Karakteristik Klinis dan Virologis Penderita Demam Berdarah Dengue di Kota Bandar Lampung
Clinical and Virological Characteristics of Dengue Patients in Bandar Lampung City
Abstract
Abstract. Clinical symptoms of dengue virus (DENV) infection range from asymptomatic mild dengue fever (DF), more severe dengue hemorrhagic fever (DHF) up to dengue shock syndrome. One of the determinants of dengue infection severity was virus virulence. This study aimed to determine the clinical and virological characteristics of dengue virus infection patients based on the severity degree. A cross-sectional study was conducted in RSUD Dr. H. Abdul Moeloek, Lampung Province between July-November 2016 with 56 dengue patients as samples selected using purposive sampling. The serological test was done using a rapid diagnostic test. Blood samples for DENV serotype identification were examined using reverse-transcription polymerase chain reaction. Classification of DENV infection severity was obtained from the patient’s medical record. The results showed that the most common clinical manifestations were fever, headache, and retroorbital pain, appearing in all patients from every degree of severity. There were Grade I DHF patients who experienced Myalgia (15.6%) and petechiae (22.2%). Laboratory results showed that thrombocytopenia appeared in every grade, even though 13.3% of grade I patients did not experience it. Secondary infection was found in 92.9% of samples, and all DENV serotype can be detected in 39.2%samples: DENV-1 (46.7%), DENV-2 (6.7%), DENV-3 (26.7%), and DENV-4 (20%). This study concluded that the majority of clinical characteristics in DHF patients are in line with the degree of severity, with the bleeding as the dominant manifestation in patients with grade II-IV. Virological characteristics of DENV-1 are dominant in all patients with DHF grade I-IV.
Abstrak. Manifestasi klinis infeksi virus dengue (DENV) dapat berupa demam dengue (DD), hingga demam berdarah dengue (DBD) dan sindrom syok dengue (DSS). Salah satu determinan keparahan dengue adalah oleh virulensi virus. Tujuan dari penelitian ini adalah untuk menentukan karakteristik klinis dan virologis penderita DBD berdasarkan derajat keparahan. Penelitian deskriptif berbasis rumah sakit dilakukan di RSUD Dr. H. Abdul Moeloek Provinsi Lampung dengan rancangan studi cross sectional. Sampel sebanyak 56 dipilih dari penderita DBD secara purposive pada bulan Juli-November 2016. Uji serologis menggunakan rapid diagnostic test (RDT). Sampel darah diambil untuk penentuan serotipe dengue dengan teknik reverse transcription polymerase chain reaction (RT-PCR). Derajat keparahan infeksi virus dengue diperoleh dari penelusuran rekam medis. Hasil penelitian menunjukkan bahwa manifestasi klinis yang paling sering ditemukan adalah demam, sakit kepala dan nyeri retro-orbital, yang muncul pada semua penderita mulai derajat keparahan DBD. Penderita grade I yang mengalami Myalgia (15,6%) dan Petechiae (22,2%). Hasil uji laboratorium memperlihatkan trombositopenia pada semua derajat keparahan (I-IV), meskipun 13,3% pasien grade I tidak mengalaminya. Infeksi sekunder ditemukan sebanyak pada 92,9% sampel. Semua serotipe virus dengue terdeteksi pada 22 sampel (39,2%), yaitu DENV-1 (46,7%), DENV-2 (6,7%), DENV-3 (26,7%), dan DENV-4 (20%). Simpulan dari penelitian ini adalah bahwa karakteristik klinis mayoritas pada penderita DBD sesuai dengan derajat keparahannya dengan manifestasi berupa perdarahan dominan pada penderita grade II-IV. Karakteristik virologis DENV-1 dominan pada seluruh penderita DBD grade I-IV.
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