Serum zinc levels and clinical severity of dengue infection in children

Abstract

Background Immunopathogenesis of dengue infection reveals the aberrant immune response. Zinc deficiency alters immune response and therefore may associated with clinical severity of dengue infection. Objective To indentifY the relationship between serum zinc levels and clinical severity of dengue infection in children. Methods A comparative study was conducted at the Department of Child Health Hasan Sadikin Hospital Bandung, from February to March 2007. We included children aged ~ 14 years fulfilled the clinical criteria for dengue fever (OF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS) according to WHO (1997), confirmed with serologic test. Subjects were selected consecutively until met the sample size for each group. Serum zinc level were measured with atomic absorption spectroscopy (MS) on admission. Data were analyzed using Kruskal-Wallis and Pearson chi square test. Significance was considered if P<0.05. Results The serum zinc levels were low in 47 (78.3%) children. The serum zinc level in OF, DHF, and DSS subjects were 56-81 (X ±SO= 68.2±8.3) J.Lg/dL; 50-77 (X± SO = 61.6 ± 8. 7) J.Lg/dL; and35-52 (X± SO= 42.7 ± 5.4) j.tg/dL, respectively (P<0.001). The prevalence ratio ofDF to DHF and DHF to DSS were 1.444 (P=0.311) and 3.353 (P=0.077), respectively. Conclusion Low serum zinc level were significantly different in each clinical severity of dengue infection. However, low serum zinc level was not a risk factor for the development of severe dengue infection in children.

Keywords

• serum zinc levels
• dengue infection
• clinical severity