Authors:
, , , , , , , , , , , , , , , , , and
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-
1.
World Health Organization Regional Office for South-East Asia, 2011. Comprehensive Guideline for Prevention and Control of Dengue and Dengue Haemorrhagic Fever. Revised and Expanded Edition. New Delhi, India: WHO Regional Office for South-East Asia.
-
2.
World Health Organization, 2023. Disease Outbreak News: Dengue—Global Situation. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498. Accessed March 27, 2024.
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3.
ASEAN Biodiaspora Virtual Center, 2023. Morbidity and Mortality Weekly Report: Infectious Diseases. Available at: https://asean.org/wp-content/uploads/2023/09/ABVC-MMWR_Infectious-Diseases_28Aug23.pdf. Accessed May 20, 2024.
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4.
Prashanth VN, Manasa G, 2019. Study of gastrointestinal manifestations in dengue fever. Int J Adv Med 6: 1476–1481.
-
5.
Gulati S, Maheshwari A, 2007. Atypical manifestations of dengue. Trop Med Int Health 12: 1087–1095.
-
6.
Samanta J, Sharma V, 2015. Dengue and its effects on liver. World J Clin Cases 3: 125–131.
-
7.
Mohan B, Patwari AK, Anand VK, 2000. Hepatic dysfunction in childhood dengue infection. J Trop Pediatr 46: 40–43.
-
8.
World Health Organization, 2009. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control: New Edition. Available at: https://www.who.int/publications/i/item/9789241547871. Accessed March 27, 2024.
-
9.
Sirivichayakul C, Limkittikul K, Chanthavanich P, Jiwariyavej V, Chokejindachai W, Pengsaa K, Suvannadabba S, Dulyachai W, Letson GW, Sabchareon A, 2012. Dengue infection in children in Ratchaburi, Thailand: A cohort study. II. Clinical manifestations. PLoS Negl Trop Dis 6: e1520.
-
10.
Ferreira RAX, Kubelka CF, Velarde LGC, Matos JPS, Ferreira LC, Reid MM, Setúbal S, Oliveira SA, 2018. Predictive factors of dengue severity in hospitalized children and adolescents in Rio de Janeiro, Brazil. Rev Soc Bras Med Trop 51: 753–760.
-
11.
Maneerattanasak S, Suwanbamrung C, 2020. Impact of nutritional status on the severity of dengue infection among pediatric patients in Southern Thailand. Pediatr Infect Dis J 39: e410–e416.
-
12.
Ledika MA, Setiabudi D, Dhamayanti M, 2015. Association between clinical profiles and severe dengue infection in children in developing country. Am J Epidemiol Infect Dis 3: 45–49.
-
13.
Mazuumder M, Hassan MN, Karim ASM, Islam R, 2021. Gastrointestinal manifestations of dengue fever in children of Bangladesh. ejpmr 8: 96–101.
-
14.
Rathod NP, Ansari NJR, Singh DK, 2018. Clinical profile of children with dengue and factors associated with severe dengue and dengue with warning signs. Pediatric Oncall 15: 1–4.
-
15.
Akram A, Akram L, Ghosh UK, Abiduzzaman M, Rahman S, 2023. Gastrointestinal manifestations of dengue fever among children. Bangladesh J Med Microbiol 17: 66–70.
-
16.
Khan MAS et al., 2021. Clinical spectrum and predictors of severity of dengue among children in 2019 outbreak: A multicenter hospital-based study in Bangladesh. BMC Pediatr 21: 478.
-
17.
Baiduri S, Husada D, Puspitasari D, Kartina L, Basuki PS, Ismoedijanto I, 2020. Prognostic factors of severe dengue infections in children. IJTID 8: 44–53.
-
18.
Pothapregada S, Sivapurapu V, Kamalakannan B, Thulasingam M, 2018. Role of early warning signs in children with severe dengue infection. Int J Contemp Pediatr 5: 1423–1430.
-
19.
Tiawilai A, Tiawila T, Thisyakorn U, 2017. Manifestations of dengue in various age groups of Thai children and adults: A cross sectional study. Southeast Asian J Trop Med Public Health 48: 122–127.
-
20.
Malavige GN, Ogg GS, 2017. Pathogenesis of vascular leak in dengue virus infection. Immunology 151: 261–269.
