Epidemiological and Clinical Features of Dengue Infection in Adults in the 2017 Outbreak in Vietnam

Purpose. The clinical features and laboratory results of dengue-infected adult patients admitted to the hospital during the 2017 outbreak were analyzed in this study. Method. This is a cross-sectional study. 2922 patients aged 18 years or more with dengue fever in National Hospital for Tropical Diseases (NHTD) in the North and Hospital for Tropical Disease (HTD) in the South of Vietnam were recruited in this study. Result. Patients were admitted in the hospital around the year and concentrated from August to December, in 53/63 (84.0%) provinces in Vietnam, and patients in all ages were affected. The number of patients with dengue fever was 1675 (57.3%), dengue with warning signs 914 (31.3%), and severe dengue 333 (11.4%), respectively. Among patients with severe dengue, severe plasma leakage and dengue shock account for 238 (8.1%), severe organ impairment 73 (2.5%), and severe bleeding 22 (0.75%). The rate of mortality was 0.8%, and the outcome of dengue patients is worse in the elderly and people with underlying diseases. Conclusion. The 2017 dengue outbreak occurred in a larger scale than in the previous years in terms of time, location, and number of patients. More elderly patients were infected by dengue in this outbreak, and this may contribute to the mortality rate. Clinical manifestations of dengue patients in Southern Vietnam are more typical than the northern, but the rate of severe dengue is not different. The mortality risk and underlying conditions associated with dengue-infected elderly patients are worthy of further investigations in the future.

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Study of hepatic involvement in children with dengue infection

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20174650 ◽

2017 ◽

Vol 4 (6) ◽

pp. 2012

Author(s):

Hima Bindu Tirumani ◽

Vinay Kumar Bejugam ◽

Altaf Naseem ◽

Arshad Hussain ◽

. Nizarlalani

Keyword(s):

Dengue Fever ◽

Liver Dysfunction ◽

Dengue Infection ◽

Fold Increase ◽

Liver Function Tests ◽

Hepatic Function ◽

Warning Signs ◽

Severe Dengue ◽

Cross Sectional ◽

Hepatic Involvement

Background: Liver dysfunction in children is variable and depends on disease severity. This study was undertaken to identify the range of hepatic involvement in children with dengue infection.Methods: It is a cross sectional observational study conducted in serologically positive dengue fever in children aged between 1-14 years. Hepatic function was studied in all suspected cases over a period of 1 year from June 2015 to June 2016.Results: Out of 55 cases admitted, liver function tests showed AST levels elevated more than 45U/L in 20 (86.9%) DF, 29 (100%) DHF, 3 (100%) DSS patients. ALT levels were elevated more than 45U/L in 16 (69.5%) DF, 24 (82.75%) DHF, 3 (100%) DSS patients. More than 10 fold increase in levels of both AST and ALT was seen in severe dengue.Conclusions: Dengue infection is associated with variable levels of liver dysfunction. The incidence of hepatic dysfunction is more in patients with dengue fever with warning signs and severe dengue. Significant elevation of transaminase levels helps in predicting the occurrence of severe dengue. It is important to be aware of this entity which needs significant attention and management.

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Comparison of severity signs between patients with primary and secondary dengue infection during the 2016 Burkina Faso (West Africa) outbreak

10.21203/rs.3.rs-85397/v1 ◽

2020 ◽

Author(s):

Eric Arnaud Diendéré ◽

Apoline Kognimisson Sondo/Ouédraogo ◽

ismael Diallo ◽

Absetou Ky/Ba ◽

Toussaint Rouamba ◽

...

