scholarly journals Clinico-epidemiological profile of paediatric dengue patients in a tertiary care hospital: a retrospective study in Visakhapatnam, Andhra Pradesh, India

Author(s):  
Chilakala Padmavathy ◽  
B. Devi Madhavi ◽  
S. Suneetha ◽  
Suresh Babu Chaduvula

Background: Dengue is a mosquito borne viral disease in the world with unpredictable clinical course and outcome. Though it is self-limiting in most of patients, the dengue hemorrhagic stage and dengue shock syndrome are life threatening.Methods: It is a retrospective cross-sectional observational record-based study conducted in King George Hospital in Andhra Medical College, Visakhapatnam, AP, India. Upon clinical suspicion, Dengue fever was confirmed by NS 1 antigen and/or Dengue antibody IgM, IgG in KGH laboratory in patients who were admitted in the hospital data was collected from records after ethical committee approval. Data of pediatric dengue positive cases in the age group ranging between 0-14 years from January 2018 - November 2018 were reviewed.Results: In this study the highest percentage of age group was found between 0-5 years. Fever was present in 100% cases, abdominal pain in 47% cases, rash, nausea/vomiting were found in 37%, headache in 12.35%, myalgia/ arthralgia or backache in 13.48%, retro orbital pain in <1% cases. Dengue fever (DF) was found in 46 % cases, dengue hemorrhagic fever (DHF) in 50% and dengue shock syndrome (DSS) in 3.9 cases.Conclusions: The study found among these 50% developed DHF and 46% DF and 3.9% DSS. Early admissions of pediatric cases can prevent major complications like DHF and DSS. The predominant complaints found were fever, vomiting and abdominal pain in paediatric group.

2020 ◽  
Vol 3 (2) ◽  
pp. 1-8
Author(s):  
Nirmal Ghimire ◽  
Damodar Paudel ◽  
Manoj Kumar Yadav ◽  
Suraj Rana ◽  
Navin Kumar Chaudhary ◽  
...  

Introduction: Dengue is a mosquito-borne viral disease transmitted from person to person by Aedes mosquitoes which result in a wide spectrum of disease severity ranging from influenza-like illness (dengue fever; DF) to the life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). Terai regions of Nepal were focal epidemics of Dengue infections during the outbreak in 2010, 2013, and 2016. Dengue infections have been reported in the valleys of upland Hill regions at an altitude of 2500 m above sea level in Nepal. Methods: A cross-sectional study was carried out among febrile patients in Nepal Police Hospital (NPH), from 1st Baisakh 2076 to 30th Chaitra 2076. Blood samples were collected from dengue presumed cases and tested against dengue specific IgM antibody and/or NS1antigen. Clinical examination findings were recorded, hematological and biochemical parameters tests were done among the patients who fulfilled the inclusion criteria. Results: A total of 87 dengue cases were included in the study during the study period. Out of these, the majority were males ( 85.05%) from Kathmandu (38/87; 43.67%) seen in the month of Asoj (40/87; 45.98%). Fever was the major symptom (100%) followed by myalgia (52.87%), headache (45.97%), retro-orbital pain (12.64%), bleeding manifestations (9.19%). Common hematological abnormalities were thrombocytopenia and leucopenia in the critical phase. There was no case of dengue shock syndrome. Conclusion: This study highlights the utilization of most common clinical and easily available laboratory profiles of dengue viral infections in particular season and place that could alert physicians to diagnose early to reduce morbidity and mortality due to dengue hemorrhagic fever and dengue shock syndrome.


2019 ◽  
Vol 6 (3) ◽  
pp. 1194
Author(s):  
Belgin Premkumar ◽  
Baburaj S. ◽  
Margaret Hepzibah N. ◽  
Misha K. P. ◽  
Binu Abraham

Background: Dengue fever is the most rapidly spreading mosquito-borne viral disease in the world.Incidence has increased 230-fold with increasing geographic expansion with potential for further spread. The rapidly expanding global footprint of dengue is a public health challenge with an economic burden. This study’s objective is to assess the outbreak of epidemic of dengue fever in a tertiary care children hospital and to describe their socio-demographic, clinical outcome and serological profile.Methods: It is an observational descriptive study conducted for a period of 1 year in less than 12 years old children in a tertiary care hospital at Southern Tamil Nadu.Results: Among the 360 children admitted with dengue fever, there were 198 boys (55%) and 162 (45%) were girls. Maximum incidence of dengue incidence was seen in infants less than 1 year (25%). The highest number of cases were admitted during September and October. The most common affected age group was less than 3 years with 179 (49%). Among the cases, 297 (82%) were of severe dengue which constitute dengue haemorrhagic fever-183(38%) and Dengue shock syndrome 114 (62%). Serological analysis showed NS1 Ag was positive in 144 children (40%), Dengue IgM was positive in 54 children (15%), both IgM and IgG positive in 126 children (35%) and IgG was positive in 36 children (10%). Out of the total children admitted with dengue fever, the case fatality was 0.5% (2 children).Conclusions: This study highlights the importance of WHO clinical criteria for early diagnosis of severe dengue. Moreover, the early and intensive management reduces the mortality significantly.


