scholarly journals Platelet count and AST can reliably predict the onset of plasma leakage in dengue, a low-cost triage tool during epidemics

2019 ◽  
Author(s):  
Arjuna Medagama ◽  
Chamara Dalugama ◽  
Darshani Lakmali ◽  
Gukes Meiyalakan
Keyword(s):  
Regression Analysis ◽  
Platelet Count ◽  
Dengue Fever ◽  
Dengue Hemorrhagic Fever ◽  
Low Cost ◽  
Clinical Signs ◽  
Hemorrhagic Fever ◽  
Severe Dengue ◽  
Upper Limit ◽  
Plasma Leakage

Abstract Background: Dengue is one of the most important mosquito-borne viral infections to affect humans. It is most often a self-limiting febrile illness but in some instances can progress to plasma leakage and in extreme cases culminate in death. The objective of this study was to identify reliable, low-cost, easily-accessible and objective predictors of Dengue hemorrhagic fever (DHF) that can be used as a triage tool in epidemic situations. Methods A cohort of dengue fever patients were selected and data on symptoms, clinical signs, routine lab tests, ultrasonography and packed cell volume measurements collected. The demographics and clinical characteristics of severe and non-severe dengue cases were described Bivariate and regression analysis were used to identify variables significantly correlated with plasma leak. Results Serologically confirmed 350 serial adult dengue patients were included in the study. 257 (73.4%) were classified as dengue fever (DF, non leakers) and 93 (26.5%) as DHF with plasma leakage. Bivariate and regression analysis showed platelet count (Pearson r 0.59), and AST (r 0.27) to be significantly correlated with plasma leakage and platelet count to have a moderate predictive association ( R 2 0.35) with plasma leakage. Platelet count <50,000/mm 3 (OR 23.7; 95% CI 12.2-45.9), AST> twice, upper limit of normal (OR 7.5; 95% CI 3.9-14.3) and ALT> twice, upper limit of normal (OR 2.4; 95%CI 1.4-3.6) increased the likelihood of DHF.In the final analysis, logistic regression identified platelet count <50,000/mm 3 (OR 17.2; 95% CI 8.6-34.1) and AST>2ULN (OR 5.1, 95% CI 2.1-12.1) at time of plasma leakage as significant independent predictors of DHF.ROC curve performed for Platelet count had an AUC of .89 and at a platelet count of 50,000/mm 3 predicted DHF with a sensitivity of 87% and specificity of 79%. AUC for AST was 0.72 and at 93Iu/L predicted DHF with a sensitivity of 85% and specificity of 60%. Conclusion: We have identified 2 laboratory parameters that could be used to identify plasma leakage and might be useful to stratify dengue-infected patients at risk for developing dengue hemorrhagic fever

scholarly journals Platelet count and AST can reliably predict the onset of plasma leakage in dengue, a low-cost triage tool during epidemics

2019 ◽  
Author(s):  
Arjuna Medagama ◽  
Chamara Dalugama ◽  
Gukes Meiyalakan ◽  
Darshani Lakmali
Keyword(s):  
Platelet Count ◽  
Health Care Services ◽  
Viral Infections ◽  
Low Cost ◽  
Febrile Illness ◽  
Final Analysis ◽  
Hemorrhagic Fever ◽  
Severe Dengue ◽  
Upper Limit ◽  
Plasma Leakage