-
21.
Laoprasopwattana K, Jundee P, Pruekprasert P, Geater A, 2016. Outcome of severe dengue viral infection-caused acute liver failure in Thai children. J Trop Pediatr 62: 200–205.
-
22.
Kye Mon K, Nontprasert A, Kittitrakul C, Tangkijvanich P, Leowattana W, Poovorawan K, 2016. Incidence and clinical outcome of acute liver failure caused by dengue in a hospital for tropical Diseases, Thailand. Am J Trop Med Hyg 95: 1338–1344.
-
23.
Kumar KJ, Chandrashekar A, Basavaraja CK, Kumar HC, 2016. Acute pancreatitis complicating dengue hemorrhagic fever. Rev Soc Bras Med Trop 49: 656–659.
-
24.
Huy BV, Toàn NV, 2022. Prognostic indicators associated with progresses of severe dengue. PLoS One 17: e0262096.
-
25.
Villar-Centeno LA, Díaz-Quijano FA, Martínez-Vega RA, 2008. Biochemical alterations as markers of dengue hemorrhagic fever. Am J Trop Med Hyg 78: 370–374.
-
26.
Thyagaraj, Sreedevi T, 2020. A study of correlation of serum albumin with dengue severity. Int J Adv Med 7: 814–816.
-
27.
Srivastava G, Chhavi N, Goel A, 2018. Validation of serum aminotransferases levels to define severe dengue fever in children. Pediatr Gastroenterol Hepatol Nutr 21: 289–296.
-
28.
Selvan T, P S, MV N, Tudu MN, 2017. Study of hepatic dysfunction of dengue fever in children. Int J Contemp Pediatr 4: 901–904.
-
29.
Maron GM, Clara AW, Diddle JW, Pleites EB, Miller L, Macdonald G, Adderson EE, 2010. Association between nutritional status and severity of dengue infection in children in El Salvador. Am J Trop Med Hyg 82: 324–329.
-
30.
Zulkipli MS, Dahlui M, Jamil N, Peramalah D, Wai HVC, Bulgiba A, Rampal S, 2018. The association between obesity and dengue severity among pediatric patients: A systematic review and meta-analysis. PLoS Negl Trop Dis 12: e0006263.
-
31.
Te H, Sriburin P, Rattanamahaphoom J, Sittikul P, Hattasingh W, Chatchen S, Sirinam S, Limkittikul K, 2022. Association between nutritional status and dengue severity in Thai children and adolescents. PLoS Negl Trop Dis 16: e0010398.
-
32.
Sangkaew S, Ming D, Boonyasiri A, Honeyford K, Kalayanarooj S, Yacoub S, Dorigatti I, Holmes A, 2021. Risk predictors of progression to severe disease during the febrile phase of dengue: A systematic review and meta-analysis. Lancet Infect Dis 21: 1014–1026.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 611 | 611 | 208 |
| Full Text Views | 43 | 43 | 22 |
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Gastrointestinal Manifestations and Prognostic Factors for Severe Dengue in Thai Children
Kittiya Setrkraising
Kittiya Setrkraising
Department of Pediatrics, Charoenkrung Pracharak Hospital, Bangkok, Thailand;
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Chatporn Kittitrakul
chatporn.kit@mahidol.ac.th
Chatporn Kittitrakul
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
Search for other papers by Chatporn Kittitrakul in
Current site
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Search for other papers by Chatporn Kittitrakul in
Current site
Google Scholar
PubMed
ABSTRACT.
