Table 2.
Comparison of clinical data and manifestations between pediatric and adult severe dengue fever (SDF) cases
| Variables | Pediatric SDF, N = 56 (N, %) | Adult SDF, N = 187 (N, %) | Odds ratio (95% CI) | P-values |
|---|---|---|---|---|
| Secondary dengue infection | 20 (35.7) | 108 (57.8) | 2.46 (1.33–4.57) | 0.004 |
| Management/place of admission | ||||
| Ward admission | 47 (83.9) | 131 (70.1) | – | – |
| Intensive care unit admission | 9 (16.1) | 56 (29.9) | 2.23 (1.02–4.86) | 0.04 |
| Outcome | ||||
| Survived | 51 (91.1) | 167 (89.3) | – | – |
| Died | 5 (8.9) | 20 (10.7) | 1.22 (0.44–3.42) | 0.70 |
| Non-warning manifestations | ||||
| Headache | 39 (69.6) | 144 (77) | 1.46 (0.75–2.83) | 0.26 |
| Musculoskeletal pain | 30 (53.6) | 127 (67.9) | 1.83 (0.99–3.37) | 0.05 |
| Maculopapular skin rash | 13 (23.2) | 37 (19.8) | 0.82 (0.39–1.67) | 0.58 |
| Warning signs of the WHO 2009 dengue classification | ||||
| Abdominal pain or tenderness | 31 (55.4) | 108 (57.8) | 1.10 (0.60–2.01) | 0.75 |
| Persistent vomiting | 45 (80.4) | 109 (58.3) | 0.34 (0.17–0.70) | 0.003 |
| Mucosal bleeding | 5 (8.9) | 8 (16) | 0.95 (0.33–2.73) | 0.93 |
| Hepatomegaly | 13 (23.2) | 49 (26.2) | 1.17 (0.58–2.37) | 0.65 |
| Lethargy | 47 (83.9) | 144 (77) | 0.64 (0.29–1.41) | 0.27 |
| Clinical fluid accumulation (all forms) | 17 (30.4) | 15 (8.0) | 0.19 (0.09–0.43) | < 0.0001 |
| Ascites | 2 (3.6) | 2 (1.1) | 0.22 (0.03–1.63) | 0.14 |
| Pleural effusion | 3 (5.4) | 4 (2.12) | 0.29 (0.06–1.38) | 0.12 |
| Both ascites and pleural effusion | 12 (21.4) | 9 (4.8) | 0.17 (0.07–0.42) | 0.0002 |
| No plasma leakage* | 35 (62.5) | 158 (84.5) | 3.27 (1.67–6.39) | 0.0005 |
| Increased hematocrit value with thrombocytopenia | 6 (10.7) | 28 (15.7) | 1.47 (0.57–3.75) | 0.42 |
| Other clinical manifestations | ||||
| Seizures | 6 (10.7) | 33 (17.6) | 1.79 (0.70–4.51) | 0.22 |
| Respiratory distress | 10 (17.9) | 8 (4.28) | 0.21 (0.08–0.55) | 0.002 |
| Bleeding (all forms) | 47 (83.93) | 157 (84.0) | 1.0 (0.44–2.26) | 0.99 |
| Hematemesis/melena | 5 (8.9) | 16 (8.6) | 0.96 (0.28–3.35) | 0.95 |
| Epistaxis | 16 (28.6) | 56 (29.9) | 1.05 (0.42–2.66) | 0.92 |
| Purpura/ecchymosis | 5 (8.9) | 8 (4.3) | 0.48 (0.13–1.84) | 0.28 |
| Gum bleeding | 5 (8.9) | 16 (8.6) | 0.96 (0.28–3.35) | 0.95 |
| Cutaneous and mucosal bleeding | 16 (28.6) | 61 (32.6) | 1.14 (0.45–2.89) | 0.78 |
| Severe bleeding† | 9 (16.1) | 17 (9.1) | 0.52 (0.22–1.25) | 0.14 |
| No bleeding* | 9 (16.1) | 30 (16) | 0.99 (0.44–2.25) | 0.99 |
| Shock (dengue shock syndrome) | 4 (7.1) | 14 (7.5) | 1.05 (0.33–3.33) | 0.93 |
| Organ failure (all forms) | 17 (30.4) | 70 (37.4) | 1.37 (0.72–2.61) | 0.33 |
| Brain | 2 (3.6) | 9 (4.8) | 1.50 (0.31–7.24) | 0.61 |
| Liver | 12 (21.4) | 24 (12.8) | 0.67 (0.31–1.46) | 0.31 |
| Brain and liver | 1 (1.8) | 15 (8.0) | 5.0 (0.64–39.09) | 0.13 |
| Multiple | 2 (3.6) | 22 (11.8) | 3.67 (0.83–16.31) | 0.09 |
| No organ failure* | 39 (69.6) | 117 (62.6) | 0.73 (0.38–1.38) | 0.33 |
* Base or reference category.
† Bleeding associated with systolic hypotension, hemoglobin < 8 g/dL, or bleeding that required blood transfusion.