Abstract Background: Dengue is one of the most important mosquito-borne viral infections to affect humans. It is most often a self-limiting febrile illness but in some instances can progress to plasma leakage and in extreme cases culminate in death. Dengue is endemic in Sri Lanka and 2017 saw the largest outbreak on record with over 160,000 cases and over 300 deaths. Health care services reached its’ limits coping with this epidemic. The objective of this study was to identify reliable, low-cost, easily-accessible and objective predictors of Dengue hemorrhagic fever (DHF) that can be used as a triage tool in epidemic situations. Methodology/Principal findings: Serologically confirmed 350 serial adult dengue patients were included in the study. 257 (73.4%) were classified as dengue fever (DF, non leakers) and 93 (26.5%) as DHF with plasma leakage. Bedside ultrasonography was used to identify plasma leakage. Bivariate and regression analysis showed platelet count (Pearson r 0.59), and AST (r 0.27) to be significantly correlated with plasma leakage and platelet count to have a moderate predictive association (R2 0.35) with plasma leakage. Platelet count <50,000/mm3 (OR 23.7; 95% CI 12.2-45.9), AST> twice, upper limit of normal (OR 7.5; 95% CI 3.9-14.3) and ALT> twice, upper limit of normal (OR 2.4; 95%CI 1.4-3.6) increased the likelihood of DHF. In the final analysis, logistic regression identified platelet count <50,000/mm3 (OR 17.2; 95% CI 8.6-34.1) and AST>2ULN (OR 5.1, 95% CI 2.1-12.1) at time of plasma leakage as significant independent predictors of DHF. ROC curve performed for Platelet count had an AUC of .89 and at a platelet count of 50,000/mm3 predicted DHF with a sensitivity of 87% and specificity of 79%. AUC for AST was 0.72 and at 93Iu/L predicted DHF with a sensitivity of 85% and specificity of 60%. Conclusion: We have identified 2 laboratory parameters that could be used to identify plasma leakage and might be useful to stratify dengue-infected patients at risk for developing severe dengue.

scholarly journals Importance of Platelet Count and Hematocrit in Dengue Fever in Children

2021 ◽  
Vol 44 (2) ◽  
pp. 74-77
Author(s):  
Farhana Rahat ◽  
Morsheda Khanam ◽  
Kazi Iman ◽  
UK Ghosh ◽  
NK Ghosh
Keyword(s):  
Platelet Count ◽  
Dengue Fever ◽  
Dengue Hemorrhagic Fever ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
Warning Signs ◽  
Care Hospital ◽  
Pediatric Age Group

Background: Dengue fever has become one of the most important public health concerns now a day due to increasing complications and fatal outcomes. Dengue hemorrhagic fever and dengue shock syndrome are life threatening but reversible complications of dengue fever. Objectives: This study was performed to evaluate the relationship between platelet count and hematocrit with the severity of dengue infection in pediatric age group. Materials & Methods: This was a prospective observational study which included 280 dengue seropositive children of 1 month to 15 years, conducted during 1st June to 30th November, 2018 in a tertiary care hospital of Dhaka. Results: Out of 280 dengue cases, 187(66.78%) had thrombocytopenia and 88(47%) had raised hematocrit. Among the thrombocytopenic patients 44% had dengue fever, 47% had dengue hemorrhagic fever and 9% dengue shock syndrome. A significant co-relation was observed between the severities of thrombocytopenia and raised hematocrit with the appearance of dengue warning signs in case of dengue hemorrhagic fever. Conclusion: Thrombocytopenia and raised hematocrit were related to the severity of dengue hemorrhagic fever. Bangladesh J Child Health 2020; VOL 44 (2) :74-77

scholarly journals The Pathogenesis and Immune-Response in Dengue Haemorrhagic Fever

2019 ◽  
pp. 1-12
Author(s):  
A. M. Meer Ahmad ◽  
S. Arumugam ◽  
Chee Loon Leong
Keyword(s):  
Immune Response ◽  
Dengue Fever ◽  
Dengue Hemorrhagic Fever ◽  
Case Fatality ◽  
Hemorrhagic Fever ◽  
Severe Dengue ◽  
Robust Immune Response ◽  
Different Strains ◽  
Original Antigenic Sin ◽  
Near Future

