Discriminating Malaria from Dengue Fever in Endemic Areas: Clinical and Biological Criteria, Prognostic Score and Utility of the C-Reactive Protein: A Retrospective Matched-Pair Study in French Guiana e2420
Background Dengue and malaria are two major public health concerns in tropical settings. Although the pathogeneses of these two arthropod-borne diseases differ, their clinical and biological presentations are unspecific. During dengue epidemics, several hundred patients with fever and diffuse pain a...
Saved in:
Published in | PLoS neglected tropical diseases Vol. 7; no. 9 |
---|---|
Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
San Francisco
Public Library of Science
01.09.2013
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Background Dengue and malaria are two major public health concerns in tropical settings. Although the pathogeneses of these two arthropod-borne diseases differ, their clinical and biological presentations are unspecific. During dengue epidemics, several hundred patients with fever and diffuse pain are weekly admitted at the emergency room. It is difficult to discriminate them from patients presenting malaria attacks. Furthermore, it may be impossible to provide a parasitological microscopic examination for all patients. This study aimed to establish a diagnostic algorithm for communities where dengue fever and malaria occur at some frequency in adults. Methodology/Principal Findings A sub-study using the control groups of a case-control study in French Guiana - originally designed to compare dengue and malaria co-infected cases to single infected cases - was performed between 2004 and 2010. In brief, 208 patients with malaria matched to 208 patients with dengue fever were compared in the present study. A predictive score of malaria versus dengue was established using .632 bootstrap procedures. Multivariate analysis showed that male gender, age, tachycardia, anemia, thrombocytopenia, and CRP>5 mg/l were independently associated with malaria. The predictive score using those variables had an AUC of 0.86 (95%CI: 0.82-0.89), and the CRP was the preponderant predictive factor. The sensitivity and specificity of CRP>5 mg/L to discriminate malaria from dengue were of 0.995 (95%CI: 0.991-1) and 0.35 (95%CI 0.32-0.39), respectively. Conclusions/Significance The clinical and biological score performed relatively well for discriminating cases of dengue versus malaria. Moreover, using only the CRP level turned to be a useful biomarker to discriminate feverish patients at low risk of malaria in an area where both infections exist. It would avoid more than 33% of unnecessary parasitological examinations with a very low risk of missing a malaria attack. |
---|---|
