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-
1.
San MartÃn JL, Brathwaite O, Zambrano B, Solórzano JO, Bouckenooghe A, Dayan GH, Guzmán MG, 2010. The epidemiology of dengue in the Americas over the last three decades: a worrisome reality. Am J Trop Med Hyg 82: 128–135.
-
2.
Guzman M, Kouri G, 2003. Dengue and dengue hemorrhagic fever in the Americas: lessons and challenges. J Clin Virol 27: 1–13.
-
3.
PAHO, 2012. Dengue Regional Information: Number of Cases. Available at: http://new.paho.org/hq/index.php?option=com_content&view=article&id=264&Itemid=363&lang=en. Accessed July 24, 2013.
-
4.
Bandyopadhyay S, Lum LCS, Kroeger A, 2006. Classifying dengue: a review of the difficulties in using the WHO case classification for dengue haemorrhagic fever. Trop Med Int Health 11: 1238–1255.
-
5.
Horstick O, Farrar J, Lum L, 2012. Reviewing the development, evidence base, and application of the revised dengue case classification. Pathog Glob Health 106: 94–101.
-
6.
Jayaratne SD, Atukorale V, Gomes L, Chang T, Wijesinghe T, Fernando S, Ogg GS, Malavige GN, 2012. Evaluation of the WHO revised criteria for classification of clinical disease severity in acute adult dengue infection. BMC Res Notes 5: 645.
-
7.
Alexander N, Balmaseda A, 2011. Multicentre prospective study on dengue classification in four Southeast Asian and three Latin American countries. Trop Med Int Health 16: 936–948.
-
8.
Hadinegoro S, 2012. The revised WHO dengue case classification: does the system need to be modified? Paediatr Int Child Health 32 (Suppl 1): 33–38.
-
9.
Narvaez F, Gutierrez G, Pérez M, 2011. Evaluation of the traditional and revised WHO classifications of dengue disease severity. PLoS Negl Trop Dis 5: 1–8.
-
10.
Hayes C, Manaloto C, Gonzalez A, Ranoa C, 1988. Dengue infections in the Philippines: clinical and virological findings in 517 hospitalized patients. Am J Trop Med Hyg 39: 110–116.
-
11.
WHO/HTM/NTD/DEN, 2009. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control, 1st Ed. Geneva: WHO.
-
12.
MSP-HIRRC, 2011. Ingresos, Egresos, Defunciones 2006–2011. Available at: http://www.hirrc.org/Mortalidad%202005-2010-junio.pdf. Accessed July 24, 2013.
-
13.
Cohen SN, Halstead SB, 1964. Shock associated with dengue infection. J Trop Pediatr 68: 448–455.
-
14.
Bharath Kumar Reddy KR, Laksmana RR, Veerappa BG, Shivananda, 2013. Ultrasonography as a tool in predicting the severity of dengue fever in children-a useful aid in a developing country. Pediatr Radiol 43: 971–977.
-
15.
Balmaseda A, Hammond SN, Pérez MA, Cuadra R, Solano S, Rocha J, Idiaquez W, Harris E, 2005. Short report: assessment of the World Health Organization scheme for classification of dengue severity in Nicaragua. Am J Trop Med Hyg 73: 1059–1062.
-
16.
Boonpucknavig S, Boonpucknavig V, Bhamarapravati N, Nimmannitya S, 1979. Immunofluorescence study of skin rash in patients with dengue hemorrhagic fever. Arch Pathol Lab Med 103: 463–466.
-
17.
Priyadarshini D, Gadia RR, Tripathy A, Gurukumar KR, Bhagat A, Patwardhan S, Mokashi N, Vaidya D, Shah PS, Cecilia D, 2010. Clinical findings and pro-inflammatory cytokines in dengue patients in Western India: a facility-based study. PLoS One 5: e8709.
-
18.
Hammond SN, Balmaseda A, Pérez L, Tellez Y, SaborÃo SI, Mercado JC, Videa E, Rodriguez Y, Pérez MA, Cuadra R, Solano S, Rocha J, Idiaquez W, Gonzalez A, Harris E, 2005. Differences in dengue severity in infants, children, and adults in a 3-year hospital-based study in Nicaragua. Am J Trop Med Hyg 73: 1063–1070.
