595. Differences in Clinical Features and Dengue Severity between Local and Migrant Chinese, Singapore
Session: Poster Abstract Session: Oh One World: Infections from Near and Far
Thursday, October 27, 2016
Room: Poster Hall
Background: Dengue is endemic in Singapore but not central China where migrant workers in Singapore often come from. We compared clinical features and illness severity of dengue between local and migrant Chinese in Singapore.

Methods: All hospitalized dengue patients with positive dengue polymerase chain reaction or acute dengue serology with clinical criteria for dengue from 2005 to 2008 were studied. Dengue hemorrhagic fever (DHF) and shock syndrome (DSS) were defined per World Health Organization 1997 guideline, and warning signs and severe dengue per WHO 2009 guideline.

Results: There were 2609 local and 1195 migrant Chinese with dengue. Compared with local Chinese, migrant Chinese were younger (35 vs. 39 years), there were more males (78% vs. 58%), and fewer had hypertension (2% vs. 13%) and diabetes (0.3% vs. 5%) (p<0.05). Migrant Chinese had more headache (57% vs. 47%), eye pain (4% vs. 2%), nausea (45% vs. 44%) and myalgia (73% vs. 69%) (p<0.05). They had significantly lower leukocyte count (1.9 vs. 2.4 x109/L), alanine (52 vs. 82 U/L) and aspartate (87 vs. 130 U/L) aminotransferases, but higher platelet count (45 vs. 40 x109/L). Among warning signs, migrant Chinese had significantly less persistent vomiting (4% vs. 6%), clinical fluid accumulation (1% vs. 5%), hepatomegaly (2% vs. 4%), hematocrit rise with rapid platelet drop (10% vs. 15%), and more mucosal bleeding (46% vs. 31%). Adjusted for age, gender and comorbidity, migrant Chinese had more DHF (adjusted odds ratio [aOR] 1.202, 95% confidence interval [CI] 1.025-1.409) and DSS (aOR 1.493, 95%CI 1.063-2.099), and less severe plasma leakage (aOR 0.655, 95%CI 0.478-0.899).

Conclusion: We documented differences in clinical and laboratory features, and severity of dengue between local and migrant Chinese in Singapore. This may be due to differences in dengue exposure or genetics, and warrants further studies.

David Lye, FRACP, FAMS, FRCP, Chuanhui Xu, MD, PhD and Yee-Sin Leo, MPH, FAMS, FRCP, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore


D. Lye, None

C. Xu, None

Y. S. Leo, None

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