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Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: a retrospective observational study

Background: Malaysia experienced an unprecedented dengue outbreak from the year 2014 to 2016 that resulted in an enormous increase in the number of cases and mortality as compared to previous years. The causes that attribute to a dengue outbreak can be multifactorial. Viral factors, such as dengue s...

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Main Authors: Chee, Hui Yee, Amin Nordin, Syafinaz, Ching, Siew Mooi, Suppiah, Jeyanthi, Kim, Gary Kuan Low, Thayan, Ravindran, Abdul Wahid, Manisya Zauri, Mat Nor, Lailatul Akmar, Ahmad Najimudin, Naematul Ain
Format: Article
Language:English
Published: Public Library of Science 2018
Online Access:http://psasir.upm.edu.my/id/eprint/73420/1/DENGUE.pdf
http://psasir.upm.edu.my/id/eprint/73420/
https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006817
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spelling my.upm.eprints.734202020-11-10T07:38:38Z http://psasir.upm.edu.my/id/eprint/73420/ Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: a retrospective observational study Chee, Hui Yee Amin Nordin, Syafinaz Ching, Siew Mooi Suppiah, Jeyanthi Kim, Gary Kuan Low Thayan, Ravindran Abdul Wahid, Manisya Zauri Mat Nor, Lailatul Akmar Ahmad Najimudin, Naematul Ain Background: Malaysia experienced an unprecedented dengue outbreak from the year 2014 to 2016 that resulted in an enormous increase in the number of cases and mortality as compared to previous years. The causes that attribute to a dengue outbreak can be multifactorial. Viral factors, such as dengue serotype and genotype, are the components of interest in this study. Although only a small number of studies investigated the association between the serotype of dengue virus and clinical manifestations, none of these studies included analyses on dengue genotypes. The present study aims to investigate dengue serotype and genotype-specific clinical characteristics among dengue fever and severe dengue cases from two Malaysian tertiary hospitals between 2014 and mid-2017. Methodology and principal findings: A total of 120 retrospective dengue serum specimens were subjected to serotyping and genotyping by Taqman Real-Time RT-PCR, sequencing and phylogenetic analysis. Subsequently, the dengue serotype and genotype data were statistically analyzed for 101 of 120 corresponding patients’ clinical manifestations to generate a descriptive relation between the genetic components and clinical outcomes of dengue infected patients. During the study period, predominant dengue serotype and genotype were found to be DENV 1 genotype I. Additionally, non-severe clinical manifestations were commonly observed in patients infected with DENV 1 and DENV 3. Meanwhile, patients with DENV 2 infection showed significant warning signs and developed severe dengue (p = 0.007). Cases infected with DENV 2 were also commonly presented with persistent vomiting (p = 0.010), epigastric pain (p = 0.018), plasma leakage (p = 0.004) and shock (p = 0.038). Moreover, myalgia and arthralgia were highly prevalent among DENV 3 infection (p = 0.015; p = 0.014). The comparison of genotype-specific clinical manifestations showed that DENV 2 Cosmopolitan was significantly common among severe dengue patients. An association was also found between genotype I of DENV 3 and myalgia. In a similar vein, genotype III of DENV 3 was significantly common among patients with arthralgia. Conclusion: The current data contended that different dengue serotype and genotype had caused distinct clinical characteristics in infected patients. Public Library of Science 2018 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/73420/1/DENGUE.pdf Chee, Hui Yee and Amin Nordin, Syafinaz and Ching, Siew Mooi and Suppiah, Jeyanthi and Kim, Gary Kuan Low and Thayan, Ravindran and Abdul Wahid, Manisya Zauri and Mat Nor, Lailatul Akmar and Ahmad Najimudin, Naematul Ain (2018) Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: a retrospective observational study. PLoS Neglected Tropical Diseases, 12 (9). pp. 1-20. ISSN 1935-2727; ESSN: 1935-2735 https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006817 10.1371/journal.pntd.0006817
