Incidence Dengue Virus Infection in Children with Acute Fever in Endemic Area, Lesson from Primary Health Care in Western Java Indonesia

Context: In endemic countries, most of dengue fever cases clinically resembles other diseases or just flu-like syndrome, it is important to detect dengue infection in patient with acute fever 1 to 4 day and which serotype of dengue virus that circulation to determine the risk of severe case of dengue to occur in primary health care. Aims: The aim of this study was to identify the incidence of dengue viral infection among children with acute fever in endemic area, and which serotype of dengue virus that circulating in community in Bandung, West Java, Indonesia. Settings and Design: Prospective cohort analysis study. Methods and Material: patients age 0 to 18 years old with acute fever from Sukajadi, Neglasari, and Padasuka Primary Health Centre form march to October 2018. These primary health centers represent three subdistricts with high dengue case every year in Bandung. Inclusion criteria: Fever at least 37.6oC, 1-4 days, with or not taking antipyretics. Name, age, and sex, nutritional status, and laboratorium examination that has been done by primary health centre was collect. Rapid NS1 antigen test is done as an additional check, multiplex real time RT-PCR assay for dengue virus (1-4) was perform from blood sample that NS1 antigen positive. Statistical analysis used: independent t-test analysis. Results: A total of 178 blood samples from patients with acute fever collected. 40 (22,5%) samples were positive with rapid NS1 antigen test, mean body temperature significantly higher in confirmed dengue virus cases (37,66 (±2,07) vs 38,33 (±0,83); p0,005) and platelet count (239.218 (±99.402) vs 164.739,13 (±98.259); p>0,005) is lower in confirmed dengue virus cases. From 40 positive NS1 antigen test, 17 (42,5%) showed all serotype (Den 1-4) of dengue can be found, with 8 (47,05%) is Den 3. Conclusions: Incidence of dengue cases in patient with acute febrile in endemic urban area is quite high, and all serotype of dengue virus can be found, so the risk of secondary dengue virus infection is imminent.