AbstractList | Background Dengue and malaria are two major public health concerns in tropical settings. Although the pathogeneses of these two arthropod-borne diseases differ, their clinical and biological presentations are unspecific. During dengue epidemics, several hundred patients with fever and diffuse pain are weekly admitted at the emergency room. It is difficult to discriminate them from patients presenting malaria attacks. Furthermore, it may be impossible to provide a parasitological microscopic examination for all patients. This study aimed to establish a diagnostic algorithm for communities where dengue fever and malaria occur at some frequency in adults. Methodology/Principal Findings A sub-study using the control groups of a case-control study in French Guiana - originally designed to compare dengue and malaria co-infected cases to single infected cases - was performed between 2004 and 2010. In brief, 208 patients with malaria matched to 208 patients with dengue fever were compared in the present study. A predictive score of malaria versus dengue was established using .632 bootstrap procedures. Multivariate analysis showed that male gender, age, tachycardia, anemia, thrombocytopenia, and CRP>5 mg/l were independently associated with malaria. The predictive score using those variables had an AUC of 0.86 (95%CI: 0.82-0.89), and the CRP was the preponderant predictive factor. The sensitivity and specificity of CRP>5 mg/L to discriminate malaria from dengue were of 0.995 (95%CI: 0.991-1) and 0.35 (95%CI 0.32-0.39), respectively. Conclusions/Significance The clinical and biological score performed relatively well for discriminating cases of dengue versus malaria. Moreover, using only the CRP level turned to be a useful biomarker to discriminate feverish patients at low risk of malaria in an area where both infections exist. It would avoid more than 33% of unnecessary parasitological examinations with a very low risk of missing a malaria attack. |
Author | Boullé, Charlotte Nacher, Mathieu Epelboin, Loïc Djossou, Félix Carme, Bernard Ouar-Epelboin, Sihem Dussart, Philippe Hanf, Matthieu |
Author_xml | – sequence: 1 givenname: Loïc surname: Epelboin fullname: Epelboin, Loïc – sequence: 2 givenname: Charlotte surname: Boullé fullname: Boullé, Charlotte – sequence: 3 givenname: Sihem surname: Ouar-Epelboin fullname: Ouar-Epelboin, Sihem – sequence: 4 givenname: Matthieu surname: Hanf fullname: Hanf, Matthieu – sequence: 5 givenname: Philippe surname: Dussart fullname: Dussart, Philippe – sequence: 6 givenname: Félix surname: Djossou fullname: Djossou, Félix – sequence: 7 givenname: Mathieu surname: Nacher fullname: Nacher, Mathieu – sequence: 8 givenname: Bernard surname: Carme fullname: Carme, Bernard |
BookMark | eNqNkM1OAkEQhCcGE_HnDTx04tXF2T8RbriAXkgI6Jl0dpulydCDM7MkvKGPJSDx7KmqU193OnWtWmKFlLqPdSdOu_HT2jZO0HS2EqqO1jrJEn2h2nEvzaOkm-atP590r9S192ut817-ErfV95B96XjDgoGlhgkadIywdHYDQ5K6IRjTjhywwEgq2nAJA0fo-1AYFi7RAEoFr2yNrU9j4TjQ4cgjTJ2txfpw2JmX1tGJ_AxsOOzBLiGsCIpoRlgG3tERD8TShwHMKDjrt_QbTDCUK6qiKbKDeWiq_fGdsSMpV_DWMAreqsslGk93Z71RD-PRR_EebZ39asiHxbklv4izLMmyLH1O0v9RP1U9dI4 |
ContentType | Journal Article |
Copyright | 2013 Epelboin et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Epelboin L, Boullé C, Ouar-Epelboin S, Hanf M, Dussart P, et al. (2013) Discriminating Malaria from Dengue Fever in Endemic Areas: Clinical and Biological Criteria, Prognostic Score and Utility of the C-Reactive Protein: A Retrospective Matched-Pair Study in French Guiana. PLoS Negl Trop Dis 7(9): e2420. doi:10.1371/journal.pntd.0002420 |
