Clinical, hematological and serological profile in suspected dengue patients at IICS-UNA, 2009-2013

Rojas, Alejandra; Aria, Laura; Guillén, Yvalena; Acosta, Ma. Eugenia; Infanzón, Belén; Díaz, Valentina; López, Liz; Meza, Teresa; Riveros, Oscar

doi:10.18004/mem.iics/1812-9528/2016.014(02)68-074

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…These data suggest that arboviral epidemiology may be relatively unique in Paraguay, which is located at the southern boundary of the DENV-endemic region in the Americas (Bhatt et al, 2013; Stanaway et al, 2016; World Health Organization, 2009). However, relatively little data has been published on dengue in the country, and the majority of available data has come either from hospitalized pediatric cases or from international studies with only a subset of patients from Paraguay (Halsey et al, 2012; Lovera et al, 2014; Lovera et al, 2016; Rojas et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Characterization of dengue cases among patients with an acute illness, Central Department, Paraguay

Rojas

Cardozo

Cantero

et al. 2019

PeerJ

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Background In 2018, Paraguay experienced a large dengue virus (DENV) outbreak. The primary objective of this study was to characterize dengue cases in the Central Department, where the majority of cases occur, and identify factors associated with DENV infection. Methods Patients were enrolled from January-May 2018 if they presented with a suspected arboviral illness. Acute-phase specimens (≤8 days after symptom onset) were tested using rRT-PCR, a rapid diagnostic test for DENV nonstructural protein 1 (NS1) and anti-DENV IgM and IgG, and ELISA for IgG against NS1 from Zika virus (ZIKV). Results A total of 231 patients were enrolled (95.2% adults) at two sites: emergency care and an outpatient clinical site. Patients included 119 (51.5%) dengue cases confirmed by rRT-PCR (n = 115, 96.6%) and/or the detection of NS1 and anti-DENV IgM (n = 4, 3.4%). DENV-1 was the predominant serotype (109/115, 94.8%). Epidemiologically, dengue cases and non-dengue cases were similar, though dengue cases were less likely to reside in a house/apartment or report a previous dengue case. Clinical and laboratory findings associated with dengue included red eyes, absence of sore throat, leucopenia and thrombocytopenia. At an emergency care site, 26% of dengue cases (26/100) required hospitalization. In univariate analysis, hospitalization was associated with increased viral load, anti-DENV IgG, and thrombocytopenia. Among dengue cases that tested positive for IgG against ZIKV NS1, the odds of DENV NS1 detection in the acute phase were decreased 10-fold (OR 0.1, 0.0–0.3). Conclusions Findings from a predominantly adult population demonstrate clinical and laboratory factors associated with DENV infections and the potential severity of dengue in this group. The combination of viral load and specific IgG antibodies warrant further study as a prognostic to identify patients at risk for severe disease.

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Section: Introductionmentioning

confidence: 99%

Characterization of dengue cases among patients with an acute illness, Central Department, Paraguay

Rojas

Cardozo

Cantero

et al. 2019

PeerJ

Self Cite

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“…7,20 However, in endemic countries such as Paraguay, DENV causes large seasonal outbreaks that exhaust laboratory reagent supply and testing capacity, resulting in under detection and potentially worse clinical outcomes. 4,25,26 In this study, we sought to address barriers to RNA virus detection that result from available extraction methods and the inherent challenges of working with RNA. We developed a simple, safe, and economical protocol for RNA extraction and storage from serum and plasma in resource-limited settings.…”

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Simple and economical RNA extraction and storage packets for viral detection from serum or plasma

Hernandez

Cardozo

Myers

et al. 2022

Preprint

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RNA extraction is an essential step for detection and surveillance of common viral pathogens. Currently, sample processing and RNA extraction are costly and rely on proprietary materials that are difficult to acquire, maintain, and safely discard in low-resource settings. We developed an economical RNA extraction and storage protocol that eliminates the use of instrumentation, expensive materials, and cold chain requirements. Through an iterative process, we optimized viral lysis and RNA binding to and elution from glass fiber membranes. Protocol changes were evaluated by testing eluates in virus-specific real-time RT-PCRs (rRT-PCRs). Efficient, non-toxic viral lysis was achieved with a sucrose buffer including KCl, proteinase K and carrier RNA. Glass fiber membranes demonstrated concentration-dependent RNA binding of three arthropod-borne RNA viruses (arboviruses): dengue, chikungunya and Oropouche. Membrane binding was significantly increased in an acidic arginine binding buffer. For the clinical evaluation, 36 dengue virus (DENV)-positive serum samples were extracted in duplicate in the optimized protocol and results were compared to a commercial method. DENV RNA was successfully extracted from 71/72 replicates (98.6%) in the extraction packets, and rRT-PCR Ct values correlated between the techniques. Five clinical samples were selected to evaluate ambient-temperature storage up to 7 days on dried glass fiber membranes. DENV RNA was stable at 1, 3 and 7 days post extraction, with a mean difference in eluate RNA concentration of 0.14 log10 copies/uL. At a cost of $0.08 /sample, RNA extraction and storage packets address key limitations to available protocols and may increase capacity for molecular detection of RNA viruses. Keywords: ribonucleic acid, extraction, dengue virus, molecular testing

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Simple and Economical Extraction of Viral RNA and Storage at Ambient Temperature

et al. 2022

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Clinical, hematological and serological profile in suspected dengue patients at IICS-UNA, 2009-2013

Cited by 3 publications

References 18 publications

Characterization of dengue cases among patients with an acute illness, Central Department, Paraguay

Characterization of dengue cases among patients with an acute illness, Central Department, Paraguay

Simple and economical RNA extraction and storage packets for viral detection from serum or plasma

Simple and Economical Extraction of Viral RNA and Storage at Ambient Temperature

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