<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1683-9803</journal-id>
<journal-title><![CDATA[Pediatría (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[Pediatr. (Asunción)]]></abbrev-journal-title>
<issn>1683-9803</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1683-98032017000200136</article-id>
<article-id pub-id-type="doi">10.18004/ped.2017.agosto.136-142</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Factores de riesgo asociados a mortalidad por Dengue en menores de 15 años. Paraguay, periodo 2010-2013]]></article-title>
<article-title xml:lang="en"><![CDATA[Risk factors associated with dengue mortality in children under 15 years of age in Paraguay, 2010-2013]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez de Cuellar]]></surname>
<given-names><![CDATA[Celia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lovera]]></surname>
<given-names><![CDATA[Dolores]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arbo]]></surname>
<given-names><![CDATA[Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Ministerio de salud Pública y Bienestar Social Instituto de Medicina Tropical ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Cátedra de Pediatría]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>08</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>08</month>
<year>2017</year>
</pub-date>
<volume>44</volume>
<numero>2</numero>
<fpage>136</fpage>
<lpage>142</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1683-98032017000200136&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1683-98032017000200136&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1683-98032017000200136&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: El dengue es la enfermedad transmitida por vectores más importante en las Américas, y principalmente en Paraguay, habiéndose observado en los últimos 10 años un incremento sostenido de los casos ambulatorios, las hospitalizaciones y muertes por dengue, afectando a todos los grupos de la edad pediátrica.  Objetivo:  Identificar los factores asociados a mortalidad en niños menores de 15 años con diagnóstico de dengue en el periodo 2010-2013.  Materiales y Métodos:  Estudio observacional, descriptivo, retrospectivo. Los datos fueron obtenidos de los boletines de epidemiología del Ministerio de Salud Pública, de donde se obtuvieron las características demográficas y clínicas de todos los casos de dengue en menores de 15 años.  Resultados: Durante el periodo 2010 al 2013, se han reportado 57.483 niños menores de 15 años con diagnostico de dengue, requirieron hospitalización el 12,2% (7.029/57.483). La letalidad (Nº de muertes/ Nº de casos totales) en el periodo de estudio fue de 0.055% (32/57.483), variando la letalidad por año de estudio de 0,03%, 0,05%, 1,3% y 0,05%, respectivamente, en los años 2010 al 2013 respectivamente. Los factores asociados con incremento de la mortalidad fueron edad &lt;1 año (p&lt;0.001; RR=6,22, IC 95% 3-12,9), manifestaciones clínicas hemorrágicas (p&lt;0,01, RR 4,5, 95% CI 1,6 - 12,8), presencia de Síndrome de shock por dengue (p&lt;0,01, RR 83,5, 95% CI 40,6 - 172,1) y pacientes con patologías de base (p&lt;0.001; RR=86,32, IC 95% 38,2-194,8). La mayor frecuencia de hospitalización se observó en el grupo etario &lt;1 año (591/3475, 17%), significativamente mayor comparado con los grupos de 1 a 4 años (6,5%) y 5 a 14 años (5687/42455. 13.4%) (p&lt;0.00001; RR=2,51; IC 95% 2,3 -2,7).  Conclusiones:  Los factores de riesgo asociados con el incremento de la mortalidad fueron la edad &lt;1 año, las manifestaciones clínicas hemorrágicas, la presencia de síndrome de choque por dengue al ingreso y las patologías de base. El presente estudio muestra el gran impacto del dengue en Paraguay en términos de morbilidad y mortalidad. La identificación de factores asociados a mortalidad puede contribuir a la detección oportuna de los grupos de alto riesgo, buscando disminución de la mortalidad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Dengue is the most important vector-borne disease in the Americas, and especially in Paraguay, with a sustained increase in outpatient cases, hospitalizations, and dengue deaths in the last 10 years, affecting all groups of the pediatric age group.  Objective:  To identify factors associated with mortality in children less than 15 years of age with diagnosis of dengue in the period 2010-2013.  Materials and Methods:  An observational, descriptive, retrospective study. The data were obtained from the weekly epidemiological bulletin of the Ministry of Public Health.  