The association between overweight and shock in children with dengue hemorrhagic fever at Wangaya General Hospital, Bali, Indonesia

Jade Irene Linardi; I Wayan Bikin Suryawan; Anak Agung Made Widiasa

doi:10.15562/ism.v%vi%i.868

The association between overweight and shock in children with dengue hemorrhagic fever at Wangaya General Hospital, Bali, Indonesia

Jade Irene Linardi ,

I Wayan Bikin Suryawan ,

Anak Agung Made Widiasa ,

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DOI: https://doi.org/10.15562/ism.v%25vi%25i.868 |
Published: 2021-03-10

Abstract

Background: Dengue Hemorrhagic Fever (DHF) which severity varies, has devastating complications and outcomes, especially when shock events appeared and are prolonged. There is no predictor of whether DHF patients would develop into shock (called Dengue Shock Syndrome or DSS). Previous studies claimed overweight as a predictor of DSS, although it remains controversial.

Objective: To find the association between overweight and shock events in children with DHF.

Methods: This was an observational analytic study with a case-control design. Data were taken from medical records with children hospitalized at Wangaya General Hospital from May 2019 through April 2020. Inclusion criteria were children < 18 years who have been diagnosed with DHF grade I through IV. Data were analyzed using the chi-square test in SPSS 24.0 for windows.

Results: Of 126 subjects who fulfilled the inclusion criteria, there were 42 DSS patients as the case group and 84 non-DSS patients as the control group. From the data analysis, there was a significant association between overweight and shock events in children with DHF (p=0.001; OR 3.76; 95% CI 1.72 to 8.20). Furthermore, pleural effusion (p=0.001), highest hematocrit of ? 46% (p=0.001), and lowest platelet count of ? 50,000/µL (p=0.006) also had significant association with shock events.

Conclusion: Overweight is associated with shock events in children with DHF. Pleural effusion, hematocrit level of ? 46%, and platelet count of ? 50,000/µL were also counted as risk factors to develop shock.

References

Chairulfatah A, Alam A, Setiabudi D, Hapsari DMM, Satari HI, Laksono IS, et al. Pedoman diagnosis dan tata laksana infeksi virus dengue pada anak. 1st ed. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia. 2014.
Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia. Situasi penyakit demam berdarah di Indonesia tahun 2017. Jakarta: Pusdatin Kementrian Kesehatan Republik Indonesia. 2018.
World Health Organization, Regioinal Office for South-East Asia. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever. Revised and expanded edition. India: WHO Regional Office for South-East Asia. 2011.
Saniathi E, Arhana BNP, Suandi IKG, Sidiartha IGL. Obesitas sebagai faktor risiko sindrom syok dengue. Sari Pediatri. 2009;11(4):238-43.
Buntubatu S, Arguni E, Indrawanti R, Laksono IS, Prawirohartono EP. Status nutrisi sebagai faktor risiko sindrom syok dengue. Sari Pediatri. 2016;18(3):226-32.
Saniathi NKE, Rianto BUDR, Juffrie M, Soetjiningsih. The effect of overnutrition toward the risk of dengue shock syndrome in pediatric patient: in-depth investigation of sVCAM-1 and adiponectin level. Bali Med J. 2018; 7(1):244-8.
Edwin J, Budiarta MO, Edward K. Analisis faktor risiko sindrom syok dengue pada anak di Rumah Sakit Ibu Anak Bunda Aliyah Jakarta. Sari Pediatri. 2019;21(2):109-14.
Tantracheewathorn T, Tantracheewathorn S. Risk factors of dengue shock syndrome in children. J Med Assoc Thai. 2007;90(2): 272-7.
Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab. 2004;89:2548-56.
Rasmussen MS, Lihn AS, Pedersen SB, Bruun JM, Rasmussen M, Richelsen B. Adiponectin receptors in human adipose tissue: effects of obesity, weight loss and fat depots. Obesity. 2006;14:28-35.
Trang NTH, Long NP, Hue TTM, Hung LP, Trung TD, Dinh DN, et al. Association between nutritional status and dengue infection: a systematic review and meta-analysis. BMC Infect Dis. 2016;16(172):1-11.
Junia J, Garna H, Setiabudi D. Clinical risk factors for dengue shock syndrome in children. Paediatr Indones. 2007;47(1):7-11.
Widiyati MMT, Laksanawati IS, Prawirohartono EP. Obesity as a risk factor for dengue shock syndrome in children. Paediatr Indones. 2013;53(4):187-92.
Kan EF, Rampengan TH. Factors associated with shock in children with dengue hemorrhagic fever. Paediatr Indones. 2004;44(9-10):171-75.
Dewi R, Tumbelaka AR, Sjarif DR. Clinical features o dengue hemorrhagic fever and risk factors of shock event. Paediatr Indones. 2006;46(5-6):144-8.
Zulkipli MS, Dahlui M, Jamil N, Peramalah D, Wai HVC, Bulgiba A, et al. The association between obesity and dengue severity among pediatric patients: A systematic review and meta-analysis. PLoS Negl Trop Dis. 2018;12(2). p62-66.
Cecilia C, Sugianto JA. Predictor of dengue shock syndrome among pediatric dengue infection in limited resource setting. J Indon Med Assoc. 2019;69(4):178-83.
Raihan, Hadinegoro SRS, Tumbelaka AR. Faktor prognosis terjadinya syok pada demam berdarah dengue. Sari Pediatri. 2010;12(1):47-52.
Michels M, Alisjahbana B, de Groot PG, et al. Platelet function alterations in dengue are associated with plasma leakage. Thromb Haemost. 2014;112(02):352-62.
Yolanda N, Alfan H. Initial clinical and laboratory profiles to predict pediatrics dengue infection severity. Paediatr Indones. 2017;57(6):303-9.
Lam PK, Hoai Tam DT, Dung NM, Tien NTH, Kieu NTT, Simmons C, et al. A Prognostic model for development of profound shock among children presenting with dengue shock syndrome. PLoS ONE. 2015;10(5). p232-236.
Hammond SN, Balmaseda A, Perez L, Tellez Y, Saborio SI, Mercado JC, et al. Differences in dengue severity in infants, children, adults, in a 3-year hospital-based in Nicaragua. Am J Trop Med. 2005;73:1063-70.