Dengue infection poses a significant public health challenge in tropical countries. In Thailand, children ages 5–14 years are among the groups with the highest incidence of dengue. This study aimed to determine the prevalence of gastrointestinal (GI) manifestations in children with dengue infection and assess prognostic factors for severe dengue. We reviewed the medical records of children ages 0–14 years who were hospitalized with a diagnosis of dengue infection between 2019 and 2022 at Charoenkrung Pracharak Hospital in Bangkok, Thailand. Dengue severity was classified according to the 2009 WHO dengue guidelines. Clinical manifestations and laboratory data were analyzed for their association with severe dengue using a logistic regression model. The study included 556 dengue cases, with 48 cases (8.6%) classified as severe dengue. The mean age (SD) of patients was 9.9 (3.7) years. The most common GI symptoms were anorexia (91.7%) and vomiting (57.6%) followed by abdominal pain (38.3%), and diarrhea (33.3%). GI bleeding was found in 3.2% of patients. Hepatomegaly and ascites were found in 20.9% and 2.9% of patients, respectively. Acute liver failure and acalculous cholecystitis were found in 0.4% and 0.2% of patients, respectively. Children younger than 5 years of age exhibited a lower prevalence of vomiting and abdominal pain compared with older children, making the diagnosis of dengue more challenging. Vomiting, ascites, aspartate aminotransferase >450 U/L, and serum albumin <3.5 g/dL were significantly associated with severe dengue infection. Children with dengue infection presenting any of these factors should be closely monitored for severe dengue.
Author Notes
Financial support: This work was supported by
Disclosure: This study was approved by the Bangkok Metropolitan Administration Human Research Ethics Committee (S016h/65).
Current contact information: Kittiya Setrkraising, Department of Pediatrics, Charoenkrung Pracharak Hospital, Bangkok, Thailand, E-mail: kittiyajune@yahoo.com. Chatporn Kittitrakul, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mail: chatporn.kit@mahidol.ac.th.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization Regional Office for South-East Asia, 2011. Comprehensive Guideline for Prevention and Control of Dengue and Dengue Haemorrhagic Fever. Revised and Expanded Edition. New Delhi, India: WHO Regional Office for South-East Asia.
-
2.
World Health Organization, 2023. Disease Outbreak News: Dengue—Global Situation. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498. Accessed March 27, 2024.
-
3.
ASEAN Biodiaspora Virtual Center, 2023. Morbidity and Mortality Weekly Report: Infectious Diseases. Available at: https://asean.org/wp-content/uploads/2023/09/ABVC-MMWR_Infectious-Diseases_28Aug23.pdf. Accessed May 20, 2024.
-
4.
Prashanth VN, Manasa G, 2019. Study of gastrointestinal manifestations in dengue fever. Int J Adv Med 6: 1476–1481.
-
5.
Gulati S, Maheshwari A, 2007. Atypical manifestations of dengue. Trop Med Int Health 12: 1087–1095.
-
6.
Samanta J, Sharma V, 2015. Dengue and its effects on liver. World J Clin Cases 3: 125–131.
-
7.
Mohan B, Patwari AK, Anand VK, 2000. Hepatic dysfunction in childhood dengue infection. J Trop Pediatr 46: 40–43.
-
8.
World Health Organization, 2009. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control: New Edition. Available at: https://www.who.int/publications/i/item/9789241547871. Accessed March 27, 2024.
-
9.
Sirivichayakul C, Limkittikul K, Chanthavanich P, Jiwariyavej V, Chokejindachai W, Pengsaa K, Suvannadabba S, Dulyachai W, Letson GW, Sabchareon A, 2012. Dengue infection in children in Ratchaburi, Thailand: A cohort study. II. Clinical manifestations. PLoS Negl Trop Dis 6: e1520.
-
10.
Ferreira RAX, Kubelka CF, Velarde LGC, Matos JPS, Ferreira LC, Reid MM, Setúbal S, Oliveira SA, 2018. Predictive factors of dengue severity in hospitalized children and adolescents in Rio de Janeiro, Brazil. Rev Soc Bras Med Trop 51: 753–760.
-
11.
Maneerattanasak S, Suwanbamrung C, 2020. Impact of nutritional status on the severity of dengue infection among pediatric patients in Southern Thailand. Pediatr Infect Dis J 39: e410–e416.
-
12.
Ledika MA, Setiabudi D, Dhamayanti M, 2015. Association between clinical profiles and severe dengue infection in children in developing country. Am J Epidemiol Infect Dis 3: 45–49.
-
13.
Mazuumder M, Hassan MN, Karim ASM, Islam R, 2021. Gastrointestinal manifestations of dengue fever in children of Bangladesh. ejpmr 8: 96–101.
-
14.
Rathod NP, Ansari NJR, Singh DK, 2018. Clinical profile of children with dengue and factors associated with severe dengue and dengue with warning signs. Pediatric Oncall 15: 1–4.
