Óbito por dengue como evento sentinela para avaliação da qualidade da assistência: estudo de caso em dois municípios da Região Nordeste, Brasil, 2008

Figueiró, Ana Cláudia; Hartz, Zulmira; Brito, Carlos; Samico, Isabella; Filha, Noêmia Teixeira de Siqueira; Cazarin, Gisele; Braga, Cynthia; Cesse, Eduarda Ângela Pessoa

doi:10.1590/s0102-311x2011001200009

Cited by 24 publications

(44 citation statements)

References 19 publications

(21 reference statements)

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“…Additionally, 5 patients had no access to an ICU bed, and 2 arrived at the hospital with advanced disease. Similar findings were observed in a descriptive study on 14 deaths due to dengue in 2 municipalities in northeastern Brazil (30). The durations of fever and hospital stay were shorter in cases than in controls, suggesting that the clinical condition of the cases on admission was worse than that of the controls, which may have contributed to the worse outcomes observed for the cases.…”

Section: Discussionsupporting

confidence: 89%

Risk factors associated with death in Brazilian children with severe dengue: a case-control study

Branco¹,

Luna²,

Braga³

et al. 2014

Clinics

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OBJECTIVE:The purpose of this case-control study was to evaluate risk factors associated with death in children with severe dengue.METHODS:The clinical condition of hospitalized patients with severe dengue who died (cases, n = 18) was compared with that of hospitalized patients with severe dengue who survived (controls, n = 77). The inclusion criteria for this study were age under 13 years; hospital admission in São Luis, northeastern Brazil; and laboratory-confirmed diagnosis of dengue.RESULTS:Severe bleeding (hemoptysis), a defining criterion for dengue severity, was the factor most strongly associated with death in our study. We also found that epistaxis and persistent vomiting, both included as warning signs in the World Health Organization (WHO) classification of dengue, were strongly associated with death. No significant association was observed between any of the laboratory findings and death.CONCLUSIONS:The finding that epistaxis and persistent vomiting were also associated with death in children with severe dengue was unexpected and deserves to be explored in future studies. Because intensive care units are often limited in resource-poor settings, any information that can help to distinguish patients with severe dengue with a higher risk to progress to death may be crucial.

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Section: Discussionsupporting

confidence: 89%

Risk factors associated with death in Brazilian children with severe dengue: a case-control study

Branco¹,

Luna²,

Braga³

et al. 2014

Clinics

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“…The authors concluded that the occurrence of death was directly related to the clinical management of the cases, that patient care has not reached the level expected in any of the evaluated services, and that the recommendations from the Ministry of Health for the management of dengue cases are not being followed. According to the authors, the warning signs of dengue and those of shock due to the disease are not routinely investigated, and professionals have not used the clinical classification as recommended by the Ministry of Health [21]. …”

Section: Discussionmentioning

confidence: 99%

Mortality Predictors in Patients with Severe Dengue in the State of Amazonas, Brazil

et al. 2016

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Dengue is a major public health problem in tropical and subtropical areas worldwide. There is a lack of information on the risk factors for death due to severe dengue fever in developing countries, including Brazil where the state of Amazonas is located. This knowledge is important for decision making and the implementation of effective measures for patient care. This study aimed to identify factors associated with death among patients with severe dengue, in Amazonas from 2001 to 2013. We conducted a retrospective cohort study based on secondary data from the epidemiological surveillance of dengue provided by the Fundação de Vigilância em Saúde do Amazonas, FVS (Health Surveillance Foundation) of the Secretaria de Saúde do Amazonas, SUSAM (Health Secretariat of the State of Amazonas). Data on dengue cases were obtained from the SINAN (Notifiable Diseases Information System) and SIM (Mortality Information System) databases. We selected cases of severe dengue with laboratory confirmation, including dengue-related deaths of residents in the state of Amazonas from January 1, 2001, to December 31, 2013. The explanatory variables analyzed were sex, age, level of education, spontaneous hemorrhagic manifestations, plasma extravasation and platelet count. Patients who died due to severe dengue had more hematuria, gastrointestinal bleeding, and thrombocytopenia than the survivors. Considering the simultaneous effects of demographic and clinical characteristics with a multiple logistic regression model, it was observed that the factors associated with death were age >55 years (odds ratio [OR] 4.98), gastrointestinal bleeding (OR 10.26), hematuria (OR 5.07), and thrombocytopenia (OR 2.55). Gastrointestinal bleeding was the clinical sign most strongly associated with death, followed by hematuria and age >55 years. The study results showed that the best predictor of death from severe dengue is based on the characteristic of age >55 years, together with the clinical signs of gastrointestinal bleeding, hematuria, and low platelet count.

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“…These social inequalities may lead to several disadvantages, ranging from a lack of health promotion to a reduced capability to successfully treat severe and potentially fatal cases, resulting from limited access to early diagnosis and timely clinical management 23,24 .…”

Section: Discussionmentioning

confidence: 99%

Occurrence of severe dengue in Rio de Janeiro: an ecological study

Gibson

Souza-Santos

Siqueira

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Introduction:This study aimed to analyze the relationship between the incidence of severe dengue during the 2008 epidemic in Rio de Janeiro, Brazil, and socioeconomic indicators, as well as indicators of health service availability and previous circulation of the dengue virus serotype-3 (DENV-3). Methods: In this ecological study, the units of analysis were the districts of Rio de Janeiro. The data were incorporated into generalized linear models, and the incidence of severe dengue in each district was the outcome variable. Results: The districts with more cases of dengue fever in the 2001 epidemic and a higher percentage of residents who declared their skin color or race as black had higher incidence rates of severe dengue in the 2008 epidemic [incidence rate ratio (IRR)= 1.21; 95% confi dence interval ( 95% CI)= 1.05-1.40 and IRR= 1.34; 95% CI= 1.16-1.54, respectively]. In contrast, the districts with Family Health Strategy (FHS) clinics were more likely to have lower incidence rates of severe dengue in the 2008 epidemic (IRR= 0.81; 95% CI= 0.70-0.93). Conclusions: At the ecological level, our fi ndings suggest the persistence of health inequalities in this region of Brazil that are possibly due to greater social vulnerability among the selfdeclared black population. Additionally, the protective effect of FHS clinics may be due to the ease of access to other levels of care in the health system or to a reduced vulnerability to dengue transmission that is afforded by local practices to promote health.

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Óbito por dengue como evento sentinela para avaliação da qualidade da assistência: estudo de caso em dois municípios da Região Nordeste, Brasil, 2008

Cited by 24 publications

References 19 publications

Risk factors associated with death in Brazilian children with severe dengue: a case-control study

Risk factors associated with death in Brazilian children with severe dengue: a case-control study

Mortality Predictors in Patients with Severe Dengue in the State of Amazonas, Brazil

Occurrence of severe dengue in Rio de Janeiro: an ecological study

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