Keyword(s):

Burkina Faso ◽

Dengue Fever ◽

Univariate Analysis ◽

Dengue Infection ◽

Cross Sectional Study ◽

Severe Dengue ◽

Severe Bleeding ◽

Cross Sectional ◽

Binary Dependent Variable ◽

The Relationship

Abstract BackgroundThe factors that expose the severity of dengue are still controversial, particularly the relationship between severe dengue and secondary dengue. More importantly, the severity of dengue infection remains poorly studied in Africa. The objective of this study was to compare severity signs between patients with primary and secondary dengue infection during the 2016 dengue outbreak in Burkina Faso.MethodsThis was a cross-sectional study through a retrospective examination of patient medical records managed in Ouagadougou for dengue fever from 1 January 2015 to 31 December 2017. All health facilities with the capacity to perform dengue diagnosis in Ouagadougou were considered in the survey. Primary dengue was defined as the presence of AgNS1 and/or IgM and secondary dengue as the presence of IgG associated with one of these two markers. Patients with only IgG were excluded. Univariate and multivariable analyzes were performed using a logistic regression with dengue infection (primary or secondary dengue) as the binary dependent variable. The statistical significant level was set at 0.05.Results Of the 811 patients managed for dengue fever during the study period, 418 (51.5%) were male. Thirty-five patients (4.3%) had primary dengue infection (AgNS1 + and / or IgM + with negative IgG) and seven hundred seventy-six (776) patients (95.7%) had secondary dengue infection. 245 patients (30.2%) experienced severe signs. Renal failure (13.1%) was the main sign of severity, followed by severe bleeding (10.6%). In univariate analysis, severe bleeding were associated with primary dengue infection (OR = 2.65, 95%IC: 1.16 -6.03, p = 0.01). Twenty-four deaths (9.8%) were reported during the period. ConclusionSigns of gravity can occur during primary dengue fever. This study highlight the need to conduct more studies on the severity factors of dengue fever.

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Liver function tests to predict the severity of dengue fever in serologically positive children below 18 years of age

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20190069 ◽

2019 ◽

Vol 6 (2) ◽

pp. 358

Author(s):

Yashwanth Raju H. N. ◽

Rajendra Kumar ◽

Sudha Rudrappa

Keyword(s):

Serum Albumin ◽

Dengue Fever ◽

Hepatic Dysfunction ◽

Dengue Infection ◽

Liver Function Tests ◽

Relevant Information ◽

Warning Signs ◽

Severe Dengue ◽

Cross Sectional ◽

The Mean

Background: Dengue fever presents with a diverse clinical spectrum. Although liver is not a major target organ, hepatic dysfunction is a well-recognized feature. In this study authors attempted to study the pattern of hepatic involvement in children with dengue and its association with disease severity.Methods: This was a cross sectional study conducted at Cheluvamba hospital during the period of 1 year. Children <18 years of age with dengue Ns1 Ag and IgM positive were included in this study. After obtaining informed consent, a pre-structured proforma was used to record the relevant information from each subject. After detailed clinical examination and haematological investigation children were categorized into three groups as dengue fever with no warning signs (DNWS), dengue fever with warning signs (DWWS) and severe dengue fever (SDF) according to WHO classification. Statistical analysis was done to know the strength of association between different clinical and biochemical variables and outcome of the disease.Results: The mean age of the study population was 8.65 years with male preponderance. The mean total bilirubin, serum albumin, SGOT, SGPT, ALP, PT and INR were 0.76 mg/dl, 3.8g/dl, 233.18U/L, 118.15U/L, 200.65 U/L, 12.9s and 1.09 respectively. The mean SGOT was significantly higher than SGPT. The degree of deranged LFTs was significantly more in SDF group than DNWS and DWWS groups. Serum albumin was significantly decreased in children with SDF group correlating with disease severity, prognosis and outcome.Conclusions: Hepatic dysfunction was present in all forms of dengue infection, with SGOT rising significantly more than SGPT. All biochemical liver parameters were significantly deranged in patients with severe dengue fever indicating prolonged illness and poor prognosis.

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FACTORS PREDICTING SEVERITY OF ILLNESS IN DENGUE FEVER: AN OBSERVATIONAL STUDY

10.36106/ijsr/9031591 ◽

2021 ◽

pp. 54-55

Author(s):

Abhay John Gray ◽

Sheela Mathew ◽

Gayathri R ◽

Akhila Arya ◽

Aswathy MA ◽

...

