Ref Number = PITIKA-ASPR0119
Gabriella Chandra. Stasya Zephora, Firmandiyara Angkasa, Bayu Kurniawan, Sondang H. Panjaitan
OBJECTIVE: Some previous studies had claimed that overnutrition, especially obesity, may serve as a predictor of dengue shock syndrome (DSS), yet it is still debatable, since some studies refute the proposition. In rural areas where overnutrition is scarce and obesity might not be a threat, the substantial amount of undernutrition in dengue patients might be a new challenge. This study aims to evaluate the relationship between nutritional status especially undernutrition and the progression of dengue hemorrhagic fever (DHF) to DSS.                                                                                                                                                        METHOD: A cross-sectional study was performed by collecting medical records of patients with DHF in Umbu Rara Meha General Hospital from December 2018 to April 2019. Patients with dengue fever (dengue infection without plasma leakage) were excluded from the study. Variables assessed were age, nutritional status, routine hematology results, and DHF grading. Nutritional statuses were classified based on WHO and CDC criteria for age groups 0-5 and 5-17 years old. Non-parametric test of Mann-Whitney and Chi-square comparative test were done to analyze the gathered data.                                                                        RESULT: A total of 63 patients were included in the study. More than half of them (61.9%) were classified as underweight and severely underweight, 31.7% and 6.3% were within normal nutritional status and overweight, respectively. Median of weight-for-height percentages was 88.32% (SD +24.6%). Among all subjects, 63.5% had DSS. Statistical studies for nutritional status classifications and DSS did not show significant relationship (Mann-Whitney test p=0.529; Chi-square test p=0.560). However, there is significant relationship between weight-for-height percentages and DSS in 5-17 years old DHF patients (Mann-Whitney test with p=0.049).                                                                        CONCLUSION: It is still debatable whether malnutrition, either under-or-over, might has a relationship with severity in dengue infection. Further studies need to be conducted to assess nutritional status as risk factors for DSS.
Keywords: Nutritional status, Dengue shock syndrome, malnutrition
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