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Characteristics of Severe Dengue Infection with Compensated and Decompensated Shock in Children in a Tertiary Hospital in Bali, Indonesia

Received: 25 March 2025     Accepted: 2 April 2025     Published: 29 April 2025
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Abstract

Severe dengue infection in Indonesia has a high mortality rate. This study aims to identify the characteristics of severe dengue infection with compensated and decompensated shock in children at a tertiary hospital in Bali, Indonesia. This study employs a descriptive retrospective design with a cross-sectional approach to identify the characteristics of severe dengue infection in children with compensated and decompensated shock at a tertiary hospital. Secondary data were utilized from children with dengue infection who were treated at Prof. Dr. I G. N. G. Ngoerah hospital from January to December 2023. The study population consists of children with dengue infection. The inclusion criteria include children aged 0–18 years diagnosed with severe dengue infection, while the exclusion criteria are children with incomplete medical record data. Prevalence of severe dengue infection in children was 36.9%, with 55.4% presenting with compensated shock. Of the 64 patients, the majority were children and adolescents (95.4%), with 70.8% being male. Most patients had good nutritional status (58.5%), no comorbidities (93.8%), and secondary dengue infection (89.2%). The median values of leukocytes, hemoglobin, hematocrit, platelets, and the neutrophil-to-lymphocyte ratio (NLR) in the compensated and decompensated shock groups were 5.25 and 6.1; 14.4 and 14.2; 42.6 and 43.1; 36 and 29; and 0.58 and 0.96, respectively. The mortality rate was 3.1%. Majority of children with severe dengue infection were children and adolescents, male, with good nutritional status, no comorbidities, and secondary infection. All cases of severe dengue manifested with significant plasma leakage, with a survival rate of 96.9%.

Published in American Journal of Pediatrics (Volume 11, Issue 2)
DOI 10.11648/j.ajp.20251102.16
Page(s) 63-71
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Severe Dengue Infection, Dengue Shock, Children

References
[1] World Health Organization. 2009. “Dengue for diagnosis, treatment and control”. Retrieved (
[2] Khanam A, Gutierrez-Barbosa H, Lyke KE, Chua JV. 2022. “Immune-mediated pathogenesis in dengue virus infection.” Virus; 14: 1-5.
[3] Indarini PF, Gustawan IW, Utama IMGDL. 2017. ”Karakteristik klinis dan luaran pasien anak dengan sindroma syok dengue di RSUP Sanglah tahun 2014.” Medicina; 48(2): 103-107.
[4] Fadilla AN, Husada D, Utomo B. 2020. ”Epidemiology of children with severe dengue infection in Dr. Soetomo general hospital.” J Indon Med Assoc; 70(4): 1-5.
[5] Capeding RZ, Brion JD, Caponpon MM, Gibbons RV, Jarman RG, Yoon IK, Libraty DH. 2001. “The incidence, characteristics, and presentation of dengue virus infections during infancy.” Am J Trop Med Hyg; 82: 330–336.
[6] Dash N, Aby E, Kumar M, Abraham AM, Rose W. 2021. “Infant dengue a 10-year experience from a tertiary center in South India.” Am J Trop Med Hyg; 105(2): 1-7.
[7] Jain A, Chaturvedi UC. 2010. “Dengue in infants: an overview.” FEMS Immunol Med Microbiol; 59(2): 1-6.
[8] 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.” Negl Trop Dis; 12(2): 1-5.
[9] Sekaran SD, Liew ZM, Yam HC, Raju CS. 2022. “The association between diabetes and obesity with dengue infections.” Diabetol Metab Syndr; 14: 1-10.
[10] Werneck GL, Macias AE, Mascarenas C, Coudeville D, Morley D, Recamier V, et al. 2018. “Comorbidities increase in-hospital mortality in dengue patients in Brazil.” Mem Inst Oswaldo Cruz; 113(8): 1-5.
[11] Yanti EL, Suryawan IWB, Widiasa M. 2021. “Hubungan derajat leukopenia terhadap tingkat keparahan penyakit Demam Berdarah Dengue (DBD) pada pasien anak yang dirawat di Ruang Kaswari RSUD Wangaya, Denpasar, Indonesia.” Intisari Sains Medis; 12(3): 908-911.
[12] Risniati Y, Tarigan LH, Tjitra E. 2011. ”Leukopenia sebagai prediktor terjadinya sindrom syok dengue pada anak dengan demam berdarah dengue di RSPI Prof. dr. Sulianti Saroso.” Media Litbang Kesehatan; 21(3): 96-103.
[13] Tantracheewathorn T, Tantracheewathorn S. 2007. “Risk factors of dengue shock syndrome in children.” J Med Assoc Thai; 90(2): 272-277.
[14] Tsheten T, Clements ACA, Gray DJ, Adhikary RK, Furuya-Kanamori L, Wangdi K. 2021. “Clinical predictors of severe dengue: a systematic review and meta-analysis.” Infect Dis Poverty; 10: 123: 1-10.
[15] Alexander N, Balmaseda A, Coelho IC. 2011. “Multicentre prospective study on dengue classification in four South-East Asian and three Latin American countries.” Trop Med Int Health; 16: 936–48.
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  • APA Style

