellow fever kills more of its victims—dengue has become a major public health concern for two reasons: the speed with which it is spreading and the escalating seriousness of its complications. In the nineteenth century, dengue fever was a mild illness found in the tropics. Deaths were rare, and years passed between major epidemics. But since the mid-twentieth century, the range of the dengue virus has steadily broadened. In the last 50 years, its worldwide incidence has increased 30-fold, and various estimates posit that anywhere from one-third to nearly one-half of the world’s population are now at risk of becoming infected. Moreover, today’s dengue infection is not what it once was. DHF, a complication of dengue infection that was not recognized until the 1950s (although cases probably occurred as early as 1870 in India), now appears in many dengue epidemics. In addition to the fever, rash, headache, and muscle and joint pain of classic dengue fever (which earned dengue its nickname of “breakbone fever”), DHF sometimes causes hemorrhaging that can lead to shock and even death. Epidemic DHF is now a leading cause of hospitalization and death among children in several Southeast Asian countries. Worldwide, of the 50 million dengue infections estimated by the World Health Organization (WHO) each year, there are 500,000 cases of DHF and 22,000 deaths, mainly among children. Once considered mainly an Asian disease, dengue fever and DHF now also permeate the tropical Americas. Between 1995 and 2001, the number of dengue cases in the Americas doubled, according to the WHO. By 2007, the annual incidence there reached nearly 900,000 cases, with more than 25,000 people suffering DHF. The dengue virus comes in four distinct serotypes. Individuals who become infected with one serotype obtain lifelong immunity against that serotype but not against the other three—and there is good evidence that a previous dengue infection increases the odds of developing DHF upon infection with a different serotype. “Somehow, having that prior infection enhances invasion of target cells by new dengue [serotypes],” explains Laura Harrington, a medical entomologist at Cornell University. Dengue experts agree on many of the causes of the disease’s spread, including demographic changes and interruptions in vector control efforts. But some controversy has surfaced over whether climate change—often cited as a factor in broadening disease vector habitats—has had or will have anything to do with the virus’s expansion. “It’s too early to predict what effects global warming will have, if any,” says David Morens, senior scientific advisor at the National Institute of Allergy and Infectious Diseases (NIAID) in Bethesda, Maryland. “But it’s certainly something to be concerned about.”

BackgroundDengue fever is a re-emerging viral disease commonly occurring in tropical and subtropical areas. The clinical features and abnormal laboratory test results of dengue infection are similar to those of other febrile illnesses; hence, its accurate and timely diagnosis for providing appropriate treatment is difficult. Delayed diagnosis may be associated with inappropriate treatment and higher risk of death. Early and correct diagnosis can help improve case management and optimise the use of resources such as hospital staff, beds, and intensive care equipment. The goal of this study was to develop a predictive model to characterise dengue severity based on early clinical and laboratory indicators using data mining and statistical tools.MethodsWe retrieved data from a study of febrile illness in children at Angkor Hospital for Children, Cambodia. Of 1225 febrile episodes recorded, 198 patients were confirmed to have dengue. A classification and regression tree (CART) was used to construct a predictive decision tree for severe dengue, while logistic regression analysis was used to independently quantify the significance of each parameter in the decision tree.ResultsA decision tree algorithm using haematocrit, Glasgow Coma Score, urine protein, creatinine, and platelet count predicted severe dengue with a sensitivity, specificity, and accuracy of 60.5%, 65% and 64.1%, respectively.ConclusionsThe decision tree we describe, using five simple clinical and laboratory indicators, can be used to predict severe cases of dengue among paediatric patients on admission. This algorithm is potentially useful for guiding a patient-monitoring plan and outpatient management of fever in resource-poor settings.