Clinical & Epidemiological Studies of Paediatric Dengue in Nicaragua
Eva Harris, of the Division of Infectious Diseases, School of Public Health, University of California, Berkeley, U.S.A. reviewed the clinical and laboratory features of Dengue Fever, which is a mosquito-borne disease affecting many children and adults worldwide (Figure 4.1). Dr. Harris discussed its distribution - predominately in the Southern hemisphere (Figure 4.2), the clinical features of the disease (Figure 4.3) and the many epidemiologic studies that she and her colleagues have performed in studying Dengue Fever, primarily in Nicaragua (Figure 4.4).
The diagnostic features of the disease are complex from both a clinical (Figure 4.3) and laboratory standpoint. Serological methods for antibody detection are used for high throughput diagnosis, along with virus isolation and RT-PCR techniques, for diagnosis and typing of dengue virus. These techniques are essential for diagnosis and for epidemiologic studies.
An essential feature of Dr. Harris’ work has been training on-site technicians and other professionals to perform complex microbiologic and molecular biologic techniques.
The principle established by Dr. Harris is that low-cost diagnostic facilities can be instituted in developing countries by training local people who continue to perform the work locally. This led to the establishment of the Sustainable Sciences Institute with the goals of initial training and long-term continued follow-up to provide access to education, training, funding, equipment, and supplies needed to diagnose, prevent and cure priority infectious diseases in developing countries (Figures 4.5, 4.6, 4.7, 4.8, 4.9 and 4.10).
Dr. Harris’s focus on helping develop self-sufficient laboratory studies within developing country settings was further discussed in the workshop.