Clinical characteristics and laboratory parameters in differentiating pediatric Dengue fever and Dengue hemorrhagic fever

OBJECTIVE: The mortality of dengue hemorrhagic fever (DHF) infection in children is still high. Discriminating dengue fever (DF) and DHF during the early phase is difficult, especially with limited diagnostic tools in peripheral areas. Hence, early identification of significant factors in DHF is imp...

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Main Authors: A. Juliansen, F. Meliani, C. Budiputri, M. Muljono, R. Heriyanto, S. Chandra, G. Octavius
Format: Article
Language:English
Published: Verduci Editore 2022-04-01
Series:Infectious Diseases and Tropical Medicine
Subjects:
Online Access:https://www.infectiousjournal.com/wp-content/uploads/sites/6/2022/04/e829.pdf
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author A. Juliansen
F. Meliani
C. Budiputri
M. Muljono
R. Heriyanto
S. Chandra
G. Octavius
author_facet A. Juliansen
F. Meliani
C. Budiputri
M. Muljono
R. Heriyanto
S. Chandra
G. Octavius
author_sort A. Juliansen
collection DOAJ
description OBJECTIVE: The mortality of dengue hemorrhagic fever (DHF) infection in children is still high. Discriminating dengue fever (DF) and DHF during the early phase is difficult, especially with limited diagnostic tools in peripheral areas. Hence, early identification of significant factors in DHF is important, with rapid disease progression may lead to mortality. This study aims to determine early clinical and laboratory parameters significant in differentiating DF and DHF. MATERIALS AND METHODS: This is a cross-sectional study using secondary data from medical records collected by purposive sampling from January 2015 to December 2020. This study included children aged 0-18 years old diagnosed with DF and DHF based on World Health Organization (WHO) 2011 criteria. RESULTS: From multivariate analysis of 528 dengue patients, presence of prior dengue infection (OR =7.1; 95% CI: 2.1-23.7, p=0.001), transfusion administration (OR = 34; 95% CI: 8.7-132, p<0.001), present hepatomegaly (OR = 7.2; 95% CI 1.3-38.2, p=0.02) and other bleeding manifestations (OR = 3.5; 95% CI 1.3-9.3, p=0.012) are significant parameters to differentiate DF and DHF with good quality of discrimination (AUC value = 0.83) and the model is a good fit (Hosmer-Lemeshow value = 0.65). ROC analysis showed two significant variables yielded 55.6% of sensitivity and 86.3% of specificity. CONCLUSIONS: Two or more characteristics of present hepatomegaly, other bleeding manifestations, transfusion received, and prior dengue infection are specific to dengue infections yet less sensitive to differentiate DF and DHF.
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spelling doaj.art-440ec3e3d6b246d59eae187c65dd62b32023-01-10T10:28:31ZengVerduci EditoreInfectious Diseases and Tropical Medicine2379-40542022-04-01810.32113/idtm_20224_829829Clinical characteristics and laboratory parameters in differentiating pediatric Dengue fever and Dengue hemorrhagic feverA. Juliansen0F. Meliani1C. Budiputri2M. Muljono3R. Heriyanto4S. Chandra5G. Octavius6Department of Pediatrics, Faculty of Medicine, Universitas Pelita Harapan, Banten, IndonesiaDepartment of Pediatrics, Faculty of Medicine, Universitas Pelita Harapan, Banten, IndonesiaDepartment of Pediatrics, Faculty of Medicine, Universitas Pelita Harapan, Banten, IndonesiaDepartment of Pediatrics, Faculty of Medicine, Universitas Pelita Harapan, Banten, IndonesiaDepartment of Pediatrics, Faculty of Medicine, Universitas Pelita Harapan, Banten, IndonesiaDepartment of Pediatrics, Faculty of Medicine, Universitas Pelita Harapan, Banten, IndonesiaDepartment of Pediatrics, Faculty of Medicine, Universitas Pelita Harapan, Banten, IndonesiaOBJECTIVE: The mortality of dengue hemorrhagic fever (DHF) infection in children is still high. Discriminating dengue fever (DF) and DHF during the early phase is difficult, especially with limited diagnostic tools in peripheral areas. Hence, early identification of significant factors in DHF is important, with rapid disease progression may lead to mortality. This study aims to determine early clinical and laboratory parameters significant in differentiating DF and DHF. MATERIALS AND METHODS: This is a cross-sectional study using secondary data from medical records collected by purposive sampling from January 2015 to December 2020. This study included children aged 0-18 years old diagnosed with DF and DHF based on World Health Organization (WHO) 2011 criteria. RESULTS: From multivariate analysis of 528 dengue patients, presence of prior dengue infection (OR =7.1; 95% CI: 2.1-23.7, p=0.001), transfusion administration (OR = 34; 95% CI: 8.7-132, p<0.001), present hepatomegaly (OR = 7.2; 95% CI 1.3-38.2, p=0.02) and other bleeding manifestations (OR = 3.5; 95% CI 1.3-9.3, p=0.012) are significant parameters to differentiate DF and DHF with good quality of discrimination (AUC value = 0.83) and the model is a good fit (Hosmer-Lemeshow value = 0.65). ROC analysis showed two significant variables yielded 55.6% of sensitivity and 86.3% of specificity. CONCLUSIONS: Two or more characteristics of present hepatomegaly, other bleeding manifestations, transfusion received, and prior dengue infection are specific to dengue infections yet less sensitive to differentiate DF and DHF.https://www.infectiousjournal.com/wp-content/uploads/sites/6/2022/04/e829.pdfdengue feverdengue hemorrhagic feverclinical characteristicschildren.
spellingShingle A. Juliansen
F. Meliani
C. Budiputri
M. Muljono
R. Heriyanto
S. Chandra
G. Octavius
Clinical characteristics and laboratory parameters in differentiating pediatric Dengue fever and Dengue hemorrhagic fever
Infectious Diseases and Tropical Medicine
dengue fever
dengue hemorrhagic fever
clinical characteristics
children.
title Clinical characteristics and laboratory parameters in differentiating pediatric Dengue fever and Dengue hemorrhagic fever
title_full Clinical characteristics and laboratory parameters in differentiating pediatric Dengue fever and Dengue hemorrhagic fever
title_fullStr Clinical characteristics and laboratory parameters in differentiating pediatric Dengue fever and Dengue hemorrhagic fever
title_full_unstemmed Clinical characteristics and laboratory parameters in differentiating pediatric Dengue fever and Dengue hemorrhagic fever
title_short Clinical characteristics and laboratory parameters in differentiating pediatric Dengue fever and Dengue hemorrhagic fever
title_sort clinical characteristics and laboratory parameters in differentiating pediatric dengue fever and dengue hemorrhagic fever
topic dengue fever
dengue hemorrhagic fever
clinical characteristics
children.
url https://www.infectiousjournal.com/wp-content/uploads/sites/6/2022/04/e829.pdf
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