1617. Differentiating Dengue and Chikungunya: A Characterization of Clinical and Laboratory Features from Guayas, Ecuador
Session: Poster Abstract Session: Global Health
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • DENGUE CHIKUNGUNYA.2.pdf (1.1 MB)
  • Background: Dengue (DENV) and chikungunya (CHIKV) infections have similar clinical presentations and commonly co-circulate in the same geographic area making them difficult to distinguish. It is important to differentiate dengue infections as unrecognized dengue fever infection carries a poor prognosis. This study aims to define and compare the clinical and laboratory features associated with dengue and chikungunya in a rural population in Ecuador.

    Methods: We performed a retrospective, cross-sectional analysis of medical records from patients presenting with dengue or chikungunya to health centers in Guayas, Ecuador from October 2014 to January 2015. We included patients with dengue fever confirmed by IgM and chikungunya confirmed by PCR. We compared percent with specific clinical symptoms by chi-square analysis and mean laboratory values by t-test. Additionally, multivariate logistic regression was performed to identify statistically significant clinical predictors of dengue or chikungunya diagnosis.

    Results: A total of 52 patients were included, of whom 26 were confirmed as dengue (50%) and 26 (50%) confirmed as chikugunya. Both groups consisted of predominantly women and the average age was similar between groups. Using multivariate logistic regression we found patients presenting with dengue had an increased odds of presenting with headache (OR 6.57, 95% CI 1.37 to 31.31 p=0.01), myalgia (OR 5.5, 95% CI 1.31 to 22.92 p=0.01), nausea (OR 6.35, 95% CI 1.08 to 37.23 p=0.01), and leukopenia (OR 3.6, 95% CI 0.97 to 13.34 p=0.04). While patients with chikungunya had an increased odds of presenting with chills (OR 13.23, 95% CI 1.24 to 140.81 p=0.01) and granulocytosis > 70% granulocytes (OR 7.5, 95% CI 1.70 to 33.03 p=0.00). 

    Conclusion: We demonstrate the difficulty in distinguishing DENV from CHIKV infection. From a clinical perspective consistent with other literature, our results indicate that leukopenia and thrombocytopenia in a dengue endemic area better supports a diagnosis of dengue as opposed to chikungunya. Contrary to findings elsewhere, in our American cohort we did not find that CHIKV was more commonly associated with arthralgias than DENV. Larger cohort studies are needed to better define the clinical patterns of CHIKV and DENV in the Americas. 

    Maria López Garcia, MD1, Sonia Joutteaux Haro, MD1, Rommel Litardo Salinas, MD2, Whitney Allyn Qualls, PhD3, Aileen Yu-Hen Chang, MD MSPH3 and Diego Vásquez Cedeño, MD1, (1)Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador, (2)Ministerio de Salud Pública del Ecuador, Pedro Carbo, Ecuador, (3)University of Miami, Miami, FL

    Disclosures:

    M. López Garcia, None

    S. Joutteaux Haro, None

    R. Litardo Salinas, None

    W. A. Qualls, None

    A. Y. H. Chang, None

    D. Vásquez Cedeño, None

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