Criteria of “persistent vomiting” in the WHO 2009 warning signs for dengue case classification

Vuong, Nguyen Lam; Manh, Dao Huy; Mai, Nguyen Thi; Phuc, Le Hong; Luong, Van Thuy; Quan, Vo Duy; Thường, Nguyễn Văn; Lan, Nguyễn Thị Phương; Nhon, Cao Thi My; Mizukami, Shusaku; Doan, Nguyen Ngoc; Huong, Vû Thi Quê; Huy, Nguyen Tien; Hirayama, Kenji

doi:10.1186/s41182-016-0014-9

Cited by 13 publications

(10 citation statements)

References 9 publications

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“…12 In the present study vomiting is associated with 56.00% which slightly higher compared to a study conducted by Vuong NL et al, who found that vomiting is associated with 44.00%. 13 In the present study joint pain is associated with 69.00%. The exact pathogenesis of joint pain in dengue infection is not precisely known.…”

Section: Discussionsupporting

confidence: 56%

Study of electrolytes in patients of Dengue in a tertiary care hospital in India

Relwani¹,

Redkar²,

Garg³

2019

Int J Adv Med

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Background: Dengue is a mosquito borne viral infection. It is the most common arboviral disease globally. In the year 2017, India had 1,53,635 cases of dengue with 226 deaths. Electrolyte disturbances reported in dengue infection are hyponatremia, hypokalaemia and hyperchloremia. Considering the serious nature of effects of dyselectrolytemias and high incidence of dengue in India, it is necessary to have a thorough understanding about electrolyte disturbances in Dengue, so as to predict, diagnose and treat them accordingly.Methods: This study was performed in a tertiary care centre in Mumbai, India. The study was a prospective observational cross-sectional study. 150 Patients diagnosed with Dengue were enrolled for the study. Patients’ demographic data, clinical history, examination findings and investigations including electrolyte values were recorded and analysed.Results: A higher incidence of dengue was seen in young age group among admitted patients (74%). Hyponatremia (45.33%) and Hypokalaemia (10.60%) were more commonly observed than hypernatremia (3.33%) and hyperkalaemia (3.33%). Hypochloraemia (6.66%) was seen slightly more than hyperchloraemia (6.00%). Fever was Present in 98.66%, retro orbital headache in 86.66%, vomiting in 56.00%, joint pain in 69.00%, lethargy in 70.66%, breathlessness in 36.00%, bleeding in 8.66%, abdominal pain /tenderness in 18.00%. 85.00% had low platelet count, 30.66% had low hemoglobin and 36.66% had leucopenia. Haematocrit was found to be less in 27.33% and high in 1.33%.Conclusions: From the above results we concluded that, there is a need to have a degree of suspicion about dyselectrolytemias while managing patients with Dengue. Also, patients need to be subjected to necessary lab investigations early during management so that if abnormalities are found, they can be promptly and appropriately managed as some of these abnormalities may lead to increased severity as well as mortality.

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Section: Discussionsupporting

confidence: 56%

Study of electrolytes in patients of Dengue in a tertiary care hospital in India

Relwani¹,

Redkar²,

Garg³

2019

Int J Adv Med

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“…When the vomiting signs were compared between the groups with or without dengue and with or without warning signs (D/DWS) versus those with SD, the severe dengue group had a significantly higher prevalence of vomiting signs and also a higher median number of vomiting episodes. 11 Vuong et al 11 reported that persistent vomiting is as an early sign for the detection of SD infection. It showed that the frequency of vomiting signs was significantly higher among patients in the SD group (92%, 11/12) than among patients in the D/DWS group (49%, 33/67), and the median number of vomiting episodes per day was also significantly higher in the SD group (2.5, range: 2-3) than in the D/DWS group (0, range: 0-2).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the study found that persistent vomiting was associated with the development of SD in 54% of the patients (OR 12.0), and the number of two or more vomiting episodes per day while predicting SD among the D/DWS group of patients showed good sensitivity (92%) and specificity (52%). 11 Shock with or without respiratory distress has been reported to be the most frequent complication in patients with SD that was caused by a clinical fluid accumulation. 9 In the present study, clinical fluid accumulation was found in 20 patients with NSD infection and 21 patients with SD infection.…”

