Factors associated with dengue with warning signs among the insured population of the department of La Libertad
DOI:
https://doi.org/10.24265/horizmed.2025.v25n1.08Keywords:
Risk Factors , Dengue , Patient AcuityAbstract
Objective: To identify the factors associated with dengue with warning signs among the insured population of the department of La Libertad in 2023. Materials and methods: This descriptive cross-sectional study analyzed a population comprising the entire universe of dengue patients with warning signs (n = 252). The sample consisted of 249 cases recorded from January to June 2023. The dependent variable was dengue with warning signs, while the independent variables were age (categorized by life stages), sex, history of dengue and comorbidities such as type 2 diabetes mellitus, hypertension, obesity, asthma, cancer (acute and chronic lymphoblastic leukemia, prostate cancer, breast cancer, stomach cancer, rectal cancer and non-Hodgkin’s lymphoma), chronic kidney disease and human immunodeficiency virus (HIV) infection. The bivariate analysis involved calculating absolute and relative frequencies, while the multivariate analysis employed binomial logistic regression to identify variables associated with dengue with warning signs. The research received approval by the Research and Ethics Committee of Red Asistencial La Libertad (La Libertad Healthcare Network). Results: Dengue with warning signs was slightly more prevalent among women (55.42 %). In the binomial logistic regression, the odds ratio (OR) revealed that hypertension, obesity and cancer were significantly associated with dengue with warning signs, while age, sex, history of dengue, type 2 diabetes mellitus, asthma, chronic kidney disease and HIV infection were not statistically significant factors. Conclusions: The factors associated with dengue with warning signs were comorbidities including hypertension, obesity and cancer. Factors such as age, sex, history of dengue, asthma, chronic kidney disease and HIV infection were not identified as significant contributors to this severity level of dengue.
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References
Ministerio de Salud del Perú. Norma técnica de salud para la vigilancia epidemiológica y diagnóstico de laboratorio de dengue, chikungunya, zika y otras Arbovirosis en el Perú. Perú: CDC; 2017. Disponible en: https://cdn.www.gob.pe/uploads/document/ file/315148/Norma_t%C3%A9cnica_de_salud_para_la_vigilancia_ epidemiol%C3%B3gica_Y_diagn%C3%B3stico_de_laboratorio_ de_dengue_chikungunya__zika_y_otras_arbovirosis_en_el_ Per%C3%BA20190521-6322-6qkhtm.pdf?v=1558473380
Wakimoto MD, Camacho LAB, Gonin ML, Brasil P. Clinical and laboratory factors associated with severe dengue: a case-control study of hospitalized children. J Trop Pediatr [Internet]. 2018;64(5):373-81.
Cortés F, Gómez S, Ocazionez R. Subtipos de virus dengue serotipos 2, 3 y 4 aislados en el departamento de Santander, Colombia. Rev Cubana Med Trop [Internet]. 2007;59(3):186-92.
Muller DA, Depelsenaire AC, Young PR. Clinical and laboratory diagnosis of dengue virus infection. J Infect Dis [Internet]. 2017;215(2):89-95.
Alfaro M, Luna M, Novoa Y, Castillo N, Benites S, Muñoz M, et al. Factores fundamentales de exposición al dengue según escenarios geo-epidemiológicos en Trujillo metropolitano. Abril - mayo 2001. Rev Perú Epidemiol [Internet]. 2002;10(7).
Ministerio de Salud del Perú. Sala situacional de dengue [Internet]. Perú: CDC; 2023. Disponible en: https://www.dge.gob.pe/salasituacional-dengue/#grafico01
Red Asistencial La Libertad-ESSALUD. Oficina de Inteligencia Sanitaria. Sala de Situación de dengue, Trujillo-Perú, 2023.
Rojas M, Ríos C. Factores asociados a la evolución a dengue grave en un hospital de tercer nivel de atención del Paraguay, 2019 a 2020. An Fac Cienc Med [Internet]. 2021;54(2):79-88.
Soo KM, Khalid B, Ching SM, Chee HY. Meta-analysis of dengue severity during infection by different dengue virus serotypes in primary and secondary infections. PLoS One [Internet]. 2016;11(5):e0154760.
Asociación Médica Mundial. Declaración de Helsinki de la AMM - Principios éticos para las investigaciones médicas con participantes humanos [Internet]. Finlandia: AMM; 2024. Disponible en: https:// www.wma.net/es/policies-post/declaracion-de-helsinki-de-laamm-principios-eticos-para-las-investigaciones-medicas-en-sereshumanos/
Del Carpio L. Dengue en poblaciones especiales. Rev Hosp Jua Mex [Internet]. 2019;86(1):33-8.
Tsheten T, Clements ACA, Gray DJ, Adhikary RK, Furuya-Kanamori L, Wangdi K. Clinical predictors of severe dengue: a systematic review and meta-analysis. Infect Dis Poverty [Internet]. 2021;10(1):123.
