Dengue in Malaysia: Factors Associated with Dengue Mortality from a National Registry
The increasing incidence and geographical distribution of dengue has had significant impact on global healthcare services and resources. This study aimed to determine the factors associated with dengue-related mortality in a cohort of Malaysian patients. This was a retrospective cohort study of pati...
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Veröffentlicht in: | PloS one 2016-06, Vol.11 (6), p.e0157631 |
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creator | Liew, Su May Khoo, Ee Ming Ho, Bee Kiau Lee, Yew Kong Omar, Mimi Ayadurai, Vickneswari Mohamed Yusoff, Fazlina Suli, Zailiza Mudin, Rose Nani Goh, Pik Pin Chinna, Karuthan |
description | The increasing incidence and geographical distribution of dengue has had significant impact on global healthcare services and resources. This study aimed to determine the factors associated with dengue-related mortality in a cohort of Malaysian patients.
This was a retrospective cohort study of patients in the Malaysian National Dengue Registry of 2013. The outcome measure was dengue-related mortality. Associations between sociodemographic and clinical variables with the outcome were analysed using multivariate analysis.
There were 43 347 cases of which 13081 were serologically confirmed. The mean age was 30.0 years (SD 15.7); 60.2% were male. The incidence of dengue increased towards the later part of the calendar year. There were 92 probable dengue mortalities, of which 41 were serologically confirmed. Multivariate analysis in those with positive serology showed that increasing age (OR 1.03; CI:1.01-1.05), persistent vomiting (OR 13.34; CI: 1.92-92.95), bleeding (OR 5.84; CI 2.17-15.70) and severe plasma leakage (OR 66.68; CI: 9.13-487.23) were associated with mortality. Factors associated with probable dengue mortality were increasing age (OR 1.04; CI:1.03-1.06), female gender (OR 1.53; CI:1.01-2.33), nausea and/or vomiting (OR 1.80; CI:1.17-2.77), bleeding (OR 3.01; CI:1.29-7.04), lethargy and/or restlessness (OR 5.97; CI:2.26-15.78), severe plasma leakage (OR 14.72; CI:1.54-140.70), and shock (OR 1805.37; CI:125.44-25982.98), in the overall study population.
Older persons and those with persistent vomiting, bleeding or severe plasma leakage, which were associated with mortality, at notification should be monitored closely and referred early if indicated. Doctors and primary care practitioners need to detect patients with dengue early before they develop these severe signs and symptoms. |
doi_str_mv | 10.1371/journal.pone.0157631 |
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This was a retrospective cohort study of patients in the Malaysian National Dengue Registry of 2013. The outcome measure was dengue-related mortality. Associations between sociodemographic and clinical variables with the outcome were analysed using multivariate analysis.
There were 43 347 cases of which 13081 were serologically confirmed. The mean age was 30.0 years (SD 15.7); 60.2% were male. The incidence of dengue increased towards the later part of the calendar year. There were 92 probable dengue mortalities, of which 41 were serologically confirmed. Multivariate analysis in those with positive serology showed that increasing age (OR 1.03; CI:1.01-1.05), persistent vomiting (OR 13.34; CI: 1.92-92.95), bleeding (OR 5.84; CI 2.17-15.70) and severe plasma leakage (OR 66.68; CI: 9.13-487.23) were associated with mortality. Factors associated with probable dengue mortality were increasing age (OR 1.04; CI:1.03-1.06), female gender (OR 1.53; CI:1.01-2.33), nausea and/or vomiting (OR 1.80; CI:1.17-2.77), bleeding (OR 3.01; CI:1.29-7.04), lethargy and/or restlessness (OR 5.97; CI:2.26-15.78), severe plasma leakage (OR 14.72; CI:1.54-140.70), and shock (OR 1805.37; CI:125.44-25982.98), in the overall study population.
