Prevalence of dengue, leptospirosis and rickettsiosis among suspected dengue patients cared for at the Mexican Social Security Institute (IMSS), 2012

[摘要] Introduction:climate changes observed around the world have substantially influenced the ecological niches where many infectious diseases develop. As consequence, today there are conditions constituting risk factors for the advent, increase and occurrence of underlying outbreaks of these kind of diseases.Objetive.determine the prevalence of dengue, leptospirosis and rickettsiosis in patients with initial diagnosis of dengue.Methods:A cross-sectional study including four IMSS delegations was performed. Patients with febrile syndrome compatible with dengue were included. Risk factors were studied and the clinical and laboratory parameters were followed. Samples were obtained for the diagnosis of dengue (NS1, IgM-IgG), rickettsiosis (IgM) and leptospirosis (IgM, dark field direct observation). Information was analyzed through simple frequencies, central tendency and dispersion measurements, and prevalence (P) with 95 % confidence intervals (CI 95 %). X2 test was used to assess association and Prevalence Ratio (RMP) and IC95 % was used as effect measurement.Results: three hundred and nine patients were studied, 58 from Baja California Sur (BCS), 89 form Guerrero, 60 from Veracruz and 102 from Yucatan; 53 % tested positive to dengue, 6 % to dengue and leptospira, 5 % to dengue and rickettsia, 2 % to leptospira, 4 % to rickettsia and 30 % was negative to all the tests performed. Some risk factors were found, although none were statistically significant, neither difference in the clinical behavior of the cases was found.Conclusions:the results show the occurrence of different infectious outbreaks overlapped with a clinical behavior similar to dengue, and the simultaneous infection with two different agents. Similarity in the clinical features between these diseases urges the implementation of feasible laboratory tests for the diagnosis and opportune case treatment, it is important to reinforce epidemiological surveillance.

[学科分类] 传染病学

[关键词] prevalence;dengue;leptospirosis;rickettsiosis;risk factors