Abstract:
Dengue fever is a mosquito-borne viral infection that imposes significant public health concern in Malaysia. Evidence has shown that Monocyte plays an essential role in dengue pathogenesis. This study evaluates the value of monocyte chemoattractant protein-2 (MCP-2) as an early severity biomarker in dengue. Total of 150 laboratories confirmed adult dengue subjects in the febrile phase arm with “Mild Dengue (MD)” and “Dengue with warning Sign/Severe Dengue (WS/SD)” were chosen for this study. Subjects in the WS/SD arm were recruited from Tuanku Ampuan Rahimah (TAR) Hospital, Klang while those in MD arm were recruited from several primary care clinics around Shah Alam, Selangor. Initially, plasma from the subject’s blood was collected for the MCP-2 protein level measurement using ELISA while statistical analysis was done using SPSS. Subject were follow-up to obtain the clinical outcome of infection. Results showed no significant difference in the mean MCP-2 protein between the MD and the WS/SD arm (p=0.841). However, age (p value=0.04) and day of illness (p value=0.049) were significantly associated with the MCP-2 ELISA concentration. In conclusion, our results suggested that MCP-2 protein is not a suitable biomarker to predict the severity of dengue in the early phase of dengue fever. Nonetheless, subject age and day of illness are independent confounding factors for MCP-2 protein concentration. MCP-2 concentration was highest on day 1 and day 2 of illness and subsequently reduce after day 2 of illness. Separately, MCP-2 concentration increases with increasing age group, with the highest concentration at more than 60 year old age group.