-
19.
Anders KL, Nguyet NM, Chau NVV, Hung NT, Thuy TT, Lien LB, Farrar J, Wills B, Hien TT, Simmons CP, 2011. Epidemiological factors associated with dengue shock syndrome and mortality in hospitalized dengue patients in Ho Chi Minh City, Vietnam. Am J Trop Med Hyg 84: 127–134.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 2145 | 1986 | 45 |
| Full Text Views | 464 | 10 | 0 |
| PDF Downloads | 165 | 11 | 0 |
Disease Severity and Mortality Caused by Dengue in a Dominican Pediatric Population
Alfredo J. Mena Lora
Alfredo J. Mena Lora
Division of Infectious Diseases, University of Illinois, Chicago, Illinois; Infectious Diseases Department, Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic
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Josefina Fernandez
Josefina Fernandez
Division of Infectious Diseases, University of Illinois, Chicago, Illinois; Infectious Diseases Department, Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic
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Alfredo Morales
Alfredo Morales
Division of Infectious Diseases, University of Illinois, Chicago, Illinois; Infectious Diseases Department, Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic
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Yahaira Soto
Yahaira Soto
Division of Infectious Diseases, University of Illinois, Chicago, Illinois; Infectious Diseases Department, Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic
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Jesus Feris-Iglesias
Jesus Feris-Iglesias
Division of Infectious Diseases, University of Illinois, Chicago, Illinois; Infectious Diseases Department, Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic
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Maximo O. Brito
Maximo O. Brito
Division of Infectious Diseases, University of Illinois, Chicago, Illinois; Infectious Diseases Department, Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic
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Millions are infected with dengue yearly. We evaluated the epidemiological and clinical characteristics of pediatric patients infected with dengue in the Dominican Republic. The applicability of World Health Organization (WHO) warning signs for predicting severe dengue and mortality was also studied. This study was a cross-sectional retrospective review of patients with a clinical diagnosis of dengue. Univariate and multivariate analyses were performed to evaluate characteristics associated with severity and mortality. The study included 796 subjects: 288 subjects were classified as dengue, 290 subjects had alarm signs, and 207 subjects were classified as severe dengue. Common findings included thrombocytopenia (96%), abdominal pain (71%), and vomiting (59%). The most important factors associated with severe dengue were rash (P < 0.01), severe thrombocytopenia (P < 0.01), and anemia (P < 0.01). These signs and symptoms were also associated with mortality. This study validates the current WHO warning signs of severity. Rash and severe thrombocytopenia may be early warning signs and need additional study.
Author Notes
Financial support: Discretionary research funds were from the Department of Medicine, University of Illinois, Chicago, IL.
Authors' addresses: Alfredo J. Mena Lora and Maximo O. Brito, Section of Infectious Diseases, Department of Medicine, University of Illinois, Chicago, IL, E-mails: amenalor@uic.edu and mbrito@uic.edu. Josefina Fernandez, Alfredo Morales, Yahaira Soto, and Jesus Feris-Iglesias, Infectious Diseases Department, Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic, E-mails: infectologia01@yahoo.es, morales_alfredo_86@hotmail.com, soto.yahaira@hotmail.com, and jesusferisiglesias@yahoo.es.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
San MartÃn JL, Brathwaite O, Zambrano B, Solórzano JO, Bouckenooghe A, Dayan GH, Guzmán MG, 2010. The epidemiology of dengue in the Americas over the last three decades: a worrisome reality. Am J Trop Med Hyg 82: 128–135.
-
2.
Guzman M, Kouri G, 2003. Dengue and dengue hemorrhagic fever in the Americas: lessons and challenges. J Clin Virol 27: 1–13.
-
3.
PAHO, 2012. Dengue Regional Information: Number of Cases. Available at: http://new.paho.org/hq/index.php?option=com_content&view=article&id=264&Itemid=363&lang=en. Accessed July 24, 2013.
