Page 61 - Abstract Book KONIKA 18

Emergency & Pediatric Intensive Care

O-EPIC-001
Risk Factors of Dengue Shock Syndrome among Indonesian Children:
A Systematic Review and Meta-Analysis

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Arya Krisna Manggala , Justika Usmadhani Aulya , Athaya Febriantyo Purnomo ,
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Dyah Kanya Wati , Inke Nadia Diniyanti Lubis 2,5
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Faculty of Medicine, Universitas Udayana, Denpasar, Bali , Universitas Sumatera Utara, Medan, North Sumatera ,
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Universitas Brawijaya, Malang, East Java , Department of Paediatrics, Faculty of Medicine, Universitas Udayana/
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Sanglah Public Hospital, Denpasar, Bali and Universitas Sumatera Utara, Medan, North Sumatera , Indonesia
Abstract
Background The unforeseeable clinical progression of dengue infection, such as seen in dengue shock
syndrome (DSS), has contributed to higher mortality in children. Furthermore, the studies regarding the
risk factors of DSS among Indonesian children were still showing inconsistent result. Objective To conduct
a recent systematic review and meta-analysis of the risk factors of DSS among Indonesian children.
Methods Published papers from PubMed, Google Scholar, Garba Rujukan Digital (GARUDA), and
Indonesian Scientific Journal Database (ISJD) as of 26 May 2021 assessing demographic aspects, clinical
manifestations, and laboratory findings were analyzed. Pooled odds ratio (OR) or event rate with 95 %
confidence intervals were estimated using random-effects models. Results We included 19 papers total
of 3086 children reporting the rate event of DSS and its risk factors. The pooled rate showed that 36.0%
children in Indonesia had DSS (PR 0.36; 95%CI 0.34 to 0.38; P<0.001). Pooled OR calculation showed
that obesity/overweight (OR 2.30; 95%CI 1.51 to 3.48; P<0.001), abdominal pain (OR 2.34; 95%CI 1.29
to 4.25; P=0.005), hepatomegaly (OR 6.31; 95%CI 2.79 to 14.30; P<0.001), ascites (OR 9.56; 95%CI 6.27
to 14.59; P<0.001), pleural effusion (OR 9.15; 95%CI 3.18 to 25.29]; P<0.001), gastrointestinal tract (GI)
bleeding (OR 5.15; 95%CI 1.88 to 14.13; P=0.001), hemoconcentration (OR 4.65; 95%CI 2.95 to 7.34;
P<0.001), thrombocytopenia (OR 3.20; 95%CI 1.81 to 5.69],P<0.001), and AST level ≥ 3 folds (OR 7.42;
95%CI 4.02 to 13.69; P<0.001) were associated to DSS. In contrast, variables of age, gender, secondary
dengue infection, nausea, vomiting, epistaxis/gum bleeding, petechiae/purpura, headache, myalgia, onset
fever, leucopenia, and ALT level ≥ 3 were not associated to DSS. Conclusion Obesity/overweight, abdominal
pain, hepatomegaly, ascites, pleural effusion, GI bleeding, hemoconcentration, thrombocytopenia, and AST
level ≥ 3 folds were risk factors of DSS among Indonesian children.
Keywords: children; dengue shock syndrome; risk factors

O-EPIC-002
Relationship between Secretory Immunoglobulin A Levels in Feces
and Sepsis Outcomes among Children

Tuminau C. Runtunuwu, Yuke M. M. M. Nelwan, Ari L. Runtunuwu, E. David Kaunang, Jose M. Mandei
Department of Child Health, Medical Faculty of Universitas Sam Ratulangi/ Prof. DR. R. D. Kandou Hospital,
Manado, North Sulawesi, Indonesia
Abstract
Background Early prediction of sepsis outcome can reduce morbidity and mortality. Secretory IgA can be
an immunological biomarker in sepsis, where the stool sample provides a direct picture of the immunological
barrier dysfunction in the intestinal mucosa of septic patients. Objective To determine the relationship
between sIgA levels in feces with mortality outcomes and length of stay for sepsis in children. Methods
A quantitative study with a prospective cohort in pediatric patients aged 2 – 18 years old with a diagnosis
of sepsis in PICU Prof. Dr. R. D Kandou General Hospital, Manado. Bivariate analysis was performed to
determine the relationship between faecal sIgA levels with mortality and length of stay. Results There were
40 patients fulfilled the inclusion criteria aged 2 – 18 years old from March 2020 until May 2020, where 23
patients (57.5%) were females and 17 patients (42.5%) were males. There were 28 (70%) alive patients and
12 (30%) deceased patients. The mean level of sIgA in alive patients was 1962.93 µg/mL, and in deceased
patients was 198.67 µg/mL. Analysis of the relationship between fecal sIgA levels and mortality showed a
strong and significant relationship (rpb = -0.930; P <0.0001). Conclusion There is a significant relationship
between fecal sIgA levels and sepsis outcome in children with sepsis who are admitted to the PICU.
Keywords: secretory immunoglobulin A; sepsis; children

KONIKA XVIII Abstract Book 15