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TEACHING HOW to Control DHF

DESCRIPTION

Dengue fever is an acute febrile disease caused by


infection with one of the serotypes of dengue virus.
It is a mosquito-born disease caused by genus Aedes.
Dengue is also known as Breakbone Fever, Hemorrhagic
Fever, Dandy Fever, Infectious Thrombocytopenic
Purpura. Dengue hemorrhagic fever is a fatal
manifestation of dengue virus that manifest with
bleeding diathesis and hypovolemic shock. These
viruses are related to the viruses that cause the West
Nile infection and yellow fever.
FACTOR DHF

Dengue fever is caused by dengue virus transmitted to


humans through Aedes aegypti and Aedes albopictus
mosquitoes. Aedes aegypti and Aedes albopictus
mosquitoes are commonly found in non-flowing
drainage water, ponds, reservoirs, or bathrooms in our
homes. That means these insects make the water calm
as a medium for breeding. Areas that have poor
sanitation levels, such as in densely populated cities
located in developing countries (one of Indonesia), are
areas that are often hit by dengue fever. In addition to
the ever-increasing population, the spread of dengue
virus is also supported by its ever-increasing mobility.
PATHOPYSIOLOGY

The pathophysiology of dengue hemorrhagic fever


include: Initial phase. The initial phase of DHF is similar
to that of dengue fever and other febrile viral illnesses.
The virus is deposited in the skin by the vector, within
few days viremia occurs, lasting until the 5th day for the
symptoms to show. Hemorrhagic symptoms. Shortly
after the fever breaks or sometimes within 24 hours
before, signs of plasma leakage appear along with the
development of hemorrhagic symptoms. Vascular
leakage. Vascular leakage in these patients results in
hemoconcentration and serous effusions and can lead to
circulatory collapse. Progression. If left untreated, DHF
most likely progresses to dengue shock syndrome.
PREVENTION

The primary preventative measure to


reduce dengue infections is the control of
mosquito populations. Because the
transmission of dengue requires mosquitoes
as vectors, the spread of dengue can be
limited by reducing mosquito populations.
In addition, mosquito repellents can be
applied to exposed skin and clothing to lower
the risk of mosquito bites
EXAMPLE

Dengue hemorrhagic fever (DHF) lead to shock and death.


Patient in Yogyakarta mostly aged 1 - 12 years old with
severe dengue. A low vitamin D intake is assumed to be
the cause of severe dengue. This assumption needs to be
proved by analyzing the effect of vitamin D intake and
severity of DHF. Study design was a case control study.
Research on childrens wards and medical record
installation in hospital. Cases were children with DHF
grade III and IV, the control of DHF grade I & II. Data
vitamin D intake was obtained by FFQ. Outer variables:
BMI, age, chronic diseases and intensity morning sun
exposure.
NEXT

Analysis by t-test and logistic regression. The results showed


60 cases and 60 controls without matching. Cut-off point
vitamin D intake based ROC curve was 2.7 g/day.
Patients with severe dengue average vitamin D intake of
1.10 times less than not severe dengue. The average
vitamin D intake lower 1 g/day with a BMI 18.75
kg/m2, chronic disease, and less exposed to the morning
sun effect on severe dengue (OR = 0.47, 95% CI: 0.32 to
0.71). Sufficient vitamin D intake is recommended to
avoid the dengue severity. Chronic diseases and more
weight should be a concern of medical personnel as early
warning shock occurrence.
THANKYOU