Results:  During the period 2010 to 2013, 57,483 children under the age of 15 years were diagnosed with dengue, requiring hospitalization in 12.2% (7,029 / 57,483). The mortality (number of deaths / number of total cases) in the study period was 0.055% (32 / 57,483), with a case-fatality rate of 0.03%, 0.05%, 1.3% and 0.05%, respectively, in the years 2010 to 2013 respectively. The factors associated with increased mortality were age &lt;1 year (p &lt;0.001, RR = 6.22, 95% CI 3-12.9), hemorrhagic clinical manifestations (p &lt;0.01, RR 4.5, 95 % CI 1.6 - 12.8), presence of dengue shock syndrome (p &lt;0.01, RR 83.5, 95% CI 40.6 - 172.1) and patients with baseline pathologies (p &lt; 0.001, RR = 86.32, 95% CI 38.2-194.8). The highest frequency of hospitalization was observed in the age group &lt;1 year (591/3475, 17%), significantly higher compared to the groups of 1 to 4 years (6.5%) and 5 to 14 years (5687/42455. 13.4%) (p &lt;0.00001; RR = 2.51; 95% CI 2.3-2.7).  Conclusions:  Risk factors associated with increased mortality were age &lt;1 year, clinical manifestations of hemorrhagic fever, presence of shock syndrome due to dengue on admission, and underlying pathologies. The present study shows the great impact of dengue in Paraguay in terms of morbidity and mortality. The identification of factors associated with mortality may contribute to the timely detection of high-risk groups, seeking to reduce mortality.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Dengue]]></kwd>
<kwd lng="es"><![CDATA[mortalidad]]></kwd>
<kwd lng="es"><![CDATA[factores de riesgo]]></kwd>
<kwd lng="es"><![CDATA[choque por dengue.]]></kwd>
<kwd lng="en"><![CDATA[Dengue]]></kwd>
<kwd lng="en"><![CDATA[mortality]]></kwd>
<kwd lng="en"><![CDATA[risk factors]]></kwd>
<kwd lng="en"><![CDATA[dengue shock.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="book">
<collab>Organización Mundial de la Salud</collab>
<source><![CDATA[Dengue: guías para el diagnóstico, tratamiento, prevención y control]]></source>
<year>2009</year>
<publisher-loc><![CDATA[La Paz ]]></publisher-loc>
<publisher-name><![CDATA[Bolivia]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Dengue an update]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guzman]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Kouri]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[Lancet Infect Dis]]></source>
<year>2002</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>33-42</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Dengue, urbanization and globalization the Unholy Trinity of the 21(st) Century]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gubler]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
</person-group>
<source><![CDATA[Trop Med Health]]></source>
<year>2011</year>
<volume>39</volume>
<numero>Suppl 4</numero>
<issue>Suppl 4</issue>
<page-range>3-11</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chang G-J]]></surname>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Molecular biology of dengue viruses]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Gubler]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Kuno]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<collab>eds</collab>
<source><![CDATA[Dengue and dengue hemorrhagic fever]]></source>
<year>1997</year>
<page-range>175-98</page-range><publisher-loc><![CDATA[London ]]></publisher-loc>
<publisher-name><![CDATA[CAB International]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Epidemiology of dengue: past, present and future prospects]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Anne Murray]]></surname>
<given-names><![CDATA[NE]]></given-names>
</name>
<name>
<surname><![CDATA[Quam]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Wilder-Smith]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Clinical Epidemiology]]></source>
<year>2013</year>
<volume>5</volume>
<page-range>299-309</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gubler]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Population growth, urbanization, automobiles and airplanes: the dengue connection]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Greenwood]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[De Cock]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<collab>eds</collab>
<source><![CDATA[New and resurgent infections: prediction, detection and management of tomorrow's epidemics]]></source>
<year>1998</year>
<page-range>117-29</page-range><publisher-loc><![CDATA[London ]]></publisher-loc>
