American Journal of Epidemiology and Infectious Disease
ISSN (Print): 2333-116X ISSN (Online): 2333-1275 Website: http://www.sciepub.com/journal/ajeid Editor-in-chief: Apply for this position
Open Access
Journal Browser
Go
American Journal of Epidemiology and Infectious Disease. 2015, 3(3), 45-49
DOI: 10.12691/ajeid-3-3-1
Open AccessArticle

Association between Clinical Profiles and Severe Dengue Infection in Children in Developing Country

Masayu Amanda Ledika1, Djatnika Setiabudi1 and Meita Dhamayanti1,

1Department of Child Health, Hasan Sadikin General Hospital–Universitas Padjadjaran, Bandung, Indonesia

Pub. Date: June 22, 2015

Cite this paper:
Masayu Amanda Ledika, Djatnika Setiabudi and Meita Dhamayanti. Association between Clinical Profiles and Severe Dengue Infection in Children in Developing Country. American Journal of Epidemiology and Infectious Disease. 2015; 3(3):45-49. doi: 10.12691/ajeid-3-3-1

Abstract

Background: Dengue virus infection is endemic and is one of major causes of morbidity and mortality in children. The cause of mortality in children with dengue infection was not limited to shock but also caused by severe bleeding and organ dysfunction. This study aim to to examined clinical profiles of children with dengue infection and their association with severe dengue. Methodology and principal findings: Cross–sectional study of children with dengue virus infection admitted to Department of Child Health, Hasan Sadikin Hospital Bandung from April 2013 to September 2014. Subjects were patient age 1–<14 who fulfilled 2009 WHO criteria for dengue virus infection. Association between clinical profile and severe dengue infection was analyzed in two steps. After bivariate analysis, variable with p value <0.25 was included in the next step by logistic regression. P value <0.05 was consider significant. Of 451 subjects, 24.6% (n=111) had severe dengue infection. Dengue shock syndrome with or without other form of severe dengue was the most common complication and occured in 65.7% (n=73) of all severe dengue cases. Patient admitted ≥4th day of illness (OR 13.25 95%CI 3.45–50.86), persistent vomiting (OR 20.32 95%CI 7.41–55.74); hepatomegaly (OR 21.72 95%CI 7.73–61.01), platelet count <50.000/mm3 (OR 26.54 95%CI 8.59–81.99), and leukocyte ≥5000/mm3 at admission (OR 4.25 95%CI 1.55–11.65) were associated with severe dengue infection. Conclusion: Clinical manifestation of severe dengue infection was not limited to dengue shock syndrome. Patient admitted ≥4th day of illness, persistent vomiting, hepatomegaly, platelet count <50.000/mm3 and leukocyte ≥5000/mm3 at admission were associated with severe dengue infection in children.

Keywords:
Children Clinical Profile Severe Dengue

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  World Health Organization. Comphrehensive guidelines for prevention and control of Dengue and Dengue Haemorrhagic Fever-Revised and Expanded Edition. 2011.
 
[2]  Hadinegoro, SR. Classification of dengue. Presented in Global Initiative for Consensus in Children. 2014.
 
[3]  Karyanti MR, Uiterwaal C, Kusriastuti R, Hadinegoro SR, Rovers M, Heesterbeek H, dkk. The changing incidence in dengue hemorrhagic fever in Indonesia: a 45-year registry based analysis. BMC Infect Dis. 14(412):1-7. 2014.
 
[4]  Citraresmi E, Hadinegoro SR, Akib A. Diagnosis and management of dengue hemorrhagic fever in outbreak in Jakarta 2004. Sari Pediatri. 8(3):8-14. 2007.
 
[5]  World Health Organization and the Special Program for Research and Training in Tropical Diseases (TDR). Dengue guidelines for diagnosis, treatment, prevention and control: new edition. 2009.
 
[6]  Gupta V, Yadav TP, Pandey RM, Singh A, Guota M, Kanaujiya P, et al. Risk Factors of dengue shock syndrome in children. J Trop Ped. 2011;57(6):451-6. 2011.
 