Introduction: Dengue fever has spread to be endemic in addition of 100 countries to a total estimate incidence of 50 – 100 million cases annually globally. About 0.7% of these cases become the complication that is dengue hemorrhagic fever which is severe and leads to about 22,000 deaths annually. The pathogenesis of benign dengue fever becoming dengue hemorrhagic fever, and aspects of the immune-response behind it, have remained relatively unknown. Methods: Existing literature on the Topic was retrieved through Google Scholar and PubMed searches, and the literature reviewed. Results: Dengue hemorrhagic fever appears commoner in females and those with co-morbids such as diabetes-mellitus and obesity. Also, the case-fatality rate in severe dengue appears much bigger in females. The reasons for this are largely unknown but the additionally robust immune response in females, resulting in females to be additionally prone to develop bigger inflammatory response or enhanced susceptibility to capillary permeability could be the reason. It has been shown that viremic-load, including the initial viremic-load at the bite of the Aedes-mosquito may be a factor leading to dengue hemorrhagic fever. Yet different factors felt to be causative in the pathogenesis of dengue hemorrhagic fever include the role of the viral-protein, and then that which is termed the original antigenic-sin, the antibody-directed enhancement, autoimmunity, inhibition of interferon-alpha and cytokine-storm within the memory-cells. Regionally, certain different strains of the DENV also seem to be associated with dengue hemorrhagic fever. Newer-vaccines, based on the immunology of the disease, offer much hope in the near future. Conclusion: Much knowledge has been forthcoming in realizing the pathogenesis of dengue hemorrhagic fever. But, additional studies need to be done.

scholarly journals Selection for Virulent Dengue Viruses Occurs in Humans and Mosquitoes

2005 ◽  
Vol 79 (2) ◽  
pp. 853-859 ◽  
Author(s):  
Raymond Cologna ◽  
Philip M. Armstrong ◽  
Rebeca Rico-Hesse
Keyword(s):  
Dengue Fever ◽  
Dengue Hemorrhagic Fever ◽  
Virus Transmission ◽  
Indirect Evidence ◽  
Hemorrhagic Fever ◽  
Viral Disease ◽  
Southeast Asian ◽  
Severe Dengue ◽  
Dengue Viruses ◽  
Dengue Disease

ABSTRACT Dengue is the most common mosquito-borne viral disease in humans. The spread of both mosquito vectors and viruses has led to the resurgence of epidemic dengue fever (a self-limited flu-like syndrome) and the emergence of dengue hemorrhagic fever (severe dengue with bleeding abnormalities) in urban centers of the tropics. There are no animal or laboratory models of dengue disease; indirect evidence suggests that dengue viruses differ in virulence, including their pathogenicities for humans and epidemic potential. We developed two assay systems (using human dendritic cells and Aedes aegypti mosquitoes) for measuring differences in virus replication that correlate with the potential to cause hemorrhagic dengue and increased virus transmission. Infection and growth experiments showed that dengue serotype 2 viruses causing dengue hemorrhagic fever epidemics (Southeast Asian genotype) can outcompete viruses that cause dengue fever only (American genotype). This fact implies that Southeast Asian genotype viruses will continue to displace other viruses, causing more hemorrhagic dengue epidemics.

scholarly journals Kajian Biaya Penggunaan Omeprazole Sebagai Terapi Profilaksis Gastritis Pada Pasien Demam Dengue dan Demam Berdarah Dengue di RSUD X daerah Jakarta Periode Januari – Desember 2014

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Marvel Marvel Marvel ◽  
Anton Bahtiar Bahtiar ◽  
Agusdini Banun Saptaningsih
Keyword(s):  
Platelet Count ◽  
Length Of Stay ◽  
Dengue Fever ◽  
Dengue Hemorrhagic Fever ◽  
Odds Ratio ◽  
Hemorrhagic Fever ◽  
T Test ◽  
Chi Square ◽  
Total Cost ◽  
The Cost