Copyright_xml | – notice: 2013 Epelboin et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Epelboin L, Boullé C, Ouar-Epelboin S, Hanf M, Dussart P, et al. (2013) Discriminating Malaria from Dengue Fever in Endemic Areas: Clinical and Biological Criteria, Prognostic Score and Utility of the C-Reactive Protein: A Retrospective Matched-Pair Study in French Guiana. PLoS Negl Trop Dis 7(9): e2420. doi:10.1371/journal.pntd.0002420 |
DBID | 3V. 7QL 7SS 7T2 7T7 7U9 7X7 7XB 88E 8C1 8FD 8FI 8FJ 8FK ABUWG AFKRA AZQEC BENPR C1K CCPQU DWQXO F1W FR3 FYUFA GHDGH H94 H95 H97 K9. L.G M0S M1P M7N P64 PIMPY PQEST PQQKQ PQUKI PRINS |
DOI | 10.1371/journal.pntd.0002420 |
DatabaseName | ProQuest Central (Corporate) Bacteriology Abstracts (Microbiology B) Entomology Abstracts (Full archive) Health and Safety Science Abstracts (Full archive) Industrial and Applied Microbiology Abstracts (Microbiology A) Virology and AIDS Abstracts Health & Medical Collection ProQuest Central (purchase pre-March 2016) Medical Database (Alumni Edition) Public Health Database Technology Research Database Hospital Premium Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) ProQuest Central (Alumni) ProQuest Central ProQuest Central Essentials ProQuest Central Environmental Sciences and Pollution Management ProQuest One Community College ProQuest Central Korea ASFA: Aquatic Sciences and Fisheries Abstracts Engineering Research Database Health Research Premium Collection Health Research Premium Collection (Alumni) AIDS and Cancer Research Abstracts Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources Aquatic Science & Fisheries Abstracts (ASFA) 3: Aquatic Pollution & Environmental Quality ProQuest Health & Medical Complete (Alumni) Aquatic Science & Fisheries Abstracts (ASFA) Professional Health & Medical Collection (Alumni Edition) PML(ProQuest Medical Library) Algology Mycology and Protozoology Abstracts (Microbiology C) Biotechnology and BioEngineering Abstracts Publicly Available Content Database ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic ProQuest One Academic UKI Edition ProQuest Central China |
DatabaseTitle | Publicly Available Content Database Aquatic Science & Fisheries Abstracts (ASFA) Professional Technology Research Database ProQuest Central Essentials ProQuest Health & Medical Complete (Alumni) ProQuest Central (Alumni Edition) ProQuest One Community College ProQuest Central China Aquatic Science & Fisheries Abstracts (ASFA) 3: Aquatic Pollution & Environmental Quality Environmental Sciences and Pollution Management ProQuest Central Health Research Premium Collection Health and Medicine Complete (Alumni Edition) ProQuest Central Korea Bacteriology Abstracts (Microbiology B) Algology Mycology and Protozoology Abstracts (Microbiology C) AIDS and Cancer Research Abstracts Health & Safety Science Abstracts Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources Industrial and Applied Microbiology Abstracts (Microbiology A) ProQuest Medical Library (Alumni) ProQuest Public Health Virology and AIDS Abstracts ProQuest One Academic Eastern Edition ProQuest Hospital Collection Health Research Premium Collection (Alumni) ProQuest Hospital Collection (Alumni) Biotechnology and BioEngineering Abstracts Entomology Abstracts ProQuest Health & Medical Complete ProQuest Medical Library ProQuest One Academic UKI Edition ASFA: Aquatic Sciences and Fisheries Abstracts Engineering Research Database ProQuest One Academic ProQuest Central (Alumni) |
