NTD and NCD Co-morbidities: The Example of Dengue Fever

Mehta, Priyanka; Hotez, Peter J.

doi:10.1371/journal.pntd.0004619

Cited by 24 publications

(13 citation statements)

References 24 publications

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“…An increased risk of infection and poorer outcomes in type 2 diabetes (T2D) is seen for intracellular pathogens, with a threefold increased risk of developing tuberculosis (TB) , and increased risk of death or treatment failure in TB . Relationships between diabetes and a range of global pathogens have been reported, including Hepatitis B , Hepatitis C , and dengue . Defects in activation and function of innate immune cells, and a subsequent delay of IFN‐γ driven T cell responses have been implicated in the increased susceptibility to infection .…”

Section: Introductionmentioning

confidence: 99%

Diabetes alters immune response patterns to acute melioidosis in humans

et al. 2019

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Diabetes mellitus (DM) is a serious global health problem currently affecting over 450 million people worldwide. Defining its interaction with major global infections is an international public health priority. Melioidosis is caused by Burkholderia pseudomallei, an exemplar pathogen for studying intracellular bacterial infection in the context of DM due to the 12‐fold increased risk in this group. We characterized immune correlates of survival in peripheral blood of acute melioidosis patients with and without DM and highlight different immune response patterns. We demonstrate the importance of circulating NK cells and show that CX3CR1 expression on lymphocytes is a novel correlate of survival from acute melioidosis. Furthermore, excessive serum levels of IL‐15 and IL‐18BP contribute to poor outcome independent of DM comorbidity. CD8+ T cells and granzyme B expression in NK cells are important for survival of non‐DM patients, whereas high antibody titers against B. pseudomallei and double‐negative T cells are linked to survival of DM patients. Recall responses support a role of γδ T‐cell‐derived IFN‐γ in the establishment of protective immunity in the DM group. Defining the hallmarks of protection in people with DM is crucial for the design of new therapies and vaccines targeting this rapidly expanding risk group.

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Section: Introductionmentioning

confidence: 99%

Diabetes alters immune response patterns to acute melioidosis in humans

et al. 2019

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“…As dengue CFR in Brazil may differ by two orders of magnitude from year to year, other dengue infection factors must be considered in estimating the disease severity. Comorbidities are highly prevalent in dengue endemic areas including Brazil, and contribute to some of the highest death rates and public health burden in those countries ( Mehta and Hotez 2016) . Dengue patients with comorbidities may be at higher risk of severe dengue and death, however, there have been no large scale studies conducted in Brazil ( Figueiredo et al 2010 Teixeira et al 2015 Toledo et al 2016) .…”

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confidence: 99%

Comorbidities increase in-hospital mortality in dengue patients in Brazil

Werneck

Macías

Mascareñas

et al. 2018

Mem. Inst. Oswaldo Cruz

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Dengue remains an unmet public health burden. We determined risk factors for dengue in-hospital mortality in Brazil. Of 326,380 hospitalised dengue cases in 9-45-year-old individuals, there were 971 deaths. Risk of dying was 11-times higher in the presence of underlying common comorbidities (renal, infectious, pulmonary disease and diabetes), similar to the risk of dying from severe dengue and much higher with the combination. Ensuring access to integrated dengue preventative measures in individuals aged ≥ 9 years including those with comorbidities may help achieve the WHO objective of 50% reduction in mortality and 25% reduction in morbidity due to dengue by 2020.

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“…26,27 Poor outcome for hypertensive individuals can be due to elevated C-reactive protein levels in the blood, which increases capillary permeability and risk of coagulopathy. 28,29 Remarkably, increased vascular permeability leading to plasma leak is unique in DHF/DSS/severe dengue. 30,31 There were a few limitations in this study, first of it being the study was carried out in a single centre so the results may not be exactly replicated in studies done at a multicentre level because of wide demographic variations within India.…”

Section: Discussionmentioning

confidence: 99%

Effect of co morbidities on the clinical outcome of Dengue fever

2019

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Background: Dengue is the most rapidly spreading mosquito-borne viral disease in the world. A number of Dengue Haemorrhagic Fever (DHF) risk factors had been suggested. However, these risk factors may not be generalized to all populations and epidemics for screening and clinical management of patients at risk of developing DHF/ Dengue shock syndrome (DSS).Methods: A hospital based prospective case control study was done by taking 40 cases each of dengue fever with diabetes mellitus, hypertension, diabetes and hypertension and 30 cases of dengue with asthma/COPD and these patients were compared with controls of 100 patients with dengue fever but no comorbidities. All patients had Dengue serology NS1 or IgM positive.Results: Patients admitted with dengue fever with comorbidities had increased duration of hospitalization with P value of 0.012. The clinical outcome of the 250 patients. In the subgroup of dengue fever patients with DM and Dengue fever with DM and HTN, they were noted to have a 2.69 and 3.06 times increased risk effect of DHF.Conclusions: Dengue fever with DM or DM with HTN have a higher risk of developing DHF when compared with patients with dengue fever with no comorbidities. This finding helps us in triaging patients with comorbidities who develop dengue fever for specialized care and closer clinical monitoring.

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NTD and NCD Co-morbidities: The Example of Dengue Fever

Cited by 24 publications

References 24 publications

Diabetes alters immune response patterns to acute melioidosis in humans

Diabetes alters immune response patterns to acute melioidosis in humans

Comorbidities increase in-hospital mortality in dengue patients in Brazil

Effect of co morbidities on the clinical outcome of Dengue fever

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