    Pratiwi, P. S., Utama, I. M. G. D. L., Gustawan, I. W., Saputra, I. M. Y. (2025). Characteristics of Severe Dengue Infection with Compensated and Decompensated Shock in Children in a Tertiary Hospital in Bali, Indonesia. American Journal of Pediatrics, 11(2), 63-71. https://doi.org/10.11648/j.ajp.20251102.16

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    ACS Style

    Pratiwi, P. S.; Utama, I. M. G. D. L.; Gustawan, I. W.; Saputra, I. M. Y. Characteristics of Severe Dengue Infection with Compensated and Decompensated Shock in Children in a Tertiary Hospital in Bali, Indonesia. Am. J. Pediatr. 2025, 11(2), 63-71. doi: 10.11648/j.ajp.20251102.16

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    AMA Style

    Pratiwi PS, Utama IMGDL, Gustawan IW, Saputra IMY. Characteristics of Severe Dengue Infection with Compensated and Decompensated Shock in Children in a Tertiary Hospital in Bali, Indonesia. Am J Pediatr. 2025;11(2):63-71. doi: 10.11648/j.ajp.20251102.16

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  • @article{10.11648/j.ajp.20251102.16,
      author = {Putu Satya Pratiwi and I Made Gede Dwi Lingga Utama and I Wayan Gustawan and I Made Yullyantara Saputra},
      title = {Characteristics of Severe Dengue Infection with Compensated and Decompensated Shock in Children in a Tertiary Hospital in Bali, Indonesia
    },
      journal = {American Journal of Pediatrics},
      volume = {11},
      number = {2},
      pages = {63-71},
      doi = {10.11648/j.ajp.20251102.16},
      url = {https://doi.org/10.11648/j.ajp.20251102.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20251102.16},
      abstract = {Severe dengue infection in Indonesia has a high mortality rate. This study aims to identify the characteristics of severe dengue infection with compensated and decompensated shock in children at a tertiary hospital in Bali, Indonesia. This study employs a descriptive retrospective design with a cross-sectional approach to identify the characteristics of severe dengue infection in children with compensated and decompensated shock at a tertiary hospital. Secondary data were utilized from children with dengue infection who were treated at Prof. Dr. I G. N. G. Ngoerah hospital from January to December 2023. The study population consists of children with dengue infection. The inclusion criteria include children aged 0–18 years diagnosed with severe dengue infection, while the exclusion criteria are children with incomplete medical record data. Prevalence of severe dengue infection in children was 36.9%, with 55.4% presenting with compensated shock. Of the 64 patients, the majority were children and adolescents (95.4%), with 70.8% being male. Most patients had good nutritional status (58.5%), no comorbidities (93.8%), and secondary dengue infection (89.2%). The median values of leukocytes, hemoglobin, hematocrit, platelets, and the neutrophil-to-lymphocyte ratio (NLR) in the compensated and decompensated shock groups were 5.25 and 6.1; 14.4 and 14.2; 42.6 and 43.1; 36 and 29; and 0.58 and 0.96, respectively. The mortality rate was 3.1%. Majority of children with severe dengue infection were children and adolescents, male, with good nutritional status, no comorbidities, and secondary infection. All cases of severe dengue manifested with significant plasma leakage, with a survival rate of 96.9%.
    },
     year = {2025}
    }
    

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