DatabaseTitleList | Publicly Available Content Database |
Database_xml | – sequence: 1 dbid: BENPR name: ProQuest Central url: https://www.proquest.com/central sourceTypes: Aggregation Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1935-2735 |
ExternalDocumentID | 3100832131 |
GeographicLocations | South America French Guiana |
GeographicLocations_xml | – name: South America – name: French Guiana |
GroupedDBID | --- 123 29O 2WC 3V. 53G 5VS 7QL 7SS 7T2 7T7 7U9 7X7 7XB 88E 8C1 8FD 8FI 8FJ 8FK AAFWJ ABDBF ABUWG ACGFO ACIHN ACPRK ADBBV ADRAZ AEAQA AENEX AFKRA AFPKN AFRAH AHMBA ALIPV ALMA_UNASSIGNED_HOLDINGS AOIJS AZQEC BAWUL BCNDV BENPR BPHCQ BVXVI BWKFM C1K CCPQU CS3 DIK DU5 DWQXO E3Z EAP EAS EBD ECGQY EMOBN ESX F1W F5P FPL FR3 FYUFA GROUPED_DOAJ GX1 H94 H95 H97 HMCUK HYE IAO IHR IHW ITC K9. KQ8 L.G M1P M48 M7N M~E O5R O5S OK1 P2P P64 PGMZT PIMPY PQEST PQQKQ PQUKI PRINS PROAC PSQYO RNS RPM SV3 TR2 TUS UKHRP |
ID | FETCH-proquest_journals_14424443623 |
IEDL.DBID | 7X7 |
ISSN | 1935-2727 |
IngestDate | Fri Sep 13 01:56:39 EDT 2024 |
IsDoiOpenAccess | true |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 9 |
Language | English |
LinkModel | DirectLink |
MergedId | FETCHMERGED-proquest_journals_14424443623 |
OpenAccessLink | https://www.proquest.com/docview/1442444362/abstract/?pq-origsite=%requestingapplication% |
PQID | 1442444362 |
PQPubID | 1436337 |
ParticipantIDs | proquest_journals_1442444362 |
PublicationCentury | 2000 |
PublicationDate | 20130901 |
PublicationDateYYYYMMDD | 2013-09-01 |
PublicationDate_xml | – month: 09 year: 2013 text: 20130901 day: 01 |
PublicationDecade | 2010 |
PublicationPlace | San Francisco |
PublicationPlace_xml | – name: San Francisco |
PublicationTitle | PLoS neglected tropical diseases |
PublicationYear | 2013 |
Publisher | Public Library of Science |
Publisher_xml | – name: Public Library of Science |
SSID | ssj0059581 |
Score | 4.134164 |
Snippet | Background Dengue and malaria are two major public health concerns in tropical settings. Although the pathogeneses of these two arthropod-borne diseases... |
SourceID | proquest |
SourceType | Aggregation Database |
SubjectTerms | Bacterial infections Emergency medical care Infections Malaria Mosquitoes Tropical diseases |
Subtitle | e2420 |
SummonAdditionalLinks | – databaseName: Scholars Portal Open Access Journals dbid: M48 link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1dS8MwFA1jgvgifuLHlAv6aMeapu06EBnb6hAqYzrYm6RrqoXRateB-4f-LO_NWl_UPZamaZJ7k9xLzslh7NqOuCUtCzPVVsQNEQvPCM0oNGZO1HI8FWNMT9zh4NEZTsTD1J7WWKXZWg7g4s_UjvSkJvm8-fmxusMJf6tVG1yz-qj5nhYR3UeIuw4m8VtcWIJ8PhA_5wq2Z2vZUoxaiInF3ZJM918tvxZovev4e2y3DBehu7bvPqup9IBtB-WB-CH76ic07wnPQvhlCCR2J5FArBHoq_R1qcBX6K6QpDBINRQea1Ny0YHyStA5yDSCtSalfiT1A_LLGxjlGeHw8N_wRNdd6pKTguC0K8hiwOAResZYSb1oUnHSzuxAF8aqyLOKxYmtIt-IjJFMciDk4oqa4xPR8A3ul-ih8ohd-YPn3tCoRuKlMhKmDUSTE7gHWsesnmapOmEgXLR4KExT2TMRW612xF3P5sJptz0Zc37KGptqOtv8-pztcC1IQSivBqsX-VJdYFhQhJfa0t_R2b4x priority: 102 providerName: Scholars Portal |
