Vitamin D Deficiency in Dengue Hemorrhagic Fever and Dengue Shock Syndrome among Sri Lankan Children: A Case-Control Study

Introduction. Dengue fever is a vector-borne disease associated with a significant public health impact. The clinical picture ranges from undifferentiated fever to more severe forms such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Compared to healthy controls, we explored the...

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Main Authors: Sharmila Dissanayake, Sureshi Tennekoon, Sharmila Gaffoor, Guwani Liyanage
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Journal of Tropical Medicine
Online Access:http://dx.doi.org/10.1155/2021/4173303
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author Sharmila Dissanayake
Sureshi Tennekoon
Sharmila Gaffoor
Guwani Liyanage
author_facet Sharmila Dissanayake
Sureshi Tennekoon
Sharmila Gaffoor
Guwani Liyanage
author_sort Sharmila Dissanayake
collection DOAJ
description Introduction. Dengue fever is a vector-borne disease associated with a significant public health impact. The clinical picture ranges from undifferentiated fever to more severe forms such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Compared to healthy controls, we explored the likelihood of having vitamin D deficiency (VDD) among children with severe dengue infection. Methods. This case-control study compared hospitalized children (2 months to 12 years) with DHF and DSS with radiologically confirmed plasma leak with age-matched healthy controls. The association of 25-hydroxy vitamin D [25(OH)D] level, age, sex, and socioeconomic status with DHF/DSS was assessed using univariate and multivariate logistic regression. Results. Forty children with DHF/DSS were compared with 52 healthy controls. Mean (SD) age was 8.8 (2.9) years and 7.9 (3.7) years among cases and controls, respectively. Most (n = 28, 70%) had DHF. In multivariate logistic regression, the likelihood of having VDD [25(OH)D < 20 ng/mL] was 3.6 times higher in cases compared to controls (Odds Ratio (OR): 3.65, 95% Confidence Interval (CI): 1.461, 9.102, p=0.006). When serum 25(OH)D was used as a continuous independent variable, the strength of the association between DHF/DSS and serum 25(OH)D was weak but statistically significant; the likelihood of having DHF/DSS is 0.94 times less with 1 ng/mL increase in serum 25(OH)D (OR: 0.940, 95% CI: 0.887, 0.995, p=0.03). Conclusion. The present study suggests that the likelihood of having VDD among children with DHF/DSS is higher than that in their healthy counterparts. Thus, further studies are critical in confirming whether vitamin D repletion is beneficial in preventing severe forms of dengue in the quest to reduce the morbidity and mortality associated with dengue infection.
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spelling doaj-art-071a95d93a3449649bc67b4cc8bca0262025-08-20T02:02:50ZengWileyJournal of Tropical Medicine1687-96861687-96942021-01-01202110.1155/2021/41733034173303Vitamin D Deficiency in Dengue Hemorrhagic Fever and Dengue Shock Syndrome among Sri Lankan Children: A Case-Control StudySharmila Dissanayake0Sureshi Tennekoon1Sharmila Gaffoor2Guwani Liyanage3Paediatric Professorial Unit, Colombo South Teaching Hospital, Kalubowila, Sri LankaPaediatric Professorial Unit, Colombo South Teaching Hospital, Kalubowila, Sri LankaPaediatric Professorial Unit, Colombo South Teaching Hospital, Kalubowila, Sri LankaDepartment of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri LankaIntroduction. Dengue fever is a vector-borne disease associated with a significant public health impact. The clinical picture ranges from undifferentiated fever to more severe forms such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Compared to healthy controls, we explored the likelihood of having vitamin D deficiency (VDD) among children with severe dengue infection. Methods. This case-control study compared hospitalized children (2 months to 12 years) with DHF and DSS with radiologically confirmed plasma leak with age-matched healthy controls. The association of 25-hydroxy vitamin D [25(OH)D] level, age, sex, and socioeconomic status with DHF/DSS was assessed using univariate and multivariate logistic regression. Results. Forty children with DHF/DSS were compared with 52 healthy controls. Mean (SD) age was 8.8 (2.9) years and 7.9 (3.7) years among cases and controls, respectively. Most (n = 28, 70%) had DHF. In multivariate logistic regression, the likelihood of having VDD [25(OH)D < 20 ng/mL] was 3.6 times higher in cases compared to controls (Odds Ratio (OR): 3.65, 95% Confidence Interval (CI): 1.461, 9.102, p=0.006). When serum 25(OH)D was used as a continuous independent variable, the strength of the association between DHF/DSS and serum 25(OH)D was weak but statistically significant; the likelihood of having DHF/DSS is 0.94 times less with 1 ng/mL increase in serum 25(OH)D (OR: 0.940, 95% CI: 0.887, 0.995, p=0.03). Conclusion. The present study suggests that the likelihood of having VDD among children with DHF/DSS is higher than that in their healthy counterparts. Thus, further studies are critical in confirming whether vitamin D repletion is beneficial in preventing severe forms of dengue in the quest to reduce the morbidity and mortality associated with dengue infection.http://dx.doi.org/10.1155/2021/4173303
spellingShingle Sharmila Dissanayake
Sureshi Tennekoon
Sharmila Gaffoor
Guwani Liyanage
Vitamin D Deficiency in Dengue Hemorrhagic Fever and Dengue Shock Syndrome among Sri Lankan Children: A Case-Control Study
Journal of Tropical Medicine
title Vitamin D Deficiency in Dengue Hemorrhagic Fever and Dengue Shock Syndrome among Sri Lankan Children: A Case-Control Study
title_full Vitamin D Deficiency in Dengue Hemorrhagic Fever and Dengue Shock Syndrome among Sri Lankan Children: A Case-Control Study
title_fullStr Vitamin D Deficiency in Dengue Hemorrhagic Fever and Dengue Shock Syndrome among Sri Lankan Children: A Case-Control Study
title_full_unstemmed Vitamin D Deficiency in Dengue Hemorrhagic Fever and Dengue Shock Syndrome among Sri Lankan Children: A Case-Control Study
title_short Vitamin D Deficiency in Dengue Hemorrhagic Fever and Dengue Shock Syndrome among Sri Lankan Children: A Case-Control Study
title_sort vitamin d deficiency in dengue hemorrhagic fever and dengue shock syndrome among sri lankan children a case control study
url http://dx.doi.org/10.1155/2021/4173303
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