Association between interleukin-8 and severity of dengue shock syndrome in children

  • Suryadi N. N. Tatura Department of Child Health, Sam Ratulangi University Medical School/Prof Dr. R. D Kandou Hospital, Manado.
  • Dasril Daud Department of Child Health, Hasanuddin University Medical School/Dr. Wahidin Sudirohusodo Hospital, Makasar.
  • Irawan Yusuf Department of Physiology, Hasanuddin University Medical School/Dr. Wahidin Sudirohusodo Hospital, Makasar.
  • Sitti Wahyuni Department of Parasitology and Immunology, Hasanuddin University Medical School/Dr. Wahidin Sudirohusodo Hospital Makasar.
  • Janno B. Bernadus Department of Biomolecular Parasitology, Sam Ratulangi University Medical School/Prof Dr. R. D Kandou Hospital, Manado.
DOI: https://doi.org/10.14238/pi56.2.2016.79-83
Keywords: dengue shock syndrome, IL-8, marker, children

Abstract

Background Dengue hemorrhagic fever (DHF) remains a major health problem in tropical countries. The case fatality rate (CFR) can be reduced from 45% to <1%, if dengue shock syndrome (DSS) is treated early and adequately. Early biomarkers for DSS outcomes in children are needed. Interleukin-8 (IL-8) might be one of the molecule, as it plays a role in the pathophysiology of DHF in children.
Objective To assess IL-8 levels in pediatric DHF patients at various stages of illness severity and to determine the correlation between serum IL-8 concentration on admission and DSS outcomes in children.
Methods A prospective cohort study was done in children with DSS who were admitted to the Pediatrics Department of Kandou Hospital, Manado. We measured subjects’ serum IL-8 levels at the time of DSS diagnosis and followed-up subjects until there was improvement or deterioration. An association between IL-8 and DSS outcome was analyzed using univariable logistic regression test. An ROC curve and Chi-square test were used to analyze the prognostic value of serum IL-8 levels. Statistical significance was considered to be a P value of <0.05 (power 80, β=0.20)..
Results Fifty-eight children with DSS were included in this study. Twenty-seven subjects had clinical deterioration (to recurrent shock, prolonged shock or died). There was a significant association between elevated IL-8 levels and clinical deterioration in DSS (OR 116.7; 95%CI 18.0 to 756.0; P=0.0001). The ROC curve revealed an IL-8 cut-off level of 194.9 pg/mL, AUC 0.982, with sensitivity 89.3%, specificity 93.3%, positive predictive value (PPV) 92.6%, negative predictive value (NPV) 90.3%.
Conclusion There is an association between elevated early serum IL-8 level and a DSS deterioration. Further prognostic studies are needed to confirm the predictive ability of serum IL-8 level on DSS deterioration in children.

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Published
2016-07-19
How to Cite
1.
Tatura SNN, Daud D, Yusuf I, Wahyuni S, Bernadus JB. Association between interleukin-8 and severity of dengue shock syndrome in children. PI [Internet]. 19Jul.2016 [cited 24Nov.2024];56(2):79-3. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/113
Issue
Vol 56 No 2 (2016): March 2016
Section
Infection & Tropical Pediatrics

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Received 2016-07-19
Accepted 2016-07-19
Published 2016-07-19