Background
Methods
Results
Study | Country of origin | Number of cases | Type of study |
---|---|---|---|
Azavedo et al. [2] | Brazil | 27 | Cross sectional |
Costa et al. [7] | Brazil | 10 | Case series |
Maia et al. [12] | Brazil | 2 | Case series |
Mayor et al. [11] | Paraguay | 8 | Cross sectional |
Nasim et al. [6] | Pakistan | 102 | Cross sectional |
Park et al. [3] | South Korea | 1 | Case report |
Prasad et al. [4] | India | 8 | Case series |
Raynaud et al. [13] | Singapore | 6 | Case series |
Tan et al. [5] | Singapore | 1 | Case report |
Tangnararatchak [14] | Thailand | 1 | Case report |
Weerakkody | Sri Lanka | 2 | Unpublished data |
• | DHF / DSS commoner in subjects on high dose steroids |
•
| Secondary infection on cyclosporine, a significantly lesser proportion of patients presented, with less severe disease DHF/DSS vs DF (p = 0.04) |
•
| Fever is commoner in patients taking low dose steroids to patients on high-dose steroids (p = 0.013) |
•
| The anti-mitotic agents (azathioprine (AZA) or mychophenolate mofetil (MMF)) have no effect; on the severity or duration of thrombocytopenia;leucopenia; and occurrence of gastro-intestinal symptoms. |
•
| Mean duration of thrombocytopenia is longer in patients on regimens containing tacrolimus |
•
| Patients on tacrolimus containing regimens have a higher mortality (p = 0.02) |
•
| Percentage rise in creatinine from pre-dengue levels was higher in DHF/DSS patients than in DF patients (p < 0.001) |
•
| Majority (85.7%) who had graft dysfunction, creatinine returned to base line by 12.6 days, whereas in 14.3% it persisted beyond 6 weeks. |
•
| All the patients who died had graft dysfunction |
•
| Of 21 patients who were IgM positive and IgG negative in the initial sample, 10 (48%) had not mounted an IgG response by an average of 15 weeks |
•
| No statistically significant difference was found in the number of years as transplantation of those who survived vs. those who died |
Composite group outcomes
Medication | Number | Percent |
---|---|---|
Azathioprine | 3 | 10.3 |
Cyclosporine | 15 | 51.7 |
MMF | 23 | 79.3 |
Steroids | 27 | 93.1 |
Tacrolimus | 13 | 44.8 |
Synthesis of results
n
| % | Prevalence7a
(n = 81,327) % |
p
| |
---|---|---|---|---|
Immunosuppression | ||||
Azathioprine | 166 | 51.8 | ||
Cyclosporine | 166 | 27.1 | ||
MMF | 166 | 43.4 | ||
Steroid | 166 | 98.8 | ||
Tacrolimus | 166 | 25.9 | ||
Symptoms and Signs | ||||
Fever at presentation | 162 | 86.4 | 98.8 | 0.006 |
Myalgia | 159 | 47.0 | 92.4 | <0.001 |
Arthlagia | 39 | 20.2 | 76.4 | <0.001 |
New bleeding complications | 127 | 14.9 | 10.2 | 0.147 |
Headache | 133 | 34.6 | 95.8 | <0.001 |
Diarrhea | 13 | 15.3 | 0.122 | |
Pleural effusions | 115 | 17.4 | 2.2 | <0.001 |
Ascites | 23 | 34.8 | 1.1 | 0.003 |
Laboratory findings | ||||
Thrombocytopenia | 127 | 93.7 | ||
Leucopenia | 133 | 66.9 | ||
LFT abnormalities | 39 | 71.8 | ||
Graft dysfunction | 141 | 58.9 | ||
Severity of disease | ||||
DHF / DSS | 168 | 16.0 | 3.7 | <0.001 |
Confirmation of disease | ||||
IgM | 168 | 87.5 | ||
RT PCR / NS1 | 168 | 13.7 | ||
Outcome | ||||
Alive with a functioning graft | 168 | 84.5 | ||
Graft failure | 168 | 6.5 | ||
Death | 168 | 8.9 | 0.062 b
| <0.001 |