<publisher-name><![CDATA[London School of Hygiene and Tropical Medicine]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The epidemiology of dengue in the Americas over the last three decades a worrisome reality]]></article-title>
<collab>San Martín Jl.Brathwaite O.Zambrano B.Solórzano Jo.Bouckenooghe A.Dayan Gh.and Guzmán G</collab>
<source><![CDATA[Am J Trop Med Hyg]]></source>
<year>2010</year>
<volume>82</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>128-35</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Enfermedades transmitidas por vectores]]></article-title>
<collab>Ministerio de Salud Pública y Bienestar Social</collab>
<collab>Dirección General de Vigilancia de la Salud</collab>
<source><![CDATA[Boletín Epidemiológico]]></source>
<year>2016</year>
<volume>30</volume>
<page-range>11</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[WHO]]></surname>
</name>
</person-group>
<source><![CDATA[Dengue: guidelines for diagnosis, treatment, prevention and control. Geneva,]]></source>
<year>2009</year>
<publisher-loc><![CDATA[Switzerland ]]></publisher-loc>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Dengue]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Halstead]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
</person-group>
<source><![CDATA[Lancet]]></source>
<year>2007</year>
<volume>370</volume>
<page-range>1644-52</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Simmons]]></surname>
<given-names><![CDATA[CP]]></given-names>
</name>
<name>
<surname><![CDATA[Farrar]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dengue]]></article-title>
<collab>van Vinh Chau N.Wills B</collab>
<source><![CDATA[N Engl J Med]]></source>
<year>2012</year>
<volume>366</volume>
<page-range>1423-32</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Age-related changes in microvascular permeability a significant factor in the susceptibility of children to shock?]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gamble]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bethell]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Day]]></surname>
<given-names><![CDATA[NP]]></given-names>
</name>
<name>
<surname><![CDATA[Loc]]></surname>
<given-names><![CDATA[PP]]></given-names>
</name>
<name>
<surname><![CDATA[Phu]]></surname>
<given-names><![CDATA[NH]]></given-names>
</name>
<name>
<surname><![CDATA[Gartside]]></surname>
<given-names><![CDATA[IB]]></given-names>
</name>
<name>
<surname><![CDATA[Farrar]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[White]]></surname>
<given-names><![CDATA[NJ]]></given-names>
</name>
</person-group>
<source><![CDATA[Clin Sci (Lond)]]></source>
<year>2000</year>
<volume>98</volume>
<page-range>211-6</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Kibuchi M, Hien TT, Zamora J and Hirayama K Factors associated with dengue shock syndrome: a systematic review and meta-analysis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Huy]]></surname>
<given-names><![CDATA[NT]]></given-names>
</name>
<name>
<surname><![CDATA[Van Giang]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Thuy]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
</person-group>
<source><![CDATA[PloS Neglected Tropical Diseases]]></source>
<year>2013</year>
<volume>7</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>e2412</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Factors associated with death dengue in the state of Minas Gerais, Brasil: historial cohort study]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brito Campos]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Figueiredo Amancio]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Miranda de Araujo]]></surname>
<given-names><![CDATA[VE]]></given-names>
</name>
<name>
<surname><![CDATA[Carneiro]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Tropical Medicine and Internacional Health]]></source>
<year>2015</year>
<volume>20</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>211-8</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Risk factores for fatality among confirmed adult dengue inpatients in Singapore a matched case-control study]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thien]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
<name>
<surname><![CDATA[Leo]]></surname>
<given-names><![CDATA[YS]]></given-names>
</name>
<name>
<surname><![CDATA[Fisher]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Low]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[Oh]]></surname>
<given-names><![CDATA[HML]]></given-names>
