Resumen

LUGO, Silvina; ARCE, Manuel; MESQUITA, Mirta  y  PAVLICICH, Viviana. Incidence of Severe Dengue in Infants in Paraguay. Pediatr. (Asunción) [online]. 2015, vol.42, n.1, pp.22-30. ISSN 1683-9803.  https://doi.org/10.18004/ped.2015.abril.22-30.

Introduction: Identification of infant age groups at risk for severe dengue (SD) could avoid unnecessary hospital admissions.  Objective: To determine the incidence of SD in infants hospitalized during the 2013 epidemic. Materials and Methods: We conducted a retrospective cohort study including all children under age 1 year with serologically-confirmed dengue fever. Results: Of 60 infants, 82% were under age 6 months: 15 (25%) developed SD, 3 presented shock with no capillary leakage, 1 was diagnosed with myocarditis, and 1 with hepatitis. Children with SD were aged ≤ 6 months (RR=1.4, CI 1.2-1.4, p=0.02). During follow up 34 (56.6%) developed alarm signs, 15 were classified as having SD, and 19 (31.6%) were discharged as having dengue with warning signs. Fever was reached in SD at 2.6 ±1.3 days, versus NSD at 2.1 ±1.2 days (p=0.14).  Capillary leakage occurred at 4-5 days of illness in (mean SD: 4.6 ±0.7). Children with SD had more sign of early-onset shock (66.7% vs. 18.2%, RR: 1.9, CI 1.1-3.3, p<0.001), alarm sign (RR: 1.8, CI 1.3-2.4, p<0.001), thrombocytopenia at day 5 (86.6% vs. 33.3%, RR: 1.7, CI 1.2-2.4, p<0.001), and higher transaminase levels (33.3% vs. 2.2%, RR 1.5, CI 1-2.2, p=0.006) and hypoalbuminemia (2.6 ±0.48 vs. 3.6 ±0.49, p<0.001). They also more frequently required crystalloid boluses (100% vs. 33.3%, RR 2, CI 1.4-2.8, p<0.001), parenteral hydration (93.3% vs. 46.5%, RR 1.6, CI 1.2-2.1, p<0.001), vasoactive agents, and blood product transfusion. Conclusions: A tendency toward more risk of the disease was seen in infants aged ≤6 months.

Palabras clave : Dengue; risk factors; early warning; infant.

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