DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20203169

Clinical and laboratory profile of dengue fever in children in a tertiary care hospital of Navi Mumbai, India

Minakshi Bhat, Anjali Otiv

Abstract


Background: Dengue fever is a mosquito born arboviral illness endemic in tropical countries and causes significant mortality and morbidity due to lack of definitive treatment. The objective of this study was to assess the clinical and laboratory profile of confirmed cases of dengue in children up to 12 years of age and also to charactrise the risk factors for severe dengue.

Methods: This is a descriptive, observational, retrospective study done in the Department of Pediatrics, Terna Medical College, Nerul, Navi Mumbai, India.   Medical records of all children up to 12 years of age diagnosed to have dengue   were reviewed.  Their clinical and laboratory profile were recorded in a pro forma and analyzed. All cases were classified as per WHO guidelines into non severe and severe dengue cases.

Results: Among the 117 confirmed dengue cases, (84.6%) had non severe dengue and (15.4%) had severe dengue. The most common age group affected was 9-12 years (45.3%) with a male to female ratio of 2.4:1. Fever was the most common clinical feature seen in all cases followed by headache (83%), myalgia (81%), ascites (24.7%), vomiting (17.9%). Clinical signs of ascitis, hepatomegally, gastrointestinal bleeding, pleural effusion and shock were predominantly associated with severe dengue cases. Laboratory parameters showed leukopenia in 58.1% and thrombocytopenia (platelet counts <20,000/cumm3) in16.2% cases. Elevated liver enzymes, raised hematocrit (36.3%) and coagulation abnormalities were seen in over 50% dengue cases and were significantly associated with severe dengue dengue.

Conclusions: Knowledge of clinical   and laboratory profile of dengue cases of a particular area will help in early prediction of risk factors for severe dengue resulting in favourable outcome of such cases.


Keywords


Clinical profile, Hematocrit, Hepatomegaly, Thrombocytopenia

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References


WHO, dengue and dengue haemorrhagic fever, Factsheet no. 117, World Health Organization, Geneva, Switzerland, 2008. Available at: http://www.who.int/mediacentre/factsheets/fs117/e/.

CDC. Imported dengue - United States, 1997 and 1998. Morb Mortal Wkly Rep. 2000;49(12):248-53.

Gupta N, Srivastava S, Jain A, Chaturvedi UC. Dengue in India. Indian J Med Res. 2012;136(3):373-90.

Suzzane MS. Dengue. Medscape. Retrieved 4/10/2014. Availabe at: http://emedicine.medscape.com/ article/215840. Accessed on 14 March 2014.

Low JGH, Ong A, Tan LK, Chaterji S, Chow A, Lim WY, et al. The early clinical features of dengue in adults: challenges for early clinical diagnosis. PLoS Negl Trop Dis. 2011;5(5):e1191.

Biswas HH, Ortega O, Gordon A, Standish K, Balmaseda A, Kuan G, et al. Early clinical features of dengue virus infection in nicaraguan children: a longitudinal analysis. PLoS Negl Trop Dis. 2012;6(3):e1562.

Wakimoto MD, Camacho LAB, Gonin ML, Brasil P. Clinical and Laboratory Factors Associated with Severe Dengue: A Case-Control Study of Hospitalized Children. J Trop Pediatr. 2018;64(5):373-81.

Kleinman ME, Chameides L, Schexnayder SM, Samson RA, Hazinski MF, Atkins DL, et al. Part 14: Pediatric advanced life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):S876-908.

WHO. Dengue Guidelines for Diagnosis, Treatment, Prevention and Control. WHO; 2009. Available at: http://whqlibdoc.who.int/ publications/2009/9789241547871_eng.pdf. Accessed on July 2012.

World Health Organization. WHO report on global surveillance of Epidemic prone infectious diseases. Available at: http://apps.who.int/iris/bitstream/10665/66485/1/WHO_CDS_CSR_ISR_2000.1.pdf.

Kumar SK, Rajendran NK, Brabhukumar AC. Clinical profile of dengue fever in children: analysis of 2017 outbreak from central Kerala. Int J Contemp Pediatr. 2018;5:2265-9.

Chandralekha, Gupta P, Trikha A. The north Indian dengue outbreak 2006: a retrospective analysis of intensive care units admissions in a tertiary care hospital. Trans R Soc Trop Med Hyg. 2008;102:143-7.

Basuki PS, Puspitasari BD, Husada D, Darmowandowo W, Soegijanto S, Yamanaka A. Application of revised dengue classification criteria as a severity marker of dengue viral infection in Indonesia. Southeast Asian J Trop Med Public Health. 2010;41(5):1088-94.

Ahmed S, Arif F, Yahya Y, Rehman A, Abbas K, Ashraf S et al. Dengue fever outbreak in Karachi 2006-a study of profile and outcome of children under 15 years of age. J Pakistan Med Asso. 2008;58(1):4-8.

Pongpan S, Wisitwong A, Tawichasri C, Patumanond J. Prognostic indicators for dengue infection severity. Int J Clin Pediatr. 2013;2:12-8.

Azin FR, Goncalves RP, Pitombeira MH, Lima DM, Branco IC. Dengue: profile of hematological and biochemical dynamics. Rev Bras Hematol Hemoter. 2012;34:36-41.

Yacoub S, Wills B. Predicting outcome for dengue. BMC Med. 2014;12:147.

Gomber S. Hematological observations as diagnostic markers in dengue hemorrhagic fever. Indian Pediatr. 2001;38:477-81.

Sharma NL, Balasubramanyam V, Kandati J, Ponugoti M. Clinical and laboratory profile of dengue fever in children during an outbreak - one year study at tertiary care hospital, Chennai, Tamilnadu, India. Int J Contemp Pediatr. 2017;4:110-5.

Nagaram PP, Pidugu P, Munagala VK, Matli VV. Clinical and laboratory profile and outcome of dengue cases among children attending a tertiary care hospital of South India. Int J Contemp Pediatr. 2017;4:1074-80.

Mairuhu ATA. Coagulation abnormalities in dengue virus infections: more common than currently received. Report of a Collaborative Study. 2010;28(2):107-10.

Joshi R, Baid V. Profile of dengue patients admitted to a tertiary care hospital in Mumbai. Turkish J Pediatr. 2011;53(6):626-31.

Pushpa V, Venkatadesikalu M, Mohan S, Cherian T, John TJ, Ponnuraj EM. An epidemic of dengue haemorrhagic fever/dengue shock syndrome in tropical India. Ann Trop Pediatr. 1998;18:289-93.