Section: Discussionmentioning

confidence: 99%

Warning sign as a predictor of dengue infection severity in children

et al. 2018

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Background: Dengue has emerged as a global public health problem, about 500,000 affected patients of 50–100 million cases will develop severe dengue infection. Therefore, early identification of severe dengue infection symptoms can save a patient’s life. The 2009 WHO dengue infection classification proposed seven warning signs to identify the risk of severe dengue. This study was conducted to predict the severity of dengue infection based on the number of warning signs.Methods: This was a diagnostic study conducted with a retrospective analytic observation of patients admitted to Adam Malik hospital with a diagnosis of dengue infection from January 2014–May 2016. The association between warning signs and severe dengue infection was analyzed using logistic regression. We also analyzed the sensitivity, specificity, positive predictive value and negative predictive value.Results: Of 140 patients who fulfilled the research criteria were collected from the medical records. The patients were classified as severe dengue (n=28) and nonsevere dengue (n =112). The warning signs that were associated with severe dengue were persistent vomiting (p<0.05, OR 31.9, 95%CI), fluid accumulation (p<0.05, OR 22.4, 95%CI), mucosal bleeding (p<0.05, OR 9.1, 95%CI), lethargy (p<0.05, OR 43.1, 95%CI). After analyzing the diagnostic tests, the combination of three or more warning signs showed that sensitivity of 92.9%, specificity of 78.6%, positive predictive value of 52%, negative predictive value of 97.7% was found to be associated with a severe dengue infection.Conclusion: The combination of three or more warning signs showed a high sensitivity and specificity for predicting a severe dengue infection.

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“…In the previous study was reported the prevalence of vomiting symptom was higher in severe dengue group than dengue infection/dengue infection with warning sign group. 20 Persistent vomiting is one warning sign according to WHO 2009. 1 Ledika et al held study in patients with severe dengue showed persistent vomiting had correlated with severe dengue.…”

Section: Resultsmentioning

confidence: 99%

Prognostic Factors of Severe Dengue Infections in Children

Baiduri

Husada

Puspitasari

et al. 2020

IJTID

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The incidence of dengue fever increase annually and can increase morbidity and mortality. Dengue fever is mosquito-borne disease and caused by one of four serotype dengue viruses. Severe dengue is characterized either by plasma leakage, fluid accumulation, respiratory distress, severe bleeding, or organ impairment. Mortality and serious morbidity of dengue were caused by several factors including the late recognition of the disease and the changing of clinical signs and symptoms. Understanding the prognostic factors in severe dengue will give early warning to physician thus decreasing the morbidity and mortality, and also improving the treatment and disease management. The aim of this study was to analyze the prognostic factors of severe dengue infection in children. This study was observational cohort study in children (2 months-18 years) with dengue infection according to WHO 2009 criteria which admitted in Soetomo and Soewandhie Hospital Surabaya. Analysis with univariate, bivariate and multivariate with IBM SPSS Statistic 17. All patients were confirmed by serologic marker (NS-1 or IgM/IgG Dengue). Clinical and laboratory examination such as complete blood count, aspartate aminotrasnferase (AST), alanine aminotrasferase (ALT), albumin, and both partial trombocite time and activated partial trombosit time (PTT and aPPT) were analyzed comparing nonsevere dengue and severe dengue patients. There were 40 subjects innonsevere and 27 subjects with severe dengue infection. On bivariate analysis, there were significant differences of nutritional status, abdominal pain, petechiae, pleural effusion, leukopenia, thrombocytopenia, hypoalbuminemia, history of transfusion, increasing AST>3x, prolonged PPT and APTT between severe and nonsevere dengue group. After multivariate analyzed, the prognostic factors of severe dengue were overweight/obesity (p=0.003, RR 94), vomiting (p=0.02, RR 13.3), hepatomegaly (p=0.01, RR=69.4), and prolonged APTT (p=0.005, RR=43.25). In conclusion, overweight/obesity, vomiting, hepatomegaly, and prolonged APTT were prognostic factors in severe dengue infection in children.Those factors should be monitored closely in order to reduce the mortality and serious morbidity.

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Criteria of “persistent vomiting” in the WHO 2009 warning signs for dengue case classification

Cited by 13 publications

References 9 publications

Study of electrolytes in patients of Dengue in a tertiary care hospital in India

Study of electrolytes in patients of Dengue in a tertiary care hospital in India

Warning sign as a predictor of dengue infection severity in children

Prognostic Factors of Severe Dengue Infections in Children

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