[1] Chairulfatah A, Alam A, Setiabudi D, Hapsari DMM, Satari HI, Laksono IS, et al. Pedoman diagnosis dan tata laksana infeksi virus dengue pada anak. 1st ed. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia. 2014.

[2] Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia. Situasi penyakit demam berdarah di Indonesia tahun 2017. Jakarta: Pusdatin Kementrian Kesehatan Republik Indonesia. 2018.

[3] World Health Organization, Regioinal Office for South-East Asia. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever. Revised and expanded edition. India: WHO Regional Office for South-East Asia. 2011.

[4] Saniathi E, Arhana BNP, Suandi IKG, Sidiartha IGL. Obesitas sebagai faktor risiko sindrom syok dengue. Sari Pediatri. 2009;11(4):238-43.

[5] Buntubatu S, Arguni E, Indrawanti R, Laksono IS, Prawirohartono EP. Status nutrisi sebagai faktor risiko sindrom syok dengue. Sari Pediatri. 2016;18(3):226-32.

[6] Saniathi NKE, Rianto BUDR, Juffrie M, Soetjiningsih. The effect of overnutrition toward the risk of dengue shock syndrome in pediatric patient: in-depth investigation of sVCAM-1 and adiponectin level. Bali Med J. 2018; 7(1):244-8.

[7] Edwin J, Budiarta MO, Edward K. Analisis faktor risiko sindrom syok dengue pada anak di Rumah Sakit Ibu Anak Bunda Aliyah Jakarta. Sari Pediatri. 2019;21(2):109-14.

[8] Tantracheewathorn T, Tantracheewathorn S. Risk factors of dengue shock syndrome in children. J Med Assoc Thai. 2007;90(2): 272-7.

[9] Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab. 2004;89:2548-56.

[10] Rasmussen MS, Lihn AS, Pedersen SB, Bruun JM, Rasmussen M, Richelsen B. Adiponectin receptors in human adipose tissue: effects of obesity, weight loss and fat depots. Obesity. 2006;14:28-35.

[11] Trang NTH, Long NP, Hue TTM, Hung LP, Trung TD, Dinh DN, et al. Association between nutritional status and dengue infection: a systematic review and meta-analysis. BMC Infect Dis. 2016;16(172):1-11.

[12] Junia J, Garna H, Setiabudi D. Clinical risk factors for dengue shock syndrome in children. Paediatr Indones. 2007;47(1):7-11.

[13] Widiyati MMT, Laksanawati IS, Prawirohartono EP. Obesity as a risk factor for dengue shock syndrome in children. Paediatr Indones. 2013;53(4):187-92.

[14] Kan EF, Rampengan TH. Factors associated with shock in children with dengue hemorrhagic fever. Paediatr Indones. 2004;44(9-10):171-75.

[15] Dewi R, Tumbelaka AR, Sjarif DR. Clinical features o dengue hemorrhagic fever and risk factors of shock event. Paediatr Indones. 2006;46(5-6):144-8.

[16] Zulkipli MS, Dahlui M, Jamil N, Peramalah D, Wai HVC, Bulgiba A, et al. The association between obesity and dengue severity among pediatric patients: A systematic review and meta-analysis. PLoS Negl Trop Dis. 2018;12(2). p62-66.

[17] Cecilia C, Sugianto JA. Predictor of dengue shock syndrome among pediatric dengue infection in limited resource setting. J Indon Med Assoc. 2019;69(4):178-83.

[18] Raihan, Hadinegoro SRS, Tumbelaka AR. Faktor prognosis terjadinya syok pada demam berdarah dengue. Sari Pediatri. 2010;12(1):47-52.

[19] Michels M, Alisjahbana B, de Groot PG, et al. Platelet function alterations in dengue are associated with plasma leakage. Thromb Haemost. 2014;112(02):352-62.

[20] Yolanda N, Alfan H. Initial clinical and laboratory profiles to predict pediatrics dengue infection severity. Paediatr Indones. 2017;57(6):303-9.

[21] Lam PK, Hoai Tam DT, Dung NM, Tien NTH, Kieu NTT, Simmons C, et al. A Prognostic model for development of profound shock among children presenting with dengue shock syndrome. PLoS ONE. 2015;10(5). p232-236.

[22] Hammond SN, Balmaseda A, Perez L, Tellez Y, Saborio SI, Mercado JC, et al. Differences in dengue severity in infants, children, adults, in a 3-year hospital-based in Nicaragua. Am J Trop Med. 2005;73:1063-70.

The association between overweight and shock in children with dengue hemorrhagic fever at Wangaya General Hospital, Bali, Indonesia

Abstract

References

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