RT info:eu-repo/semantics/article T1 Characterization of dengue cases among patients with an acute illness, Central Department, Paraguay A1 Rojas Segovia, Alejandra María A1 Cardozo Segovia, Fátima María A1 Cantero, César A1 Stittleburg, Victoria A1 López, Sanny A1 Bernal, Cynthia A1 Giménez Acosta, Francisco Eugenio A1 Mendoza Torres, Laura Patricia A1 Pinsky, Benjamin A. A1 Arévalo de Guillén, Ivalena A1 Páez Acchiardi, Gloria Malvina A1 Waggoner, Jesse J. AB 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. PB PeerJ Inc. YR 2019 FD 2019-10-09 LK http://hdl.handle.net/20.500.14066/4373 UL http://hdl.handle.net/20.500.14066/4373 LA eng NO Rojas A, Cardozo F, Cantero C, Stittleburg V, López S, Bernal C, Gimenez Acosta FE, Mendoza L, Pinsky BA,Arévalo de Guillén I, Páez M, Waggoner J. 2019. Characterization of dengue cases among patients with an acute illness, Central Department, Paraguay. PeerJ 7:e7852 http://doi.org/10.7717/peerj.7852 NO Corresponding authors: Alejandra Rojas, alerojaspy@gmail.com; Jesse Waggoner, jesse.waggoner@emoryhealthcare.org NO Consejo Nacional de Ciencia y Tecnología DS MINDS@UW RD 25-jun-2024