-
15.
Akram A, Akram L, Ghosh UK, Abiduzzaman M, Rahman S, 2023. Gastrointestinal manifestations of dengue fever among children. Bangladesh J Med Microbiol 17: 66–70.
-
16.
Khan MAS et al., 2021. Clinical spectrum and predictors of severity of dengue among children in 2019 outbreak: A multicenter hospital-based study in Bangladesh. BMC Pediatr 21: 478.
-
17.
Baiduri S, Husada D, Puspitasari D, Kartina L, Basuki PS, Ismoedijanto I, 2020. Prognostic factors of severe dengue infections in children. IJTID 8: 44–53.
-
18.
Pothapregada S, Sivapurapu V, Kamalakannan B, Thulasingam M, 2018. Role of early warning signs in children with severe dengue infection. Int J Contemp Pediatr 5: 1423–1430.
-
19.
Tiawilai A, Tiawila T, Thisyakorn U, 2017. Manifestations of dengue in various age groups of Thai children and adults: A cross sectional study. Southeast Asian J Trop Med Public Health 48: 122–127.
-
20.
Malavige GN, Ogg GS, 2017. Pathogenesis of vascular leak in dengue virus infection. Immunology 151: 261–269.
-
21.
Laoprasopwattana K, Jundee P, Pruekprasert P, Geater A, 2016. Outcome of severe dengue viral infection-caused acute liver failure in Thai children. J Trop Pediatr 62: 200–205.
-
22.
Kye Mon K, Nontprasert A, Kittitrakul C, Tangkijvanich P, Leowattana W, Poovorawan K, 2016. Incidence and clinical outcome of acute liver failure caused by dengue in a hospital for tropical Diseases, Thailand. Am J Trop Med Hyg 95: 1338–1344.
-
23.
Kumar KJ, Chandrashekar A, Basavaraja CK, Kumar HC, 2016. Acute pancreatitis complicating dengue hemorrhagic fever. Rev Soc Bras Med Trop 49: 656–659.
-
24.
Huy BV, Toàn NV, 2022. Prognostic indicators associated with progresses of severe dengue. PLoS One 17: e0262096.
-
25.
Villar-Centeno LA, Díaz-Quijano FA, Martínez-Vega RA, 2008. Biochemical alterations as markers of dengue hemorrhagic fever. Am J Trop Med Hyg 78: 370–374.
-
26.
Thyagaraj, Sreedevi T, 2020. A study of correlation of serum albumin with dengue severity. Int J Adv Med 7: 814–816.
-
27.
Srivastava G, Chhavi N, Goel A, 2018. Validation of serum aminotransferases levels to define severe dengue fever in children. Pediatr Gastroenterol Hepatol Nutr 21: 289–296.
-
28.
Selvan T, P S, MV N, Tudu MN, 2017. Study of hepatic dysfunction of dengue fever in children. Int J Contemp Pediatr 4: 901–904.
-
29.
Maron GM, Clara AW, Diddle JW, Pleites EB, Miller L, Macdonald G, Adderson EE, 2010. Association between nutritional status and severity of dengue infection in children in El Salvador. Am J Trop Med Hyg 82: 324–329.
-
30.
Zulkipli MS, Dahlui M, Jamil N, Peramalah D, Wai HVC, Bulgiba A, Rampal S, 2018. The association between obesity and dengue severity among pediatric patients: A systematic review and meta-analysis. PLoS Negl Trop Dis 12: e0006263.
-
31.
Te H, Sriburin P, Rattanamahaphoom J, Sittikul P, Hattasingh W, Chatchen S, Sirinam S, Limkittikul K, 2022. Association between nutritional status and dengue severity in Thai children and adolescents. PLoS Negl Trop Dis 16: e0010398.
-
32.
Sangkaew S, Ming D, Boonyasiri A, Honeyford K, Kalayanarooj S, Yacoub S, Dorigatti I, Holmes A, 2021. Risk predictors of progression to severe disease during the febrile phase of dengue: A systematic review and meta-analysis. Lancet Infect Dis 21: 1014–1026.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 611 | 611 | 208 |
| Full Text Views | 43 | 43 | 22 |
| PDF Downloads | 65 | 65 | 35 |