Keyword(s):

Dengue Fever ◽

Ldl Cholesterol ◽

Severe Disease ◽

Dengue Infection ◽

Clinical Manifestations ◽

Severity Of Illness ◽

Warning Signs ◽

Severe Dengue ◽

Detailed History ◽

Dengue With Warning Signs

Introduction: Dengue is a systemic viral infection caused by the virus from genus Flaviviridae. Dengue infection has got a wide clinical spectrum that includes both severe and non-severe clinical manifestations. The group progressing from non-severe to severe disease is difcult to dene. Early detection and access to proper medical care signicantly lower fatality rates and would help to reduce the burden of hospital stay and economy loss. Objectives: To study the inammatory markers predicting the severity of dengue infection. Methods: 250 diagnosed patients were evaluated with detailed history, physical examination and blood investigations. Inammatory markers associated with severity of dengue were studied. Observations and conclusions- 97 patients (39%) had dengue without warning signs, 62(25%) had dengue with warning signs, 63(25%) had severe dengue and 28(11%) had expanded dengue. Low CRP, ESR, HDL and LDL cholesterol were observed in dengue fever, without any statistical signicance. Ferritin levels more than 1000 and triglyceride more than 200 was signicantly associated with severity of dengue.

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The changing clinico-demographic profile of dengue infection in children: a hospital-based study from eastern India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20202003 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1901

Author(s):

Radheshyam Purkait ◽

Rajarshi Basu

Keyword(s):

Dengue Fever ◽

Dengue Infection ◽

Tertiary Care ◽

Clinical Manifestations ◽

Warning Signs ◽

Severe Dengue ◽

Eastern India ◽

Female Ratio ◽

Male Female Ratio ◽

Study Population

Background: Many parts of India, including the eastern regions, are now endemic for the dengue infection with increased recognition of atypical neurological manifestations apart from the classical clinical features.Methods: This prospective study was conducted in the department of paediatrics in a tertiary care teaching hospital in eastern India from July 2019 to November 2019 to determine the changing trends of the clinical features in the dengue patients of this region in the recent years among paediatric populations. All the serologically confirmed dengue patients admitted during this period satisfying the inclusion criteria were enrolled in the study population and classified as per new WHO-2009 classification into: dengue fever without warning signs (DF), dengue fever with warning signs (DFWS) and severe dengue (SD). Detailed history, clinical and laboratory parameters were recorded and analysed for all children.Results: Out of the total of 110 cases, 16 cases (14.55%) were DF, 80 cases (72.73%) were DFWS and 14 cases (12.73%) were SD. The commonest age group affected (63.64 %) was between 4-<10 years. The male: female ratio of cases was 1.68:1. Besides classical clinical manifestations, we observed CNS involvement in nine cases (8.18%). Among them, five patients had dengue encephalitis, two patients had dengue encephalopathy, one patient had hypokalemic paralysis and one patient had Guillain-Barré syndrome. All the patients were treated as per standard guidelines.Conclusions: Clinician must be aware of such association during dengue outbreak because early diagnosis and appropriate supportive care can reverse this potentially fatal disease.

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Comparison of severity signs between patients with primary and secondary dengue infection during the 2016 Burkina Faso (West Africa) outbreak.

10.21203/rs.3.rs-111786/v1 ◽

2020 ◽

Author(s):

Eric Arnaud Diendéré ◽

Apoline Kognimisson Sondo/Ouédraogo ◽

ismael Diallo ◽

Absetou Ky/Ba ◽

Toussaint Rouamba ◽

...

Keyword(s):

