Obesity as a risk factor for dengue shock syndrome in children
Keywords:
dengue hemorrhagic fever, dengue shock syndrome, obesity
Abstract
Background Dengue hemorrhagic fever (DHF) leads to highmorbidity and mortality if not be treated properly and promptly.
Obesity may play a role in the progression ofDHF to dengue shock
syndrome (DSS) and could be a prognostic factor.
Objective To evaluate childhood obesity as a prognostic factor
for DSS.
Methods We reviewed medical records of patients with DHF
and DSS admitted to Department of Child Health, Dr. Sardjito
Hospital, Yogyakarta between June 2008 and February 2011.
Subjects were aged less than 18 years and fulfilled WHO criteria
(1997) for DHF or DSS. The exclusion criteria were the dengue
fever, a milder form of disease, or other viral infections. Risk
factors for DSS were analyzed by logistic regression analysis.
Results Of342 patients who met the inclusion criteria, there were
116 DSS patients (33 .9%) as the case group and 226 DHF patients
(66.1%) as the control group. Univariate analysis revealed that
risk factors for DSS were obesity (OR= 1.88; 95%CI 1.01 to3.5 l) ,
secondary infection type (OR=0.82; 95%CI 0.41 to 1.63), plasma
leakage with hematocrit increase> 25% (OR=3.42; 95%CI 2.06
to 5.65), platelet count < 20,000/μL (OR= l.95; 95%CI 1.20 to
3 .16), and inadequate fluid management from prior hospitalization
(OR=9.ll; 95% CI 1.13 to 73.66). By multivariate analysis,
plasma leakage with hematocrit increase > 25% was associated
with DSS (OR=2.5 l; 95%CI 1.12 to 5.59), while obesity was not
associated with DSS (OR= l.03; 95%CI 0.32 to3.3 1).
Conclusion Obesity is not a risk factor for DSS, while plasma
leakage with hematocrit increase > 25% is associated with DSS.
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In: Hadinegoro SRH, Satari HI, editors. Naskah lengkap
pelatihan bagi pelatih dokter spesialis anak dan dokter
spesialis penyakit dalam dalam tatalaksana kasus DBD.
Jakarta: Fakultas Kedokteran UI; 2000. p. 45.
penentunya. Surabaya: Pustlitbang Pelayanan dan Teknologi
Kesehatan; 2007.
2. Halstead SB. Dengue haemorrhagic fever-a public health
problem and a field for research. Bull World Health Organ.
1980;58: l-21.
3. World Health Organization (WHO). Dengue haemorrhagic
fever: diagnosis, treatment, prevention and control. 2nd ed.
Geneva; 1997.
4. Suroso T, Umar AI. Epidemiologi dan Penanggulangan
Penyakit Demam Berdarah Den gue (DBD) di Indonesia
saat ini. In: Hadinegoro SR, Satari HI, editors. In: Naskah
lengkap pelatihan bagi pelatih dokter spesialis anak & dokter
spesialis penyakit dalam dalam tatalaksana kasus DBD.
Jakarta: Fakultas Kedokteran UI; 2000. p. 14-3 1.
5. Soedarmo SSP, Gama H, Hadinegoro SRS, Satari HI. Buku
ajar infeksi & pediatri tropis: infeksi virus dengue. 2nd ed.
2008. p. 155-60.
6. Kalayanarooj S, Nimmannitya S. Is dengue severity related to nutritional status? Southeast Asian J Trop Med Public
Health. 2005 ;36:3 78-84.
7. Chuansumrit A, Puripokal C, Butthep P, Wongtiraporn
W, Sasanakul W, Tangnararatchakit K, et al. Laboratory
predictors of dengue shock syndrome during the febrile stage.
Southeast Asian J Trop Med Public Health. 2010;41:326-
32.
8. Sutaryo. Dengue. Yogyakarta: Medika Fakultas Kedokteran
UGM; 2004.
9. Tantracheewathorn T, Tantracheewathorn S. Risk factors
of dengue shock syndrome in children. J Med Assoc Thai.
2007;90:272-7.
