Increased Carotid Intima-Media Thickness in Children with a History of Dengue Hemorrhagic Fever

Tom Versteege Julius Global Health/Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands;

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Mulya R. Karyanti Department of Pediatrics, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia;

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Witri Septiani Department of Pediatrics, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia;

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Annisa L. Widjanarko Department of Pediatrics, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia;

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Nikmah S. Idris Julius Global Health/Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands;
Department of Pediatrics, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia;

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Aryono Hendarto Department of Pediatrics, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia;

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Diederick E. Grobbee Julius Global Health/Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands;

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David Burgner Department of Pediatrics, University of Melbourne, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia;
Department of Pediatrics, Monash University, Victoria, Australia

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Cuno S. P. M. Uiterwaal Julius Global Health/Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands;

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Patricia C. J. L. Bruijning-Verhagen Julius Global Health/Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands;

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We assessed carotid intima-media thickness (cIMT) and arterial stiffness in 28 children and adolescents with previous dengue hemorrhagic fever (DHF) (mean interval between DHF and cardiovascular assessment, 8.4 years), and 34 controls in a low-resource setting. Participants with previous DHF had an adjusted increased cIMT of 42.6 µm (95% confidence interval [CI]: 10.0–75.3, P = 0.01), and 61.7 µm (95% CI: 21.5–102.0, P < 0.01) in a subgroup analysis on dengue shock syndrome. There were no differences in arterial stiffness. In this first exploratory study, children and adolescents with a history of DHF had an increased cIMT, which may be modulated by dengue severity.

Author Notes

Address correspondence to Tom Versteege, Julius Global Health/Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht 3508 GA, The Netherlands. E-mail: tom_versteege@hotmail.com

Disclaimer: T. V. reports grants from K. F. Hein Study Fund during the conduct of the study. M. K. reports grants from UMC Utrecht Developmental World Support grant during the conduct of the study. D. B. reports grants from National Health and Medical Research Council (Australia) during the conduct of the study.

Authors’ addresses: Tom Versteege, Diederick E. Grobbee, Cuno S. P. M. Uiterwaal, and Patricia C. J. L. Bruijning-Verhagen, Julius Global Health/Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands, E-mails: tom_versteege@hotmail.com, d.e.grobbee@umcutrecht.nl, cuiterwa@umcutrecht.nl, and p.bruijning@umcutrecht.nl. Mulya R. Karyanti, Witri Septiani, Annisa L. Widjanarko, and Aryono Hendarto, Department of Pediatrics, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia, E-mails: karyanti@doctor.com, septianiwitri@gmail.com, annisa.layalia@yahoo.com, and aryhendarto@yahoo.com. Nikmah S. Idris, Julius Global Health/Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands, and Department of Pediatrics, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia, E-mail: salamia.nikmah@gmail.com. David Burgner, Department of Pediatrics, University of Melbourne, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia, and Department of Pediatrics, Monash University, Victoria, Australia, E-mail: david.burgner@mcri.edu.au.

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