-
4.
Bandyopadhyay S, Lum LCS, Kroeger A, 2006. Classifying dengue: a review of the difficulties in using the WHO case classification for dengue haemorrhagic fever. Trop Med Int Health 11: 1238–1255.
-
5.
Horstick O, Farrar J, Lum L, 2012. Reviewing the development, evidence base, and application of the revised dengue case classification. Pathog Glob Health 106: 94–101.
-
6.
Jayaratne SD, Atukorale V, Gomes L, Chang T, Wijesinghe T, Fernando S, Ogg GS, Malavige GN, 2012. Evaluation of the WHO revised criteria for classification of clinical disease severity in acute adult dengue infection. BMC Res Notes 5: 645.
-
7.
Alexander N, Balmaseda A, 2011. Multicentre prospective study on dengue classification in four Southeast Asian and three Latin American countries. Trop Med Int Health 16: 936–948.
-
8.
Hadinegoro S, 2012. The revised WHO dengue case classification: does the system need to be modified? Paediatr Int Child Health 32 (Suppl 1): 33–38.
-
9.
Narvaez F, Gutierrez G, Pérez M, 2011. Evaluation of the traditional and revised WHO classifications of dengue disease severity. PLoS Negl Trop Dis 5: 1–8.
-
10.
Hayes C, Manaloto C, Gonzalez A, Ranoa C, 1988. Dengue infections in the Philippines: clinical and virological findings in 517 hospitalized patients. Am J Trop Med Hyg 39: 110–116.
-
11.
WHO/HTM/NTD/DEN, 2009. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control, 1st Ed. Geneva: WHO.
-
12.
MSP-HIRRC, 2011. Ingresos, Egresos, Defunciones 2006–2011. Available at: http://www.hirrc.org/Mortalidad%202005-2010-junio.pdf. Accessed July 24, 2013.
-
13.
Cohen SN, Halstead SB, 1964. Shock associated with dengue infection. J Trop Pediatr 68: 448–455.
-
14.
Bharath Kumar Reddy KR, Laksmana RR, Veerappa BG, Shivananda, 2013. Ultrasonography as a tool in predicting the severity of dengue fever in children-a useful aid in a developing country. Pediatr Radiol 43: 971–977.
-
15.
Balmaseda A, Hammond SN, Pérez MA, Cuadra R, Solano S, Rocha J, Idiaquez W, Harris E, 2005. Short report: assessment of the World Health Organization scheme for classification of dengue severity in Nicaragua. Am J Trop Med Hyg 73: 1059–1062.
-
16.
Boonpucknavig S, Boonpucknavig V, Bhamarapravati N, Nimmannitya S, 1979. Immunofluorescence study of skin rash in patients with dengue hemorrhagic fever. Arch Pathol Lab Med 103: 463–466.
-
17.
Priyadarshini D, Gadia RR, Tripathy A, Gurukumar KR, Bhagat A, Patwardhan S, Mokashi N, Vaidya D, Shah PS, Cecilia D, 2010. Clinical findings and pro-inflammatory cytokines in dengue patients in Western India: a facility-based study. PLoS One 5: e8709.
-
18.
Hammond SN, Balmaseda A, Pérez L, Tellez Y, SaborÃo SI, Mercado JC, Videa E, Rodriguez Y, Pérez MA, Cuadra R, Solano S, Rocha J, Idiaquez W, Gonzalez A, Harris E, 2005. Differences in dengue severity in infants, children, and adults in a 3-year hospital-based study in Nicaragua. Am J Trop Med Hyg 73: 1063–1070.
-
19.
Anders KL, Nguyet NM, Chau NVV, Hung NT, Thuy TT, Lien LB, Farrar J, Wills B, Hien TT, Simmons CP, 2011. Epidemiological factors associated with dengue shock syndrome and mortality in hospitalized dengue patients in Ho Chi Minh City, Vietnam. Am J Trop Med Hyg 84: 127–134.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 2145 | 1986 | 45 |
| Full Text Views | 464 | 10 | 0 |
| PDF Downloads | 165 | 11 | 0 |