Older persons and those with persistent vomiting, bleeding or severe plasma leakage, which were associated with mortality, at notification should be monitored closely and referred early if indicated. Doctors and primary care practitioners need to detect patients with dengue early before they develop these severe signs and symptoms.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0157631</identifier><identifier>PMID: 27336440</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Age ; Aged ; Aged, 80 and over ; Analysis ; Biology and Life Sciences ; Bleeding ; Care and treatment ; Child ; Child, Preschool ; Cohort Studies ; Dengue ; Dengue - epidemiology ; Dengue - mortality ; Dengue fever ; Development and progression ; Diagnosis ; Epidemics ; Epidemiology ; Female ; Geographical distribution ; Health aspects ; Health care ; Humans ; Incidence ; Infant ; Leakage ; Lethargy ; Malaysia ; Malaysia - epidemiology ; Male ; Medical personnel ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Multivariate analysis ; Nausea ; Older people ; Patients ; Physical Sciences ; Physicians ; Population studies ; Registries ; Registries (Medicine) ; Research and Analysis Methods ; Retrospective Studies ; Risk Factors ; Serology ; Signs and symptoms ; Tropical diseases ; Vector-borne diseases ; Vomiting ; Young Adult</subject><ispartof>PloS one, 2016-06, Vol.11 (6), p.e0157631</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Liew et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Liew et al 2016 Liew et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-708d31317b2a347de78c6ec93274ca58d676f94234f00cbf42090d1133cb6a063</citedby><cites>FETCH-LOGICAL-c725t-708d31317b2a347de78c6ec93274ca58d676f94234f00cbf42090d1133cb6a063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919027/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919027/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27336440$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Borrow, Ray</contributor><creatorcontrib>Liew, Su May</creatorcontrib><creatorcontrib>Khoo, Ee Ming</creatorcontrib><creatorcontrib>Ho, Bee Kiau</creatorcontrib><creatorcontrib>Lee, Yew Kong</creatorcontrib><creatorcontrib>Omar, Mimi</creatorcontrib><creatorcontrib>Ayadurai, Vickneswari</creatorcontrib><creatorcontrib>Mohamed Yusoff, Fazlina</creatorcontrib><creatorcontrib>Suli, Zailiza</creatorcontrib><creatorcontrib>Mudin, Rose Nani</creatorcontrib><creatorcontrib>Goh, Pik Pin</creatorcontrib><creatorcontrib>Chinna, Karuthan</creatorcontrib><title>Dengue in Malaysia: Factors Associated with Dengue Mortality from a National Registry</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The increasing incidence and geographical distribution of dengue has had significant impact on global healthcare services and resources. This study aimed to determine the factors associated with dengue-related mortality in a cohort of Malaysian patients.
This was a retrospective cohort study of patients in the Malaysian National Dengue Registry of 2013. The outcome measure was dengue-related mortality. Associations between sociodemographic and clinical variables with the outcome were analysed using multivariate analysis.
There were 43 347 cases of which 13081 were serologically confirmed. The mean age was 30.0 years (SD 15.7); 60.2% were male. The incidence of dengue increased towards the later part of the calendar year. There were 92 probable dengue mortalities, of which 41 were serologically confirmed. Multivariate analysis in those with positive serology showed that increasing age (OR 1.03; CI:1.01-1.05), persistent vomiting (OR 13.34; CI: 1.92-92.95), bleeding (OR 5.84; CI 2.17-15.70) and severe plasma leakage (OR 66.68; CI: 9.13-487.23) were associated with mortality. Factors associated with probable dengue mortality were increasing age (OR 1.04; CI:1.03-1.06), female gender (OR 1.53; CI:1.01-2.33), nausea and/or vomiting (OR 1.80; CI:1.17-2.77), bleeding (OR 3.01; CI:1.29-7.04), lethargy and/or restlessness (OR 5.97; CI:2.26-15.78), severe plasma leakage (OR 14.72; CI:1.54-140.70), and shock (OR 1805.37; CI:125.44-25982.98), in the overall study population.
Older persons and those with persistent vomiting, bleeding or severe plasma leakage, which were associated with mortality, at notification should be monitored closely and referred early if indicated. Doctors and primary care practitioners need to detect patients with dengue early before they develop these severe signs and symptoms.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Bleeding</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Dengue</subject><subject>Dengue - epidemiology</subject><subject>Dengue - mortality</subject><subject>Dengue fever</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Epidemics</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Geographical distribution</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Leakage</subject><subject>Lethargy</subject><subject>Malaysia</subject><subject>Malaysia - epidemiology</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Nausea</subject><subject>Older people</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Physicians</subject><subject>Population studies</subject><subject>Registries</subject><subject>Registries (Medicine)</subject><subject>Research and Analysis Methods</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Serology</subject><subject>Signs and symptoms</subject><subject>Tropical diseases</subject><subject>Vector-borne