Gastritis merupakan komplikasi yang dapat terjadi pada pasien demam dengue dan demam berdarah dengue. Faktor risiko perdarahan gastrointestinal adalah trombosit <50.000/mm3. Terapi pada pasien gastritis dapat diberikan omeprazole. Penelitian ini bertujuan untuk mengevaluasi pengaruh pemberian omeprazole pada pasien demam dengue dan demam berdarah dengue terhadap biaya, hari perawatan dan biaya omeprazole di RSUD X daerah Jakarta. Rancangan penelitian yang digunakan adalah kohort retrospektif. Kriteria inklusi adalah pasien rawat inap kelas tiga dengan diagnosis demam dengue dan demam berdarah dengue pada bulan Januari sampai Desember 2014. Sampel penelitian terdiri dari 42 pasien kelompok nonkriteria (trombosit>50.000/mm3) dan 39 pasien kelompok kriteria (trombosit<50.000/mm3). Alat pengumpul data merupakan catatan rekam medik pasien. Analisis data menggunakan uji Mann-Whitney, t-test dan uji Chi-Square. Hasil penelitian menunjukkan bahwa penggunaan omeprazole tidak terdapat perbedaan total biaya perawatan (p=0,345) dan biaya omeprazole (p=0,916) antara kelompok nonkriteria dan kelompok kriteria. Terdapat perbedaan hari rawat (p=0,004) pada kelompok nonkriteria dengan kelompok kriteria. Kategori pasien yaitu kelompok pasien nonkriteria dan kelompok kriteria tidak berpengaruh terhadap total biaya dan biaya omeprazole dilihat dari nilai OR secara berturut-turut sebesar 1,191 (IK; 0,450-3,152), 1,182 (IK; 0,469-2,977). Kategori pasien berpengaruh signifikan (p=0,005) dalam peningkatan lama hari rawat dengan OR (odds ratio) = 3,963 (IK; 1,530 – 10,265). Komorbiditas merupakan faktor yang mempengaruhi terjadinya peningkatan total biaya perawatan, lama hari rawat dan biaya penggunaan omeprazole.Kata kunci : omeprazole, gastritis, demam berdarah dengue, biaya perawatan, lama rawat inapGastritis is a complication that can occur in patients with dengue fever and dengue hemorrhagic fever. Risk factor for gastrointestinal bleeding is platelet count <50.000/mm3. Omeprazole is the one of choice for gastritis prophylaxis therapy. The purpose of this study is to evaluate the effect of omeprazole in patients with dengue fever and dengue hemorrhagic fever according to the cost, length of stay and the cost of omeprazole at X Public Hospital in Jakarta. Retrospective cohort is design of the study. The inclusion criteria were third class of inpatients with a diagnosis of dengue fever and dengue hemorrhagic fever in January to December 2014. The study sample consisted of 42 patients in the noncriteria group (platelets count>50,000 / mm3) and 39 patients criteria group (platelets count<50,000 / mm3 ). Data collection tool is a patient medical record. Data analysis using the Mann-Whitney test, t-test and Chi-Square test. Results showed that use of omeprazole there is no difference in the total cost of treatment (p = 0.345) and the cost of omeprazole (p = 0.916) between the group of noncriteria and criteria group. There are differences in length of stay (p = 0.004) in the group of noncriteria with the group criteria. Noncriteria group (platelets> 50,000 / mm3) and a group of criteria (platelet count <50,000 / mm3) did not affect the total cost, and cost of omeprazole seen from the OR (odds ratio) respectively, 1,191 (CI; 0,450 - 3,152), 1,182 (CI; 0,469 - 2,977). Platelet count have a significant effect (p = 0.005) in the increased length of stay with OR = 3.963 (CI; 1.530 - 10.265). Comorbidity is a factor that affecting the increase in the total cost, length of stay and cost of omeprazole.Key words : omeprazole, gastritis, dengue hemorraghic fever, cost of hospitalization, length of stay

scholarly journals DIFFERENT OF HEMATOCRIT VALUE MICROHEMATOCRIT METHODS AND AUTOMATIC METHODS IN DENGUE HEMORRHAGIC PATIENTS WITH HEMOCONCENTRATION

2019 ◽  
Vol 3 (2) ◽  
pp. 67
Author(s):  
Alvin Dwi Rizky Meilanie
Keyword(s):  
Dengue Fever ◽  
Dengue Hemorrhagic Fever ◽  
Statistical Tests ◽  
Hemorrhagic Fever ◽  
Automatic Method ◽  
Paired Sample ◽  
Hematology Analyzer ◽  
Automatic Methods ◽  
Plasma Leakage ◽  
Automated Hematology Analyzer