Burkina Faso ◽

Dengue Fever ◽

Univariate Analysis ◽

Dengue Infection ◽

Cross Sectional Study ◽

Severe Dengue ◽

Severe Bleeding ◽

Cross Sectional ◽

Binary Dependent Variable ◽

The Relationship

Abstract Background The factors that expose the severity of dengue are still controversial, particularly the relationship between severe dengue and secondary dengue. More importantly, the severity of dengue infection remains poorly studied in Africa. The objective of this study was to compare severity signs between patients with primary and secondary dengue infection during the 2016 dengue outbreak in Burkina Faso.Methods This was a cross-sectional study through a retrospective examination of patient medical records managed in Ouagadougou for dengue fever from 1 January 2015 to 31 December 2017. All health facilities with the capacity to perform dengue diagnosis in Ouagadougou were considered in the survey. Primary dengue was defined as the presence of AgNS1 and/or IgM and secondary dengue as the presence of IgG associated with one of these two markers. Patients with only IgG were excluded. Univariate and multivariable analyzes were performed using a logistic regression with dengue infection (primary or secondary dengue) as the binary dependent variable. The statistical significant level was set at 0.05.Results Of the 811 patients managed for dengue fever during the study period, 418 (51.5%) were male. Thirty-five patients (4.3%) had primary dengue infection (AgNS1 + and / or IgM + with negative IgG) and seven hundred seventy-six (776) patients (95.7%) had secondary dengue infection. 245 patients (30.2%) experienced severe signs. Renal failure (13.1%) was the main sign of severity, followed by severe bleeding (10.6%). In univariate analysis, severe bleeding were associated with primary dengue infection (OR = 2.65, 95%IC: 1.16 -6.03, p = 0.01). Twenty-four deaths (9.8%) were reported during the period. Conclusion Signs of gravity can occur during primary dengue fever. This study highlight the need to conduct more studies on the severity factors of dengue fever.

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Increased levels of pentraxins protein and cytokines bear good association in patients with severe dengue infection

Scientific Reports ◽

10.1038/s41598-020-80144-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Goutam Patra ◽

Bibhuti Saha ◽

Sumi Mukhopadhyay

Keyword(s):

Dengue Infection ◽

Clinical Manifestations ◽

Blood Parameters ◽

Warning Signs ◽

Severe Dengue ◽

Disease Manifestation ◽

Mild Disease ◽

Tnf Α ◽

The Status ◽

The Tropics

AbstractDengue is an arboviral infection with high rates of morbidity and mortality throughout the tropics and sub-tropics. This work studied the status of pentraxin (CRP/SAP) protein, ferritin, TNF-α and IL-1β levels in Dengue patients of different pathophysiological manifestations. Accordingly, clinically confirmed Dengue cases (n = 97) were enrolled and subsequently blood parameters were studied by Haematology cell counter and Biochemistry Autoanalyser. CRP, SAP, ferritin, TNF-α and IL-1β ELISA were done in all the samples by using standard ELISA kits. Statistical Analysis was done in all the experiments. The levels of CRP (p < 0.0001), SAP (p < 0.0001), ferritin (p < 0.0001), TNF-α (p < 0.0001) and IL-1β (p < 0.0001) were high in patients with Severe Dengue as compared to Dengue without warning signs. High levels of SGOT, SGPT and decreased platelet counts were found in severe patients as compared to Healthy donor. CRP/SAP as well as TNF-α/IL-1β were independently associated with both dengue severity and overall disease manifestation. Statistically significant increased CRP, SAP, ferritin, TNF-α and IL-1β titres were correlated in patients with severe clinical manifestations as compared to mild disease forms of dengue. Elevated levels of pentraxin, TNF-α/IL-1β in blood during dengue infection could act as an early predictor in Severe Dengue infection.

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Clinical profile of dengue fever in children: analysis of 2017 outbreak from Central Kerala, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20184293 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2265 ◽

Cited By ~ 1

Author(s):

Senthil Kumar K. ◽

Rajendran N. K. ◽

Ajith Brabhukumar C.

Keyword(s):