[7]  Carasco LR, Leo YS, Cook AR, Lee VJ, Thein TL, Go CJ. Predictive tools for severe dengue conforming to World Health Organization 2009 criteria. PloS Negl Trop Dis. 8(7):e2972. 2014.
 
[8]  Chen RF, Yang KD, Wang L, Liu JW, Chiu CC, Cheng JT. Different clinical and laboratory manifestations between dengue haemorrhagic fever and dengue fever with bleeding tendency. Trans Soc Trop Med. 101:1106-13. 2007
 
[9]  Basuki PS, Budiyanto, Puspitasari D, Husada D, Darmowandowo W, Ismoedijanto. Application of revised dengue classification criteria as a severity marker of dengue viral infection in Indonesia. Southeast Asian J Tro Med Public Health. 41(5):1088-113. 2010
 
[10]  Chairulfatah A, Setiabudi D, Ridad A, Colebunders R. Clinical manifestations of dengue haemorrhagic fever in children in Bandung, Indonesia. Ann Soc Belge Med Trop. 75:291-5. 1995
 
[11]  The TD, Thu TL, Minh DN, Van NT, Tinh HT, Vinh C, et al. Clinical features of dengue in a large Vietnamese cohort: intrinsically lower platelet counts and greater risk for bleeding an adult and children. PloS Negl Trop Dis. 6(1):e1679. 2012
 
[12]  Martina BEE, Koraka P, Osterhaus ADME. Dengue virus pathogenesis: an integrated view. Clin Microbiol Rev. 22(4):564-81. 2009
 
[13]  Sirivichayakul C, Limkittikul K, Chanthavanich P, Jiwariyavej V, Chokejindachai W, Pengsaa K, dkk. Dengue infection in children in Ratchaburi, Thailand: a cohort study II clinical manifestations. PloS Negl Trop Med. 6(2)e1520. 2012
 
[14]  Huy N, Giang T, Thuy D, Kikuchi M, Hien T, Zamora J, Hirayama K. Factors associated with dengue shock syndrome: a systematic review and meta-analysis. PloS Negl Trop Dis. 7(9):e2412. 2013
 
[15]  Branco M, Luna E, Junior L, de Oliviera R, Rios L, da Silva M. Risk factors associated with death in Brazilian children with severe dengue: a case-control study. Clinics. 69(1):55-60. 2014
 
[16]  Mcbride WJH, Ohmann HB. Dengue viral infections: pathogenesis and epidemiology. Microb Infect. 2000;2:1041-50.
 
[17]  Zhang H, Zhou YP, Peng HJ, Zhang H, Zhou FY, Liu ZH, et al. Predictive symptoms and signs of severe dengue disease for patients with dengue fever: a meta analysis. BioMed Res Int.
 
[18]  Mayetti. Hubungan gambaran klinis dan laboratorium sebagai faktor risiko syok pada demam berdarah dengue. Sari Pediatri. 11(5):367-73. 2010.
 
[19]  Risniati R, Tarigan LH, Tjitra E. Leukopenia sebagai prediktor terjadinya sindrom syok dengue pada anak dengan demam berdarah dengue di RSPI Prof. Dr. Sulianti Saroso. Media Litbangkes. 21(3):96-103. 2011.
 
[20]  Potts JA, Gibbons RV, Rothman AL, Srikiatkhachorn A. Thomas SJ, Supradish P, et al. Prediction of dengue disease severity among pediatric Thai patients using early clinical laboratory indicators. PloS Negl Trop Dis. 4(8):e769. 2011.
 
[21]  Ramya N, Shankar SP. Clinico-hematological study of dengue in adults and the significance of total leukocyte count in management of dengue. JMSCR. 2(10):2547-53. 2013.
 
[22]  The TD, Thu TL, Minh DN, Van NT, Tinh HT, Vinh C, et al. Clinical features of dengue in a large Vietnamese cohort: intrinsically lower platelet counts and greater risk for bleeding an adult and children. PloS Negl Trop Dis. 6(1):e1679. 2012
 
[23]  Kalayanarooj S, Nimmannitya S. Is dengue severity related to nutritional status? Southeast Asian J Trop Med Public Health. 36(2):378-84. 2005.