Allergies and Diabetes as Risk Factors for Dengue Hemorrhagic Fever Results of a Case Control Study 英文参考文献.docVIP

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Allergies and Diabetes as Risk Factors for Dengue Hemorrhagic Fever Results of a Case Control Study 英文参考文献.doc

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Allergies and Diabetes as Risk Factors for Dengue Hemorrhagic Fever Results of a Case Control Study 英文参考文献

AllergiesandDiabetesasRiskFactorsforDengue HemorrhagicFever:ResultsofaCaseControlStudy MariaAparecidaA.Figueiredo1,LauraC.Rodrigues2,Maur?′cioL.Barreto3,Jose′ WellingtonO.Lima4, MariaC.N.Costa3,VanessaMorato3,RonaldBlanton5,PedroF.C.Vasconcelos6,Ma′rcioR.T.Nunes6, MariaGlo′riaTeixeira3* 1StateUniversityofBahia,Salvador, Brazil, 2London SchoolofHygieneTropicalMedicine,London,United Kingdom,3FederalUniversityofBahia,Salvador, Brazil, 4StateUniversityofCeara′, Fortaleza,Brazil,5CaseWesternReserveUniversity,Cleveland,Ohio,UnitedStatesofAmerica,6EvandroChagasInstitute,Para′, Brazil Abstract Background: The physiopathology of dengue hemorrhagic fever (DHF), a severe form of Dengue Fever, is poorly understood.WeareunabletoidentifypatientslikelytoprogresstoDHFforclosermonitoringandearlyinterventionduring epidemics,somostcasesaresenthome.Thisstudyexploredwhetherpatientswithselectedco-morbiditiesareathigher riskofdevelopingDHF. Methods: A matched case-control study wasconducted in adengue sero-positive population in twoBrazilian cities. For eachcaseofDHF,7sero-positivecontrolswereselected.Casesandcontrolswereinterviewedandinformationcollectedon demographicandsocio-economicstatus,reportedco-morbidities(diabetes,hypertension,allergy)anduseofmedication. Conditional logistic regression was used to calculate the strength of the association between the co-morbidities and occurrenceofDHF. Results:170casesofDHFand1,175controlswereincluded.SignificantassociationswerefoundbetweenDHFandwhite ethnicity (OR=4.70; 2.17–10.20), high income (OR=6.84; 4.09–11.43), high education (OR=4.67; 2.35–9.27), reported diabetes (OR=2.75; 1.12–6.73) and reported allergy treated with steroids (OR=2.94; 1.01–8.54). Black individuals who reportedbeingtreatedforhypertensionhad13timeshigherriskofDHFthenblackindividualsreportingnohypertension. Conclusions:ThisisthefirststudytofindanassociationbetweenDHFanddiabetes,allergyandhypertension.Giventhe highcasefatalityrateofDHF(1–5%),webelie