Dengue Fever ◽

Dengue Infection ◽

Tertiary Care ◽

Hemorrhagic Fever ◽

Warning Signs ◽

Clinical Profile ◽

Severe Dengue ◽

High Morbidity ◽

Care Hospital ◽

High Grade Fever

Background: In India, dengue epidemics are becoming more frequent (WHO, 2008). The majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality. The objective of this study is to assess the clinical profile of the dengue infection in children less than 15 years of age and to evaluate the outcomes of dengue fever from March 2017 to July 2017 at the Pediatric Department of Karuna Medical College, the tertiary care hospital in Palakkad.Methods: In this retrospective study, medical records were reviewed and analyzed. Patients with suspected dengue infection were classified further into 2 groups, Dengue fever (probable dengue, dengue with warning signs) and ‘Severe Dengue’ (dengue hemorrhagic fever and/or dengue shock syndrome (DHF/DSS) according to WHO.Results: A total of 77 cases were classified into 67 (87%) non-severe and 10 (13%) severe dengue cases. The most common age of presentation was above 10 yrs. The mean age of admission was 8.9 yrs. The most common presenting symptom was fever seen in 93% followed by vomiting in 68%. Elevation in Aspartate transaminase (SGOT) and thrombocytopenia were found in 32.4 %.Conclusions: High grade fever, vomiting, abdominal pain and skin rash with normal or low platelet count were the presenting features. Early diagnosis, monitoring and prompt supportive management can reduce mortality.

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Retrospective study of clinical profile and outcome of pediatric dengue cases in a teaching hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20164609 ◽

2016 ◽

Vol 4 (1) ◽

pp. 226

Author(s):

Alok Kumar M. K. ◽

Timmangouda R. Patil ◽

Santhosh Veerabadhraiah

Keyword(s):

Retrospective Study ◽

Respiratory Distress ◽

Dengue Fever ◽

Clinical Symptoms ◽

Fluid Management ◽

Clinical Manifestations ◽

Warning Signs ◽

Severe Dengue ◽

Study Results ◽

Wide Range

Background: Dengue fever is an acute febrile illness caused by 4 closely related viral serotypes of the genus Flavivirus. Dengue has a broad range of clinical manifestations and often with unpredictable clinical evaluation and outcome. So this study has been done to see the wide range of clinical presentation of dengue and its outcome.Methods: It is a retrospective study done in tertiary hospital during the period of 8 months. Study was done by collecting the previous records from hospital record section. There were 48 cases of serologically confirmed cases of dengue which satisfied the inclusion and exclusion criteria were included in the study. Results: In our study there were 52% of the cases of dengue fever, 16.6% of cases were dengue fever with warning signs and remaining 31.4% of patients were severe dengue. Common Clinical symptoms at admission were fever (100%), vomiting (77%), respiratory distress (56.25%), generalised weakness (54.1%) and pain abdomen (33.3%). Less common symptoms were loose stools (6.25%), periorbital puffiness (6.25%), altered sensorium (4.1%), oliguria (2%) and bleeding manifestations (2%). Out of these dengue children 70.8% of these children improved without complication, 20.8 % of children improved with complication, in the form of ARDS, acute liver failure, DSS, meningitis, 6.25 % of these children went DAMA and 2 % of children expired.Conclusions: In our study atypical presentations like respiratory distress, loose stools meningitis were commonly noted and bleeding manifestation at admission was rare in our study. Platelet transfusions have little role in management of dengue patients. Early diagnosis, careful monitoring and proper fluid management goes a long way in reducing the mortality due to dengue hemorrhagic fever and shock syndrome.

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Serum sodium level in dengue infected children: a retrospective study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20183509 ◽

2018 ◽

Vol 5 (5) ◽

pp. 1801

Author(s):

Reshma Raj ◽

Rashmi Alva

Keyword(s):

Dengue Fever ◽

Serum Sodium ◽

Sodium Level ◽

Serum Sodium Level ◽

Tertiary Care ◽

Clinical Manifestations ◽

Warning Signs ◽

Severe Dengue ◽

Dengue With Warning Signs ◽

Group B

Background: Dengue fever is one of the most common arbo virus mediated outbreaks, being reported from different parts of the world. Now as the outbreaks are hitting different geographic locations, different clinical manifestations are being reported recently. Aim of this study is to document the serum Sodium level in dengue infected children in a tertiary care centre.Methods: A total 128 cases of NS1 antigen, IgM positive or ELISA positive dengue patients were included in this observational study and analyzed.Results: The serum Sodium level in dengue varies according to the different groups. In group A (dengue with no warning signs) the serum Sodium level was normal, whereas in case of group B (dengue with warning signs), there was significant hyponatremia. In group C, severe dengue the serum Sodium was normalConclusions: Mild hyponatremia is a common electrolyte disturbance in patients with dengue with warning signs. Hence, the lower the serum Sodium levels the higher is the incidence of complications associated with dengue fever.

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