Background: Many people in Indonesia. Hematocrit examination is one of the important examinations to help diagnose dengue fever. Increased hematocrit (hemoconcentration) occurs with dengue hemorrhagic fever caused by plasma leakage. Hematocrit examination can be done by microhematocrit method and automatic method. The microhematocrit method has the principle that the blood with anticoagulants is centrifuged at a certain speed, the erythrocytes will separate from the plasma. While the automated hematology analyzer uses the principle of flowcytometry which detects based on the height of the erythrocyte pulse. Purpose: To know the differences in hematocrit values of the microhematocrit method and the automatic method in patients with hemoconcentration of Dengue Hemorrhagic Fever. Methods: The study was conducted by observational analytics in March 2019 with a total of 30 samples at RSU. Haji Surabaya. The data obtained was analyzed using the Paired Sample T-Test with the SPSS 16.0 program to determine whether there were significant differences in hematocrit values between the microhematocrit method and the automatic method. Results: The results showed that the hematocrit examination results of microhematocrit method obtained an average of 46.93%, while the automatic method obtained an average of 45%. This shows the hematocrit examination results of the microhematocrit method are higher than the automatic method. Based the results of paired sample statistical tests t Tests obtained a significance value of 0.00 were less than 0.05. Conclusion: There are significant differences between the hematocrit examination results of the microhematocrit method and the automatic method.

scholarly journals DENGUE FEVER: STAGES, COMPLICATION, DIAGNOSIS, AND PREVENTION STRATEGIES

2021 ◽  
pp. 3-11
Author(s):  
POULOMI BISWAS ◽  
SANTOSH GANGULY ◽  
BIPLAB DEBNATH
Keyword(s):  
Dengue Fever ◽  
Rna Virus ◽  
Incidence Structure ◽  
Clinical Signs ◽  
Dengue Shock Syndrome ◽  
Signs And Symptoms ◽  
Hemorrhagic Fever ◽  
The Other ◽  
Severe Dengue ◽  
Modes Of Transmission

Dengue fever virus (DENV) is said to be a single-stranded, positive-sense RNA virus that belongs to the family Flaviviridae and the genus is Flavivirus. The disease can be transmitted through infected blood products and also through organ donation. Vertical transmission (from mother to child) at the time of pregnancy or during birth has been reported. Other unusual reports showed man-to-man modes of transmission. Hemorrhagic fever is specified by hemorrhage, thrombocytopenia, leakage of blood plasma, or dengue shock syndrome. Dengue is basically transmitted by various species of mosquito among the genus Aedes, the most uniquely identified one is Aedes aegypti. There are four different but very closely related serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) of the virus that causes Dengue. Lifelong immunity against the particular serotype that has caused the infection is believed to have been imparted upon recovery. However, cross-immunity to the other serotypes is either partial or temporary upon recovery and hence future infections by any of the other serotypes enhance the risk of developing severe dengue. Prevention is identified by reducing the habitat and the number of mosquitoes and also by limiting exposure to bites. Treatment of mild or moderate type is supportive, with oral or intravenous rehydration. The intravenous fluids and blood transfusion for more severe cases are found to be effective. The present study aimed to present brief and informative salient features of various facts regarding dengue, including its global incidence, structure, mode of transmission, clinical signs and symptoms, control, and preventive measures.

PENGARUH PELATIHAN PENGENDALIAN VEKTOR DEMAM BERDARAH TERHADAP MAYA INDEX PADA SISWA SEKOLAH DASAR DI MAJALENGKA

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Wawan Kurniawan
Keyword(s):  
Vector Control ◽  
Dengue Fever ◽  
Dengue Hemorrhagic Fever ◽  
Intervention Group ◽  
Hemorrhagic Fever ◽  
Control Group ◽  
Control Group Design ◽  
Group Design ◽  
Quasi Experimental ◽  
Dengue Vector Control

