Clinicolaboratory profile and outcome of dengue fever cases in peak season of an academic year among pediatric population admitted to teaching hospital, Bangalore, Karnataka, India
Keywords:Mortality, Dengue fever, Thrombocytopenia
Background: Dengue is a vector borne diseases with varied clinical manifestations, a major concern to public health globally. This study was done to describe the salient clinical as well as haematological profile of serologically confirmed cases of dengue fever and outcome in admitted cases.
Methods: This was a prospective study conducted at major Government teaching Hospitals in Bangalore from July 2019 to December 2019. Total 164 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire format. Haematological parameters on admission, duration of stay and outcomes were analysed. The outcomes of the cases were mentioned as improved and death.
Results: In this study commonly affected age band was adolescents group (36.6%) without any sex predilection. Maximum number of dengue cases were presented with warning signs (87.5%), 14 (8.69%) cases without warning signs and 6 (3.72%) with severe dengue. Fever was the most common symptom (100%), followed by vomiting (58%) and abdominal pain (38.5%). NS1 antigen positive cases (61.5%). Severe Leukopenia was present in 57% of cases and Thrombocytopenia in all admitted patients (100%). Most of the cases were treated with antipyretics, oral fluids (46%) and IV fluids (53%), only single case received platelet transfusion. Duration of stay was more in severe dengue cases. Mortality of our study was 1.8%.
Conclusions: Dengue presents with varied clinical features. Community awareness, early diagnosis and management and vector control measures needs to be strengthened in order to reduce the increasing number of dengue case. Both clinical, haematological parameters should be monitored for better outcome.
Special programme for research, training in tropical diseases, and World Health Organization, dengue: guidelines for diagnosis, treatment, prevention and control, World Health Organization, Geneva, Switzerland; 2009.
World Health Organization. National guidelines for clinical management of dengue fever. India: World Health Organization. 2015.
WHO. Dengue and dengue haemorrhagic fever. Factsheet No 117, revised May 2008. Geneva, World Health Organization, 2008. Available at: http://www.who.int/mediacentre/factsheets/fs117/e n/. Accessed on June 9 2020.
Srivastava VK, Suri S, Bhasin A, Srivastava L, Bharadwaj M. An epidemic of dengue hemorrhagic fever and dengue shock syndrome in Delhi: a clinical study. Ann Trop Pediatr. 1990;10:329-34.
Mishra S, Ramanathan R, Agarwalla SK. Clinical profile of dengue fever in children: a study from Southern Odisha, India. Scientifica. 2016;2016.
Subbalaxmi MV, Kumar GV, Ramanjaneyulu KH, Kapoor A, Teja VD, Lakshmi V. Clinical, laboratory profile and outcome of dengue fever at a south Indian tertiary care hospital. J Clin Sci Res. 2017;6(3):160.
Badaam KM. Clinical Profile and Outcome of Dengue Fever from a Tertiary Care Centre at Aurangabad Maharashtra India: An Observational Study.
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. 2016;4(1):110-5.
Rabbani MU, Aslam M, Zaheer MS, Ashraf MU. Clinical and laboratory profile of dengue fever in a North Indian tertiary hospital. J Association Physicians India. 2018;66:37.
Lovera D, Araya S, Mesquita MJ, Avalos C, Ledesma S, Arbo A. Prospective applicability study of the new dengue classification system for clinical management in children. The Pediatric Infectious Disease J. 2014;33(9):933-5.
Mittal HM, Faridi MA, Arora SK, Patil R. Clinicohematological profile and platelet trends in children with dengue during 2010 epidemic in North India. Indian J Pediatr. 2012;79(4):467-71.
Chacko B, Subramanian G. Clinical, laboratory and radiological parameters in children with dengue fever and predictive factors for dengue shock syndrome. J Tropical Pediatrics. 2008;54(2):137-40.
Joshi R, Baid V. Profile of dengue patients admitted to a tertiary care hospital in Mumbai. Turkish J Pediatr. 2011;53(6):626-31.
Ashis SK, Shibendu G. Clinico-pathological profile in the infants and children in dengue 2012 epidemic, Kolkata. Intern J Med Res Health Sci. 2014;3(1):59-64.
Padyana M, Karanth S, Vaidya S, Gopaldas JA. Clinical profile and outcome of dengue fever in multidisciplinary intensive care unit of a tertiary level hospital in India. Indian J Critical Care Med. 2019;23(6):270.
Aggarwal A, Chandra J, Aneja S, Patwari AK, Dutta AK. An epidemic of dengue hemorrhagic fever and dengu shock syndrome in children in Delhi. Indian pediatrics. 1998;35:727-32.
Hung NT. Fluid management for dengue in children. Paediatrics and international child health. 2012;32(sup1):39-42.
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 Pedia. 2015;82(2):109-13.
Halstead SB. Pathophysiology and pathogenesis of dengue haemorrhagic fever. In: Thongchareon P, ed. Monograph on dengue/dengue haemorrhagic fever. New Delhi, World Health Organization, Regional Office for South-East Asia. 1993:80-103.
World Health Organization. Handbook for clinical management of dengue. Geneva: WHO; 2012.
World Health Organization. Dengue, guidelines for diagnosis, treatment, prevention and control. Geneva: WHO; c2013. Accessed 14Aug 2012.