10. J uffrie M, Meer GM, Haasnoot K, Sutaryo, Veerman AJ, Thijs
LG. Inflammatory mediators in dengue virus infection in
children: interleukin-6 and its relation to C-reactive protein
and secretory p hospholipase A2. Am J Trop Med H yg. 2001;
65:70-5.
11. Bosch I, Xhaja K, Estevez L, Raines G, Melichar H, Warke
RV, et al. Increased production of interleukin-8 in primary
human monocytes and in human epithelial and endothelial
cell lines after dengue virus challenge. J Virol. 2002; 7 6 :5 5 88-
97.
12. Novriant i H. Respon imun dan derajat kesakitan demam
berdarah dengue dan dengue shock syndrome. Cermin Dunia
Kedokteran. 2002; 134:47-50.
13. Calabro P, Chang DW, Willerson JT, Yeh ET. Release of
C-reactive protein in response to inflammatory cytokines by
human adipocytes: linking obesity to vascular inflammation.
J Am Coll Cardiol. 2005;46: 1112-3 .
14. Madiyono B, Moeslichan SM, Sastroasmoro S, Budiman I,
Purwanto SH. Perkiraan besar sampel. In: Sastroasmoro S,
Ismael S, editors. Dasar-dasar metodologi penelitian klinis.
Jakarta: Sagung Seto; 2002. p. 259-87.
15. World Health Organization (WHO) and United Nations of
Children's Funds (UNICEF). WHO child growth standards
and the identification of severe acute malnutrition in infants
and children. Geneva: WHO ; 2006.
16. Anto S, Sebodo T, Sutaryo, Suminta, Ismangoen. Nutritional
status of dengue haemorrhagic fever in children. Paediatr
Indones.1983;23: 15-24.
17. Thysakom U, Nimmannitya S. Nutritional status of children
with dengue haemorrhagic fever. Clin Infect Dis.1993; 16:295-
7.
18. Malavige GN, Ranatunga PK, Velathanthiri VG, Fernando
S, Karunatilaka DH, Aaskov J, et al. Patterns of disease in Sri
Lankan dengue patients. Arch Dis Child. 2006;91:396-400.
19. Chuansumrit A, Phimolthares V, Tardtong P, TapaneyaOlarn
C, Tapaneya-Olam W, Kowsathit P, et al. Transfusion requirements in patients with dengue hemorrhagic fever.
Southeast Asian J Trop Med Public Health. 2000;3 l: 10-4.
20. Pichainarong N, Mongkalangoon N, Kalayanarooj S,
Chaveepojnkamjorn W. Relationship between body size
and severity of dengue hemorrhagic fever among children
aged 0-14 years. Southeast Asian J Trop Med Public Health.
2006;37 :283-8.
21. Hung NT, Lan NT, Lei H, Lin Y, Lien LB, Huang K, et al.
Association between sex, nutritional status, severity of dengue
hemorrhagic fever, and immune status in infants with dengue
hemorrhagic fever. AmJ Trop Med Hyg. 2005;72:370---4.
192 • Paediatr lndones, Vol. 53, No. 4, July 2013
22. Dewi R, Tumbelaka AR, Syarif DR. Clinical features of
dengue hemorrhagic fever and risk factors of shock event.
Paediatr Indones. 2006;46:144-8.
23. Kan EF, Rampengan TH. Factors associated with shock in
children with dengue hemorrhagic fever. Paediatr Indones.
2004;44:171-5.
24. Gatot D, Perubahan Hematologi pada infeksi Dengue.
In: Hadinegoro SRH, Satari HI, editors. Naskah lengkap
pelatihan bagi pelatih dokter spesialis anak dan dokter
spesialis penyakit dalam dalam tatalaksana kasus DBD.
Jakarta: Fakultas Kedokteran UI; 2000. p. 45.
Published
2013-08-31
How to Cite
1.
Widiyati M, Laksanawati I, Prawirohartono E. Obesity as a risk factor for dengue shock syndrome in children. PI [Internet]. 31Aug.2013 [cited 25Apr.2024];53(4):187-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/279
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Received 2016-08-21
Accepted 2016-08-21
Published 2013-08-31
Accepted 2016-08-21
Published 2013-08-31
