Changing trends in clinicopathological parameters in dengue with evaluation of predictors of poor outcome in children

Authors

  • Smita Ramachandran Department of Pediatrics, Safdarjung Hospital, Mahatma Gandhi Marg, Ansari Nagar West, New Delhi
  • Akriti Gera Department of Pediatrics, Safdarjung Hospital, Mahatma Gandhi Marg, Ansari Nagar West, New Delhi
  • Murtaza Kamal Department of Pediatrics, Safdarjung Hospital, Mahatma Gandhi Marg, Ansari Nagar West, New Delhi
  • Rani Gera Department of Pediatrics, Safdarjung Hospital, Mahatma Gandhi Marg, Ansari Nagar West, New Delhi
  • Manas Pratim Roy Public Health Specialist, Safdarjung Hospital, Mahatma Gandhi Marg, Ansari Nagar West, New Delhi

DOI:

https://doi.org/10.18203/2349-3291.ijcp20163688

Keywords:

Changing trends dengue, Clinicopathological parameters, Pediatrics, Prognostic factors, Poor outcomes

Abstract

Background:A study was planned to evaluate the changing trends in dengue according to the revised WHO guidelines in children and at identifying and evaluating the association between clinical features the child and the outcome.

Methods: This was a retrospective observational study conducted in Safdarjung Hospital. Children with signs and symptoms of dengue fever along with serological or antigen NS1 positivity were included. Continuous variables were analysed using percentage, mean, standard deviation. Categorical variables were analysed using chi-square test. P value < 0.05 was considered significant.

Results:A total number of 69 patients of dengue were included. The mean age of presentation was 7.1±3 years. All patients with mucosal bleeds had thrombocytopenia which was statistically significant (p<0.002). There was a significant correlation (p < 0.000) between presence of more than three warning signs and prolonged hospital stay (>5 days) (p < 0.000) and progression to shock.

Conclusions:Lethargy, presence of more than 3 warning signs at the time of presentation can be used as predictors of severe dengue.  

References

World Health Organisation and Tropical Diseases Research. Dengue: Guidelines for diagnosis, treatment, prevention and control. Geneva: World Health Organisation; 2009.

World Health Organisation. First report on neglected tropical diseases: working to overcome the global impact of neglected tropical diseases. Geneva: World Health Organisation. 2010.

World Health Organisation. Global strategy for dengue prevention and cure-2012-2020. Geneva: World Health Organisation. 2012.

Suaya JA, Shepard DS, Siqueira JB, Martelli CT, Lum LCS, Tan LH, et al. Cost of dengue cases in eight countries in the Americas and Asia: a prospective study. Am J Tropical Med Hygiene. 2009;80:846-55.

World Health Organisation and Tropical Diseases Research. Handbook for clinical management of dengue. Geneva: World Health Organisation. 2012.

World Health Organization. Geneva, Switzerland: WHO. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. 2009.

Sahana KS, Sujatha R. Clinical profile of dengue among children according to revised who classification: analysis of a 2012 outbreak from southern India. Indian J Pediatr. 2015;82(2):109-13.

Mittal H, Faridi MMA, Arora SK, Patil R. Clinico hematological profile and platelet trends in children with dengue during 2010 epidemic in north India. Indian J Pediatr. 2012;79(4):467-71.

Ahmed S, Arif F, Yahya Y. Dengue fever outbreak in Karachi 2006- a study of profile and outcome of children under 15 years of age. J Pak Med Assoc. 2008;58:4-8.

Aggrawal A, Chandra J, Aneja S, Patwari A, Dutta A. An epidemic of dengue haemorrhagic fever and dengue shock syndrome in children in Delhi. Indian Pediatr. 1998;35:727-32.

Joshi R, Baid V. Profile of dengue patients admitted to a teritiary care hospital in Mumbai. Turk J Pediatr. 2011;53:626-31.

Poovorawan Y, Chongsrisawat V, Shafi F, Boudville I, Liu Y, Hutagalung Y, Bock HL. Acute hepatic failure among hospitalized Thai children. Southeast Asian J Trop Med Public Health. 2013;44:50-3.

Deepak NA, Patel ND. Differential diagnosis of acute liver failure in India. Ann Hepatol. 2006;5:150-6.

Giri S, Agarwal MP, Sharma V, Singh A. Acute hepatic failure due to dengue: a case report. Cases J. 2008;1:204.

Karoli R, Fatima J, Siddiqi Z, Kazmi KI, Sultania AR. Clinical profile of dengue infection at a teaching hospital in North India. J Infect Dev Ctries. 2012;6:551-4.

Thao TT, Hien TT, Hung NT, Vinh NN, Hien PT, Chinh NT, Simmons C, Wills B. Liver involvement associated with dengue infection in adults in Vietnam. Am J Trop Med Hyg. 2010;83:774-80.

Samanta J, Sharma V. Dengue and its effects on liver. World J Clinical Cases. 2015;3(2):125.

Shah I, Deshpande GC, Tardeja PN. Outbreak of dengue in Mumbai and predictive markers for dengue shock syndrome. J Trop Pediatr. 2004;50(5):301-5.

Prasad D, Kumar C, Jain A, Kumar R. Accuracy and applicability of revised WHO classification (2009) of dengue in children seen at a teritiary healthcare facility in northern India. Infection. 2013;41:775-82.

Sharma P, Kumar CM, Patwari AK. Clinical profile of early diagnosed dengue fever in hospitalized children in south Delhi. Indian J Pediatr. 2014;81(9):975.

Downloads

Published

2016-12-22

Issue

Section

Original Research Articles