</name>
<name>
<surname><![CDATA[Gan]]></surname>
<given-names><![CDATA[VC]]></given-names>
</name>
<name>
<surname><![CDATA[Wong]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[Lye]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
</person-group>
<source><![CDATA[PloS One]]></source>
<year>2013</year>
<volume>8</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>e81060</page-range></nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Dengue in travelers]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wilder-Smith]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Schwartz]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[N Engl J Med]]></source>
<year>2005</year>
<volume>353</volume>
<page-range>924-32</page-range></nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Outbreak of dengue in Mumbai and predictive markers for dengue shock syndrome]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Shah]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Deshpande]]></surname>
<given-names><![CDATA[GC]]></given-names>
</name>
<name>
<surname><![CDATA[Tardeja]]></surname>
<given-names><![CDATA[PN]]></given-names>
</name>
</person-group>
<source><![CDATA[J Trop Pediatr]]></source>
<year>2004</year>
<volume>50</volume>
<page-range>301-5</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Association between sex, nutritional status, severity of dengue hemorrhagic fever, and immune status in infants with dengue hemorrhagic fever]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hung]]></surname>
<given-names><![CDATA[NT]]></given-names>
</name>
<name>
<surname><![CDATA[Lan]]></surname>
<given-names><![CDATA[NT]]></given-names>
</name>
<name>
<surname><![CDATA[Lei H-Y]]></surname>
</name>
<name>
<surname><![CDATA[Lin Y-S]]></surname>
</name>
<name>
<surname><![CDATA[Lien]]></surname>
<given-names><![CDATA[LB]]></given-names>
</name>
<name>
<surname><![CDATA[Huang K-J]]></surname>
</name>
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[CF]]></given-names>
</name>
<name>
<surname><![CDATA[Do]]></surname>
<given-names><![CDATA[QH]]></given-names>
</name>
<name>
<surname><![CDATA[Vu]]></surname>
<given-names><![CDATA[TQ]]></given-names>
</name>
<name>
<surname><![CDATA[Lam]]></surname>
<given-names><![CDATA[TM]]></given-names>
</name>
<name>
<surname><![CDATA[Yeh]]></surname>
<given-names><![CDATA[TM]]></given-names>
</name>
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Halstead]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
</person-group>
<source><![CDATA[Am J Trop Med Hyg]]></source>
<year>2005</year>
<volume>72</volume>
<page-range>370</page-range></nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Effect of age on outcome of secondary dengue 2 infections]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guzman]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Kouri]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Bravo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Valdes]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Vazquez]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Halstead]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
</person-group>
<source><![CDATA[Int J Infect Dis]]></source>
<year>2002</year>
<volume>6</volume>
<page-range>118-24</page-range></nlm-citation>
</ref>
<ref id="B20">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Características epidemiológicas del Dengue en niños menores de 15 años en el Paraguay 2008 - 2013]]></article-title>
<collab>Martínez de Cuellar C.Arbo A</collab>
<source><![CDATA[Rev Inst Med Trop]]></source>
<year>2016</year>
<volume>11</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>4-14</page-range></nlm-citation>
</ref>
<ref id="B21">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Determinants of mortality and prolonged hospital stay among dengue patients attending tertiary care hospital a cross-sectional retrospective analysis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mallhi]]></surname>
<given-names><![CDATA[TH]]></given-names>
</name>
<name>
<surname><![CDATA[Khan]]></surname>
<given-names><![CDATA[AH]]></given-names>
</name>
<name>
<surname><![CDATA[Sarriff]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Adnan]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
<name>
<surname><![CDATA[Khan]]></surname>
<given-names><![CDATA[YH]]></given-names>
</name>
</person-group>
<source><![CDATA[BMJ Open]]></source>
<year>2017</year>
<volume>7</volume>
<page-range>e016805</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