Title | Discriminating Malaria from Dengue Fever in Endemic Areas: Clinical and Biological Criteria, Prognostic Score and Utility of the C-Reactive Protein: A Retrospective Matched-Pair Study in French Guiana |
URI | https://www.proquest.com/docview/1442444362/abstract/ |
Volume | 7 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV3da8IwEA9OYexl7JN9ODnYHtdp09S2vgznx2SgiJvgm6Qm3QqjdVof_A_3Z-0u1u1h4EugNKQhd73cJb_fHWN3ruKOdByMVGuKWyISgRXaKrRmdVWrBzpCn564w_1BvTcWLxN3UmC9LReGYJVbm2gMtUpndEZeRccfdyKB9rYqQzoFmGXVx_mXRfWj6J41L6axx0o2R7cCNdub_IZebuCacqXorRADi3s5ic7x7Gous4d5kinKZoh7Vu2fYTa7TfeIHeZuIjQ3cj1mBZ2csP1-fhF-yr7bMf3vhGMh3DL0JUaosQRii0BbJ-8rDV2NagpxAp3EQOBxNC2XDchTgX6CTBRsalGaR6p6QPp4D8NFSvg7_Da8UppL03OcEYx2DWkE6DRCyxppaYwldaeamQ1owkhni3TL3sRZkU4oayjjBRBicU3T6RLB8AOeV6iZ8ozddjtvrZ61XYlpvlLL6Z8snHNWTNJEXzAQHko6FLat3ZmInJqvuBe4XNR9P5AR55esvGukq92vr9kBN4UoCN1VZsVssdI36A5kYcVIGlu_ZVdY6akzGI4qJrTGti_8H2W1wEo |
link.rule.ids | 315,786,790,870,12083,12250,21416,24346,27957,27958,31754,33301,33779,43345,43614,43840,74102,74371,74659 |
linkProvider | ProQuest |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1LTwIxEG4UE_VifMYH6iR6dHXfy3IxhIeoQAhCwo0U2tVNzC4uy4F_6M9yphQ9mHDctOk2nenMtP1mPsZuPWE73HHwpGoK23AjNzTGlhgbE1-YfigjjOkpd7jd8ZsD92XoDfWF20zDKlc2URlqkU7ojvwBA3_0RC7a28fpl0GsUfS6qik0NtkWtlhUO79U_YV4eKGnSEoxRqG8KzvQqXNOYD1oSd1Pk1xQDUP0VOY_c6x8TGOf7engECpLaR6wDZkcsu22fv4-Yt-1mHY5oVcIrQxtjufSmAPliEBNJu9zCQ2JyglxAvVEAd9xNMlnZdAFQD-BJwKWDJTqk7gOSAvvoJulhLrDf8MbFbdUPQc5gWcXkEaAoSJUjZ7kykRSd2LKLEMFejLP0lXOJs6KNEEYXR5nQDjFBU2nQWmFH_A0R33kx-ymUe9Xm8ZqJUZ6pWajPwk4J6yQpIk8ZeAGKN-xa1nSm7iRY5aEHYSe7fqlUsgj2z5jxXUjna9vvmY7zX67NWo9d14v2K6tqCgI31VkhTyby0sMCPLxlZL6D-gsuxI |
linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1LT8JAEN4oJMSL8RkfqJPo0Qq025ZyMQhUfEAISsKNbNmtkpgWSznwD_1ZzpRtPJhwbLrZbvabnZ3tfjMfYze2NC1hWXhSrUrT4CH3jKAmA2PqyKrjqRBjesod7vWd7og_j-2x5j8tNK0y94mZo5bxlP6RVzDwx52Io7-thJoWMWj79_NvgxSk6KZVy2lss6LLHRstvPjQ6Q-GuV-2PTuTLMWIhbKwTFcn0lluraJxu5tHqaSKhrhvVf8552zH8ffYrg4VobnGdp9tqeiAlXr6MvyQ_bRntOaJy0LcZegJPKXOBFDGCLRV9LFU4Cs0VZhF0IkyGjz2psSiAboc6BeISMJajzJ7JOUDsslbGCQxcfDw2_BGpS6zlqOUqLQriEPAwBFaxlCJzGFSc9LNbEAThipN4jyDE0dFdiGNgZglQKzFFQ3HpyTDT3hconWKI3btd95bXSOfiYmeqcXkDw_rmBWiOFInDLiLaAe8VlP2lIdWtS5N17NN7tTrnghN85SVN_V0tvn1FSsh5JPXp_7LOdsxM10KInuVWSFNluoCo4M0uNSw_wKOk8Dq |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Discriminating+Malaria+from+Dengue+Fever+in+Endemic+Areas%3A+Clinical+and+Biological+Criteria%2C+Prognostic+Score+and+Utility+of+the+C-Reactive+Protein%3A+A+Retrospective+Matched-Pair+Study+in+French+Guiana&rft.jtitle=PLoS+neglected+tropical+diseases&rft.au=Epelboin%2C+Lo%C3%AFc&rft.au=Boull%C3%A9%2C+Charlotte&rft.au=Ouar-Epelboin%2C+Sihem&rft.au=Hanf%2C+Matthieu&rft.date=2013-09-01&rft.pub=Public+Library+of+Science&rft.issn=1935-2727&rft.eissn=1935-2735&rft.volume=7&rft.issue=9&rft_id=info:doi/10.1371%2Fjournal.pntd.0002420&rft.externalDBID=HAS_PDF_LINK&rft.externalDocID=3100832131 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1935-2727&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1935-2727&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1935-2727&client=summon |