The association between obesity and dengue severity among pediatric patients: A systematic review and meta-analysis

Zulkipli, Mohd Syis; Dahlui, Maznah; Jamil, Nor’Ashikin; Peramalah, Devi; Hoe, Victor Chee Wai; Bulgiba, Awang; Rampal, Sanjay

doi:10.1371/journal.pntd.0006263

Cited by 58 publications

(56 citation statements)

References 37 publications

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“…14 However, metaanalysis and systematic review recently enroled 15 studies from 2000 until 2016 reported obesity as a risk factor of severity in children with dengue infection (OR = 1.38; 95% CI:1.10, 1.73). 15 In addition, recent study shown obese patients with dengue infection possess many clinical parameters suggestive of more severe clinical manifestations. 16 Study of obesity in severe dengue infection still rare.…”

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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Section: Resultsmentioning

confidence: 99%

Prognostic Factors of Severe Dengue Infections in Children

Baiduri

Husada

Puspitasari

et al. 2020

IJTID

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“…This was not possible in view of only one study with children. Moreover, there might be some extent of interaction with TNF-α -238 G>A or TNF-α -308 G>A and other genes (gen-gen interaction/synergism) or other potential confounding factors such as nutritional status of the patients included [ 16 ]. Hence, findings in this meta-analysis should be interpreted with cautions.…”

Section: Resultsmentioning

confidence: 99%

“…The total score for each study ranged between 0 (the worst) and 9 (the best). As described in a published systematic review [ 16 ], we adapted the cut-off score points as good (≥7), moderate (≥5) and poor (≤4) for study quality assessment. Any discrepancy between the two investigators was resolved by consensus.…”

Section: Methodsmentioning

confidence: 99%

Association of tumour necrosis factor-α (TNF-α) gene polymorphisms (-308 G>A and -238 G>A) and the risk of severe dengue: A meta-analysis and trial sequential analysis

et al. 2018

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Individual studies have assessed the association between TNF-α-308G>A and TNF-α-238 G>A polymorphisms and severity of dengue infection. However, the results are inconclusive and most studies had small sample sizes. The objective of this study was to summarize the evidence of association between TNF-α-308 G>A and TNF-α-238 G>A and severity of dengue infection.This study follows the preferred reporting items for systematic reviews and meta- analyses of genetic association studies, recommended by PLOS One. We calculated pooled odds ratio and its 95% confidence interval (CI) to estimate the association between TNF-α-308 G>A or TNF-α-238 G>A and the risk of severe dengue infections. To determine the information size required for this meta-analysis study, a trial sequential analysis (TSA) was done. Eight studies (640 cases and 1275 controls), which assessed the association of TNF-α-308 G>A or TNF-α-238 G>A and the risk of DHF were included. Overall, we found no significant association between TNF-α-308 G>A and the DHF risk in the allelic model (OR, 0.91; 95% CI, 0.51–1.63), the recessive model (OR,1.32;95%CI,0.73–2.37), the dominant model (OR,0.93;95%CI:0.59–1.47) or the additive model (OR,1.43,95;95%CI:0.79–2.59). There was also no significant association between TNF-α-238 G>A and DHF risk under the allele contrast model (OR:1.51;95%CI:0.88–2.58), the recessive model (OR,1.48,95% CI:0.33–6.58), the dominant model (OR,1.48;95%CI:0.56–3.92), or the additive model (OR:1.5;95%CI:0.34–6.69). On subgroup analysis, neither the Asian population nor the non-Asian population showed significant association between TNF-α-308 G>A/TNF-α-238 G>A and the DHF risk under any genetic models. Leave-one-out meta-analysis showed stability of the results. TSA plots suggested that the sample size in this meta-analysis study was below the required information size.The findings suggest an inclusive evidence of the association between TNF-α-308/ TNF-α-238 G>A and the risk of developing severe dengue infection. Large studies with evidence of Hardy-Weinberg equilibrium, assessing gene-gene interactions are recommended.

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“…Gender and parental education were included as confounders based on observed differences and BMI z-score, as obesity has been previously associated with DHF risk. 12 Participant and parental smoking status were not included because of no observed group differences.…”

Section: Methodsmentioning

confidence: 99%

Increased Carotid Intima-Media Thickness in Children with a History of Dengue Hemorrhagic Fever

Versteege

Karyanti

Septiani

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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We assessed carotid intima-media thickness (cIMT) and arterial stiffness in 28 children and adolescents with previous dengue hemorrhagic fever (DHF) (mean interval between DHF and cardiovascular assessment, 8.4 years), and 34 controls in a low-resource setting. Participants with previous DHF had an adjusted increased cIMT of 42.6 μm (95% confidence interval [CI]: 10.0-75.3, P = 0.01), and 61.7 μm (95% CI: 21.5-102.0, P < 0.01) in a subgroup analysis on dengue shock syndrome. There were no differences in arterial stiffness. In this first exploratory study, children and adolescents with a history of DHF had an increased cIMT, which may be modulated by dengue severity.

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The association between obesity and dengue severity among pediatric patients: A systematic review and meta-analysis

Abstract: Background

Cited by 58 publications

References 37 publications

Prognostic Factors of Severe Dengue Infections in Children

Prognostic Factors of Severe Dengue Infections in Children

Association of tumour necrosis factor-α (TNF-α) gene polymorphisms (-308 G>A and -238 G>A) and the risk of severe dengue: A meta-analysis and trial sequential analysis

Increased Carotid Intima-Media Thickness in Children with a History of Dengue Hemorrhagic Fever

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