institution Universiti Putra Malaysia
building UPM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Putra Malaysia
content_source UPM Institutional Repository
url_provider http://psasir.upm.edu.my/
language English
description Background: Malaysia experienced an unprecedented dengue outbreak from the year 2014 to 2016 that resulted in an enormous increase in the number of cases and mortality as compared to previous years. The causes that attribute to a dengue outbreak can be multifactorial. Viral factors, such as dengue serotype and genotype, are the components of interest in this study. Although only a small number of studies investigated the association between the serotype of dengue virus and clinical manifestations, none of these studies included analyses on dengue genotypes. The present study aims to investigate dengue serotype and genotype-specific clinical characteristics among dengue fever and severe dengue cases from two Malaysian tertiary hospitals between 2014 and mid-2017. Methodology and principal findings: A total of 120 retrospective dengue serum specimens were subjected to serotyping and genotyping by Taqman Real-Time RT-PCR, sequencing and phylogenetic analysis. Subsequently, the dengue serotype and genotype data were statistically analyzed for 101 of 120 corresponding patients’ clinical manifestations to generate a descriptive relation between the genetic components and clinical outcomes of dengue infected patients. During the study period, predominant dengue serotype and genotype were found to be DENV 1 genotype I. Additionally, non-severe clinical manifestations were commonly observed in patients infected with DENV 1 and DENV 3. Meanwhile, patients with DENV 2 infection showed significant warning signs and developed severe dengue (p = 0.007). Cases infected with DENV 2 were also commonly presented with persistent vomiting (p = 0.010), epigastric pain (p = 0.018), plasma leakage (p = 0.004) and shock (p = 0.038). Moreover, myalgia and arthralgia were highly prevalent among DENV 3 infection (p = 0.015; p = 0.014). The comparison of genotype-specific clinical manifestations showed that DENV 2 Cosmopolitan was significantly common among severe dengue patients. An association was also found between genotype I of DENV 3 and myalgia. In a similar vein, genotype III of DENV 3 was significantly common among patients with arthralgia. Conclusion: The current data contended that different dengue serotype and genotype had caused distinct clinical characteristics in infected patients.
format Article
author Chee, Hui Yee
Amin Nordin, Syafinaz
Ching, Siew Mooi
Suppiah, Jeyanthi
Kim, Gary Kuan Low
Thayan, Ravindran
Abdul Wahid, Manisya Zauri
Mat Nor, Lailatul Akmar
Ahmad Najimudin, Naematul Ain
spellingShingle Chee, Hui Yee
Amin Nordin, Syafinaz
Ching, Siew Mooi
Suppiah, Jeyanthi
Kim, Gary Kuan Low
Thayan, Ravindran
Abdul Wahid, Manisya Zauri
Mat Nor, Lailatul Akmar
Ahmad Najimudin, Naematul Ain
Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: a retrospective observational study
author_facet Chee, Hui Yee
Amin Nordin, Syafinaz
Ching, Siew Mooi
Suppiah, Jeyanthi
Kim, Gary Kuan Low
Thayan, Ravindran
Abdul Wahid, Manisya Zauri
Mat Nor, Lailatul Akmar
Ahmad Najimudin, Naematul Ain
author_sort Chee, Hui Yee
title Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: a retrospective observational study
title_short Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: a retrospective observational study
title_full Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: a retrospective observational study
title_fullStr Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: a retrospective observational study
title_full_unstemmed Clinical manifestations of dengue in relation to dengue serotype and genotype in Malaysia: a retrospective observational study
title_sort clinical manifestations of dengue in relation to dengue serotype and genotype in malaysia: a retrospective observational study
publisher Public Library of Science
publishDate 2018
url http://psasir.upm.edu.my/id/eprint/73420/1/DENGUE.pdf
http://psasir.upm.edu.my/id/eprint/73420/
https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006817
_version_ 1683232221273522176
score 13.223943

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