diseases</subject><subject>Vomiting</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11v0zAUhiMEYmPwDxBEQkJw0WLHjp1wgVQNBpU2Jg3GrXXqOKkrJy62A_Tf49BsatAkkC9sHT_n9fnwSZKnGM0x4fjNxvauAzPf2k7NEc45I_hecoxLks1Yhsj9g_NR8sj7DUI5KRh7mBxlnBBGKTpOrt-rrulVqrv0AgzsvIa36RnIYJ1PF95bqSGoKv2pwzod2QvrAhgddmntbJtC-hmCtjGW9Eo12ge3e5w8qMF49WTcT5Lrsw9fTz_Nzi8_Lk8X5zPJszzMOCoqggnmqwwI5ZXihWRKxqg5lZAXFeOsLmlGaI2QXNU0QyWqMCZErhggRk6S53vdrbFejBXxAvOyzHCGGI_Eck9UFjZi63QLbicsaPHHYF0jwAUtjRI5UwWqaihK4LREJbAcASfZimKGoBq03o2v9atWVVJ1wYGZiE5vOr0Wjf0haIlLlA0Cr0YBZ7_3ygfRai-VMdAp28e4C1Rwiggp_o3GFHOGCjagL_5C7y7ESDUQc9VdbWOIchAVC5ozSghnOFLzO6i4KtVqGX9araN94vB64hCZoH6FBnrvxfLL1f-zl9-m7MsDdq3AhLW3ph8-mp-CdA9KZ713qr7tB0ZiGJSbaohhUMQ4KNHt2WEvb51uJoP8Bit1CuU</recordid><startdate>20160623</startdate><enddate>20160623</enddate><creator>Liew, Su May</creator><creator>Khoo, Ee Ming</creator><creator>Ho, Bee Kiau</creator><creator>Lee, Yew Kong</creator><creator>Omar, Mimi</creator><creator>Ayadurai, Vickneswari</creator><creator>Mohamed Yusoff, Fazlina</creator><creator>Suli, Zailiza</creator><creator>Mudin, Rose Nani</creator><creator>Goh, Pik Pin</creator><creator>Chinna, Karuthan</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>F1W</scope><scope>H95</scope><scope>H97</scope><scope>L.G</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20160623</creationdate><title>Dengue in Malaysia: Factors Associated with Dengue Mortality from a National Registry</title><author>Liew, Su May ; Khoo, Ee Ming ; Ho, Bee Kiau ; Lee, Yew Kong ; Omar, Mimi ; Ayadurai, Vickneswari ; Mohamed Yusoff, Fazlina ; Suli, Zailiza ; Mudin, Rose Nani ; Goh, Pik Pin ; Chinna, Karuthan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c725t-708d31317b2a347de78c6ec93274ca58d676f94234f00cbf42090d1133cb6a063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Bleeding</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Dengue</topic><topic>Dengue - 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Academic</collection><collection>ASFA: Aquatic Sciences and Fisheries Abstracts</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 3: Aquatic Pollution & Environmental Quality</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) Professional</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liew, Su May</au><au>Khoo, Ee Ming</au><au>Ho, Bee Kiau</au><au>Lee, Yew Kong</au><au>Omar, Mimi</au><au>Ayadurai, Vickneswari</au><au>Mohamed Yusoff, Fazlina</au><au>Suli, Zailiza</au><au>Mudin, Rose Nani</au><au>Goh, Pik Pin</au><au>Chinna, Karuthan</au><au>Borrow, Ray</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dengue in Malaysia: Factors Associated with Dengue Mortality from a National Registry</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-06-23</date><risdate>2016</risdate><volume>11</volume><issue>6</issue><spage>e0157631</spage><pages>e0157631-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The increasing incidence and geographical distribution of dengue has had significant impact on global healthcare services and resources. This study aimed to determine the factors associated with dengue-related mortality in a cohort of Malaysian patients.
This was a retrospective cohort study of patients in the Malaysian National Dengue Registry of 2013. The outcome measure was dengue-related mortality. Associations between sociodemographic and clinical variables with the outcome were analysed using multivariate analysis.
There were 43 347 cases of which 13081 were serologically confirmed. The mean age was 30.0 years (SD 15.7); 60.2% were male. The incidence of dengue increased towards the later part of the calendar year. There were 92 probable dengue mortalities, of which 41 were serologically confirmed. Multivariate analysis in those with positive serology showed that increasing age (OR 1.03; CI:1.01-1.05), persistent vomiting (OR 13.34; CI: 1.92-92.95), bleeding (OR 5.84; CI 2.17-15.70) and severe plasma leakage (OR 66.68; CI: 9.13-487.23) were associated with mortality. Factors associated with probable dengue mortality were increasing age (OR 1.04; CI:1.03-1.06), female gender (OR 1.53; CI:1.01-2.33), nausea and/or vomiting (OR 1.80; CI:1.17-2.77), bleeding (OR 3.01; CI:1.29-7.04), lethargy and/or restlessness (OR 5.97; CI:2.26-15.78), severe plasma leakage (OR 14.72; CI:1.54-140.70), and shock (OR 1805.37; CI:125.44-25982.98), in the overall study population.
Older persons and those with persistent vomiting, bleeding or severe plasma leakage, which were associated with mortality, at notification should be monitored closely and referred early if indicated. Doctors and primary care practitioners need to detect patients with dengue early before they develop these severe signs and symptoms.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27336440</pmid><doi>10.1371/journal.pone.0157631</doi><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1932-6203 |
ispartof | PloS one, 2016-06, Vol.11 (6), p.e0157631 |
issn | 1932-6203 1932-6203 |
language | eng |
recordid | cdi_plos_journals_1799212067 |
source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
subjects | Adolescent Adult Age Aged Aged, 80 and over Analysis Biology and Life Sciences Bleeding Care and treatment Child Child, Preschool Cohort Studies Dengue Dengue - epidemiology Dengue - mortality Dengue fever Development and progression Diagnosis Epidemics Epidemiology Female Geographical distribution Health aspects Health care Humans Incidence Infant Leakage Lethargy Malaysia Malaysia - epidemiology Male Medical personnel Medicine and Health Sciences Middle Aged Mortality Multivariate analysis Nausea Older people Patients Physical Sciences Physicians Population studies Registries Registries (Medicine) Research and Analysis Methods Retrospective Studies Risk Factors Serology Signs and symptoms Tropical diseases Vector-borne diseases Vomiting Young Adult |
title | Dengue in Malaysia: Factors Associated with Dengue Mortality from a National Registry |
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