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