Risk Factors of Deaths among Dengue Shock Syndrome under National Disease Surveillance System, Thailand, 2003 – 2013

Abstract

From national disease surveillance system (R506) in Thailand from 2003-2013 AD., it revealed that death from Dengue Shock Syndrome (DSS) was higher the death from Dengue Fever (DF) and Dengue Haemorrhagic Fever (DHF). To study a possible of risk factor of deaths among DSS, a cross sectional study was conducted to compare factors that associated with death and survival groups among DSS reported in R506. The DSS cases from R506 between 2003 and 2013 were verified and analyzed by multivariate logistic regression for Adjusted Odds Ratio (OR) 95% confidence interval (CI). Results were found that age group older than 15 years old was associated with the deaths in DSS (Adjusted Odds Ratio 1.74, 95% CI=1.37-2.21) and having a residence in Bangkok was associated with the deaths in DSS (Adjusted Odds Ratio 4.87, 95% CI=3.33-7.11). Due to age group older than 15 years old were infected the second time (secondary infection). The risk of secondary infection were higher approximately 160 times. To reduce the mortality from DSS, during the rainy season, medical service should strengthen a screening process and follow up patients in an early stage of onset by checking blood examination more frequently to detect any changes of WBC, Hct and Plt level. All hospitals should strengthen a program of larvae and mosquitoes free zone as well as the area of houses and surrounding areas, especially in urban or slums in Bangkok.