Hemoconcentration as Predictor of Dengue Hemorrhagic Fever Infection Severity in Pediatric Patients
Abstract
Background: Dengue infection can be asymptomatic or symptomatic, as undifferentiated, dengue fever or dengue hemorrhagic fever, or may even be a dengue shock syndrome. The progression of dengue hemorrhagic infections varies in each person. Patients with mild clinical symptoms may initially progress rapidly to more severe even to death. Assessment of the degree of severity as early as possible is important for adequate management, preventing shock and further bleeding. The objective of this study is to determine the association between patient characteristics, clinical symptoms, and laboratory results with the severity of infection in dengue hemorrhagic fever.
Method: This study was an observational analytic study with a prospective cohort design, sampling was done by looking at the medical record, laboratory results, and anamnesis was done by using questionnaires on the first day of hospital admission and followed during treatment until the determination of DF and DHF diagnosis. This research was conducted from May to October 2017 in the pediatric ward in Sleman and Bantul Regional Public Hospital, Yogyakarta. The subjects of this study were 42 patients consisting of 24 patients with severe dengue and 18 patients with mild dengue.
Results: The bivariate analysis found that age, gender, and length of treatment showed no significant difference in dengue severity (p>0.05). Clinical symptoms of fever duration, headache duration, abdominal pain, days starting nauseous, petechiae, vomiting frequency, myalgia, arthralgia, nosebleeds, and bleeding gums showed no significant difference. The laboratory result of hematocrit, and hemoconcentration during hospitalization showed a significant difference in dengue severity (p<0.05) whereas thrombocytopenia showed no significant difference. Multivariate analysis found hemoconcentration during hospitalization showed a significant association with dengue severity (p<0.05).
Conclusion: This result shows that hemoconcentration can be used as a predictor of dengue hemorrhagic fever severity of infection in pediatric patients in Sleman and Bantul Regional Public Hospital.
Keywords: Dengue hemorrhagic fever; Hemoconcentration; Pediatric patients; The severity of infection.
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Universitas Ahmad Dahlan on Public Health International Conference Proceeding (UPHEC)
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