부산대학교 도서관

Previous studies measuring the health-related quality of life (HRQoL) of individuals with dengue focused on treatment seeking populations. However, the vast majority of global dengue cases are unlikely to be detected by health systems. Representative measurements of HRQoL should therefore include patients with disease not likely to trigger treatment-seeking behavior. This study based in Iquitos, Peru used the Quality of Wellbeing Scale-Self Administered, a survey that enquires about not only physical health, but also psychological health, self-care, mobility, and usual social activities, and rates HRQoL between 0 (death) and 1 (optimum function), to evaluate the impact of dengue on HRQoL. In order to enroll treatment and non treatment-seeking participants, three modalities of participant recruitment were used. In addition to clinic and community-based febrile surveillance, a contact-cluster methodology was also employed to identify infected individuals less likely to seek treatment. We measured changes in HRQoL and identified common areas of health impairment in 73 virologically confirmed dengue cases at 3 time points during the participant's illness; the early-acute (days 0–6 post symptom onset), late-acute (days 7–20), and convalescent illness phases (days 21 +). Participants reported HRQoL related impairments at significantly higher frequency during the early-acute versus convalescent illness phase (Fisher's exact: P<0.01). There was substantial heterogeneity in scores during each illness phase with median scores in the early-acute, late-acute and convalescent phases of 0.56 (IQR: 0.41–0.64), 0.70 (IQR: 0.57–0.94), and 1 (IQR: 0.80–1.00), respectively. In all illness phases participants recruited in clinics had on average the lowest HRQoL scores where as those recruited in the contact clusters had the highest. Only 1 individual who was recruited in the contact-clusters had no reduction in HRQoL score during their illness. These data illustrate that dengue should be considered as a disease that may have significant implications for not only physical health but also psychological health and social functioning. The impact of dengue on the HRQoL of non-treatment-seeking individuals, although lower than the impact among treatment-seeking individuals, is not necessarily trivial. Author summary: Dengue, a viral illness occurring following the bite of an infected mosquito, is common in tropical urban areas of the globe. Using a survey that enquires about not only physical health but also psychological health, self-care, mobility and usual social activities, this study assesses the overall impact of dengue on the well-being of those with the disease. Of the estimated 390 million annual infections, approximately 75 percent do not cause individuals to attend medical facilities, possibly because many infections do not result in significant symptoms or because access to healthcare is limited. Unlike previous studies, this study recruited those who would have been unlikely to seek healthcare as well as individuals who attended health facilities. This study adds to the growing body of evidence that healthcare professionals should regard dengue as a disease that affects not only physical, but also psychological health and aspects of social functioning. Furthermore, it suggests that those not seeking treatment may also have a substantial reduction in quality of life during their infection. Given the millions of dengue infected people who do not attend healthcare facilities annually this could amount to a very meaningful societal impact. [ABSTRACT FROM AUTHOR]