Risk factors associated with death in Brazilian children with severe dengue: a case-control study

Area of Science:

• Pediatric Infectious Diseases
• Dengue Virus Epidemiology
• Clinical Risk Factor Analysis

Background:

• Severe dengue poses a significant threat to child mortality globally.
• Identifying specific risk factors is crucial for improving patient outcomes.
• Early recognition of warning signs can guide clinical management.

Purpose of the Study:

• To investigate clinical risk factors associated with mortality in pediatric severe dengue cases.
• To compare characteristics of children with severe dengue who died versus those who survived.

Main Methods:

• Case-control study design involving hospitalized children under 13 years old.
• Comparison of clinical data between deceased (cases, n=18) and survived (controls, n=77) severe dengue patients.
• Inclusion criteria: hospital admission in São Luis, Brazil, and laboratory-confirmed dengue.

Main Results:

• Severe bleeding (hemoptysis) was the strongest predictor of death.
• Epistaxis (nosebleeds) and persistent vomiting, WHO warning signs, were also strongly associated with mortality.
• No significant association was found between laboratory findings and death in this cohort.

Conclusions:

• Epistaxis and persistent vomiting are significant, previously underestimated, risk factors for death in pediatric severe dengue.
• These findings highlight the importance of closely monitoring these signs in children.
• This information is vital for resource-limited settings to identify high-risk patients for intensive care.