Hökerberg YHM, Kohn F, Souza TS, Passos SRL. Clinical profile of dengue in the elderly using surveillance data from two epidemics. Rev Soc Bras Med Trop [Internet]. 2022;55:e0290.
Yuan K, Chen Y, Zhong M, Lin Y, Liu L. Risk and predictive factors for severe dengue infection: A systematic review and meta-analysis. PLoS One [Internet]. 2022;17(4):e0267186.
Singh V, Mishra SC, Agarwal NA, Mallikarjuna PA, Raut BB. Dengue infection with warning signs: The 2019 epidemic. Med J Armed Forces India [Internet]. 2022;78(2):140-6.
Pizarro Y, Vila K. Factores de riesgo asociados a la infección por dengue con signos de alarma en un hospital de la selva central, 2022 [Tesis de Pregrado]. Perú: Universidad Nacional del Centro del Perú; 2023. Recuperado a partir de: https://repositorio.uncp.edu.pe/ bitstream/handle/20.500.12894/8976/T010_75365915_T%20%20%20 %20pizarro%20-%20vila.pdf?sequence=1&isAllowed=y
Gamble J, Bethel D, Day N, Loc PP, Phu N, Gartside IB, et al. Age-related changes in microvascular permeability: a significant factor in the susceptibility of children to shock? Clin Sci (Lond) [Internet]. 2000;98(2):211–6.
Rosso F, Vanegas S, Rodríguez S, Pacheco R. Prevalencia y curso clínico de la infección por dengue en adultos mayores con cuadro febril agudo en un hospital de alta complejidad en Cali, Colombia. Biomédica [Internet]. 2016;36(2):179-86.
Sangkaew S, Ming D, Boonyasiri A, Honeyford K, Kalayanarooj S, Yacoub S, et al. Risk predictors of progression to severe disease during the febrile phase of dengue: a systematic review and meta-analysis. Lancet Infect Dis [Internet]. 2021;21(7):1014-26.
Halstead SB, Nimmannitya S, Cohen SN. Observations related to pathogenesis of dengue hemorrhagic fever. IV. Relation of disease severity to antibody response and virus recovered. Yale J Biol Med [Internet]. 1970;42(5):311–28.
Mahmood S, Hafeez S, Nabeel H, Zahra U, Nazeer H. Does comorbidity increase the risk of dengue hemorrhagic fever and dengue shock syndrome? Int Sch Res Notices [Internet]. 2017;2017:2725850.
Pang J, Pu J, Wen T, Sin Y, Lye D. Diabetes, cardiac disorders and asthma as risk factors for severe organ involvement among adult dengue patients: A matched case-control study. Sci Rep [Internet]. 2017;7:39872.
Geerlings S, Hoepelman A. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Inmunol Med Microbiol [Internet]. 1999; 26(3-4):259–65.
Cruz J, Licea M, Hernández P, Yanes M, Salvato A. Disfunción endotelial y diabetes mellitus. Rev Cuba Endocrinol [Internet]. 2012;23(2):166-85.
O’Keefe JH, Bell DSH. Postprandial hyperglycemia/hyperlipidemia (postprandial dysmetabolism) is a cardiovascular risk factor. Am J Cardiol [Internet]. 2007;100(5):899–904.
Chen CY, Chiu YY, Chen YC, Huang CH, Wang WH, Chen Y, et al. Obesity as a clinical predictor for severe manifestation of dengue: a systematic review and meta-analysis. BMC Infect Dis [Internet]. 2023;23(1):502.
Harharpreet K, Harpreet K, Navjot K, Kawalinder K. Study of nutritional status, comorbidities and other risk factors associated with dengue fever: data from a tertiary hospital in North India. Int J Adv Med [Internet]. 2017;4(1):82-7.
Karlsson EA, Beck MA. The burden of obesity on infectious disease. Exp Biol Med (Maywood) [Internet]. 2010;235(12):1412–24.
Jartti T, Korppi M. Rhinovirus-induced bronchiolitis and asthma development. Pediatr Allergy Immunol [Internet]. 2011;22(4):350-5.
Rashid N, Sultan F, Nazeer SH, Raza A, Mahboob A. Dengue infection in cancer patients. Esculapio [Internet]. 2014;10(3):138-45.
Talwar V, Goel V, Raina S, Talwar J, Patnaik N, Doval D. Dengue fever in cancer patients: retrospective analysis. Curr Med Res Opin [Internet]. 2016;6(4):157-9.
Pecoits-Filho R, Heimbürger O, Bárány P, Suliman M, Fehrman-Ekholm I, Lindholm B, et al. Associations between circulating inflammatory markers and residual renal function in CFR patients. Am J Kidney Dis [Internet]. 2003;41(6):1212-8.
Torrentes-Carvalho A, Hottz ED, Marinho CF, Badolato-Correa JB, Oliveira LM, Fialho LG, et al. Characterization of clinical and immunological features in patients coinfected with dengue virus and HIV. Clin Immunol [Internet]. 2016;164:95-105.
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