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Who brings dengue into North Queensland? A descriptive, exploratory study


  • Author contributions: CJ, research design, data collection, data analysis, data interpretation, manuscript draft and final edit of manuscript; WM, study conception, research design, ethics application, data analysis, data interpretation, manuscript review and final edit, article submission; KE, data collection, manuscript draft review; JM, research design, ethics application, data interpretation, manuscript draft and final edit of manuscript.

William John Hannan McBride, School of Medicine and Dentistry, James Cook University, Cairns Campus, C/- Cairns Base Hospital, PO Box 902, Cairns, Queensland 4870, Australia. Email:


Objective:  To describe the demographics, patterns of assessment and treatment of people visiting a regional emergency department with potential diagnoses of malaria or dengue fever.

Design:  To identify potential dengue fever cases, we used an indicator of recent overseas travel and fever that is a request for malaria testing. A chart audit of 301 medical records of people between 2008 and 2010 was conducted to describe patient characteristics, diagnostic tests performed and treatment.

Setting:  A regional hospital located in the wet tropics.

Results:  Malaria testing was most often performed on Australian citizens (64.1%), medical evacuees (20.3%) and tourists (18.6%). Overall, 49.8% of patients tested for malaria did not also have a dengue test, despite being indicated in 54% of this group. People tested for malaria usually lived in a residential house or unit (69.7%). Only 9% were staying in hotels and hostels. Oceania was the most commonly visited region in the two weeks prior to presentation. Malaria was diagnosed in 17.3% and dengue fever in 12% of patients tested. Patients with dengue fever were more likely than patients with malaria to self-refer to hospital, be staying in commercial accommodation and to have recently travelled to Southeast Asia.

Conclusion:  Both dengue fever and malaria occur predominantly in residents who reside in non-commercial accommodation. Efforts to identify imported dengue fever cases should focus on both tourists and local residents returning from overseas countries.