ABSTRAK  Latar belakang: Demam Berdarah Dengue (DBD) disebabkan oleh virus Dengue dapat menyebabkan kematian. Pencegahan DBD yang dianggap paling tepat adalah Pemberantasan Sarang Nyamuk (PSN). Penelitian ini bertujuan untuk mengetahui pengaruh pelatihan pengendalian vektor Demam Berdarah pada siswa sekolah dasar terhadap Maya Index di Majalengka. Metode: Penelitian ini menggunakan desain quasi experiment (pretest-posttest control group design). Sebanyak 4 sekolah terpilih sebagai kelompok intervensi dan 4 sekolah lainnya sebagai kontrol. Subyek penelitian adalah siswa kelas IV-VI yang terdiri dari 171 siswa pada kelompok intervensi dan 163 pada kelompok kontrol. Instrumen yang digunakan adalah formulir pemantauan jentik berkala. Hasil: Jumlah rumah dengan kategori Maya Index tinggi berkurang dari 27,5% menjadi 9,4%. Terjadi penurunan angka BRI kategori tinggi pada kelompok intervensi dari 20,5% menjadi 1,8%. Pada kelompok kontrol tidak terjadi penurunan angka BRI kategori tinggi (22,1%), sebaliknya terjadi penurunan kategori rendah dari 34,4% menjadi 3,7%. Tidak terjadi penurunan angka HRI pada kelompok intervensi maupun kontrol. Kesimpulan: Pelatihan pengendalian vektor Demam Berdarah dapat menurunkan nilai BRI dan Maya Index, tetapi tidak berpengaruh terhadap nilai HRI. Tidak adanya perubahan nilai HRI menunjukkan bahwa kebersihan dan sanitasi lingkungan merupakan faktor yang berpengaruh terhadap probabilitas kejadian demam berdarah. Kata Kunci : Demam Berdarah, Maya Index, pelatihan, pengendalian vektor   ABSTRACT Background: Dengue Hemorrhagic Fever (DHF) caused by Dengue virus could cause death. The most appropriate prevention of Dengue is eradication of mosquito nests (PSN). This study aims to determine the effect of Dengue vector control training on elementary students towards Maya Index in Majalengka. Method: This study used quasi-experimental design (pretest-posttest control group design). A total of 4 schools were selected as intervention groups and 4 other schools as controls. The subjects were students in grades IV-VI consisting of 171 students in the intervention group and 163 in the control group. The instrument used was periodic larva monitoring form. Results: The number of houses with a high Maya Index category in the intervention group decreased from 27.5% to 9.4%. There was a decrease in the high BRI category in the intervention group from 20.5% to 1.8%. In the control group, there was no decrease in the high BRI category (22.1%), on the contrary, there was a decrease in the low category from 34.4% to 3.7%. There was no decrease in HRI rates both of intervention or control groups. Conclusion: Dengue Fever vector control training could decrease the value of BRI and Maya Index, but does not affect the value of HRI. The absence of changes in HRI  indicate that environmental hygiene and sanitation are factors that influence the probability of dengue fever occurrence. Keywords: Dengue Hemorrhagic Fever, Maya Index, training, vector control

scholarly journals Hyperventilation in Children with Dengue Hemorrhagic Fever (DHF)

2019 ◽  
Vol 31 (9-10) ◽  
pp. 245-56
Author(s):  
Kasim Y. A. ◽  
Anky Tri Rini K. E. ◽  
Sumarmo S. P. S.
Keyword(s):  
Dengue Hemorrhagic Fever ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
Lung Edema ◽  
Respiratory Problems ◽  
Ventilatory Pattern ◽  
Grade Ii ◽  
Plasma Leakage ◽  
The Difference ◽  
Respiratory Disturbance

Many studies of Dengue Hemorrhagic Fever (DHF) have been done but only a few revealed the respiratory status. Respiratory problems arise. because of plasma leakage through the 'damaged capillaries, causing lung edema and in turn result in hypoxemia. This later on will be compensated by a hyperventilation state. During a 6-month-period (May to September 1988), two aspects were studied in 85 patients hospitalized with DHF. First, the ventilatory pattern and second, the result of giving oxygen support in improving the respiratory disturbance, in this case alveolar hyperventilation. The incidence of alveolar hyperventilation in DHF grade II (DHF II) and Dengue Shock Syndrome (DSS) differed significantly. Hypoxemia occurred in DHF II and DSS with no significant differences. The difference of the incidence of metabolic acidosis in DHF II and DSS were significant. In DHF II patients having had hyperventilation state, oxygen therapy decreased respiration rate significantly and increased the PaC02 though not significantly.

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