2015 ◽  
Vol 24 (Number 1) ◽  
pp. 3-7
Author(s):  
A H M Karnal ◽  
K H Mollah ◽  
A Begum ◽  
K Khoda ◽  
S Tanzeem ◽  
...  

Dengue is a rapidly spreading mosquito-borne viral disease worldwide. The endemicity in Bangladesh is also increasing gradually. The study was a prospective observational one, documented the presenting features and outcome of management. It was carried out in Department of Medicine in Holy Family Red Crescent Medical College Hospital, Dhaka from June 2013 to December 2013. Total 100 admitted cases of both sera positive and sera-negative were included in this study. Detailed history was taken, clinical examination and relevant investigations were done. Out of 100 patients 54 (54%) were male and 46 (46%) were female. So male to female ratio was 1.7:1. The age of the patients ranged from 12-75 years. Among them 20-40 years age group was highest 63%. Patients of higher socio-economic group were (69%) more affected. Out of 100 cases 54 had classical dengue fever (DF), 46 had dengue hemorrhagic fever (DHF). Antibody was positive in 81% cases. All patients presented with high fever, headache in 90%, retro-orbital pain in 45%, body ache in 56%, and backache in 48%. Leucopenia found in 60, platelet count <100x1091L was in 57, HCT- normal 17, <20% rise in 48%, ?20% rise in 28%. With proper management all patients were recovered.


2018 ◽  
Vol 10 (1) ◽  
pp. e2018021 ◽  
Author(s):  
Vishal Vishnu Tewari ◽  
Kunal Tewari ◽  
Ritu Mehta

AbstractBackground: Dengue is a major health issue with seasonal rise in dengue fever cases imposing an additional burden on hospitals, necessitating bolstering of services in the emergency department, laboratory with creation of additional dengue fever wards.Objectives: To study the clinical and hematological profile of dengue fever cases presenting to a hospital.Methods: Patients with fever and other signs of dengue with either positive NS1 antigen test or IgM or IgG antibody were included. Age, gender, clinical presentation, platelet count and hematocrit were noted and patients classified as dengue fever (DF), dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Duration of hospitalization, bleeding manifestations, requirement for platelet component support and mortality were recorded.Results: There were 443 adults and 57 children between 6 months to 77 year age. NS1 was positive in 115 patients (23%). Fever (99.8%) and severe bodyache (97.4%) were the commonest presentation. DF was seen in 484 (96.8 %), DHF in 10 (2%) and DSS in 6 cases (1.2%). OPD treatment was needed in 412 (82%) and hospitalization in 88 (18%). Intravenous fluid resuscitation was needed in 16 (3.2%) patients. Thrombocytopenia was seen in 335 (67%) patients at presentation. Platelet transfusion was needed in 46 (9.2%). PRC transfusion was given in 3 patients with DF and 10 of DHF. Death occurred in 03 DSS and 2 DHF patients. Conclusions: Majority of DF cases can be managed on OPD basis. DHF and DSS carry high mortality. Hospitals can analyze annual data for resource allocation for capacity expansion.


2013 ◽  
Vol 5 (1) ◽  
pp. e2013014 ◽  
Author(s):  
Muhammad Imran Hasan Khan ◽  
Eram Anwar ◽  
Adnan Agha ◽  
Noha Saleh ◽  
Ehsan Ullah ◽  
...  

Introduction: Dengue virus (DENV) affects over half the world’s population in 112 countries, and dengue fever (DF) is the second largest arthropod borne infectious global hazard after malaria with complications like Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) accounting for significant morbidity and mortality world over. Pakistan is significantly affected with DENV infection and to-date no study identifying risk factors associated with complications of DF has been done. Methods: 997 confirmed cases of DF were collected in a tertiary care hospital in Lahore, Pakistan and their clinical and biochemical data were collected. Univariate, multivariate and logistics regression analysis was performed to identify risk factors associated with development of DHF and DSS. Results: Bleeding OR 70.7 (CI 38.4-129.9), deranged liver function test OR 1.9 (CI 0.97-0.99), platelet count on admission less than 50,000 x109/L OR 0.16 (CI 0.13-0.19), presence of urinary red blood cells OR 1.4 (CI 0.179-0.900) and presence of urinary protein OR 1.1 (CI 0.191-0.974) were related to development of DHF and DSS.


2021 ◽  
Vol 44 (2) ◽  
pp. 74-77
Author(s):  
Farhana Rahat ◽  
Morsheda Khanam ◽  
Kazi Iman ◽  
UK Ghosh ◽  
NK Ghosh

Background: Dengue fever has become one of the most important public health concerns now a day due to increasing complications and fatal outcomes. Dengue hemorrhagic fever and dengue shock syndrome are life threatening but reversible complications of dengue fever. Objectives: This study was performed to evaluate the relationship between platelet count and hematocrit with the severity of dengue infection in pediatric age group. Materials & Methods: This was a prospective observational study which included 280 dengue seropositive children of 1 month to 15 years, conducted during 1st June to 30th November, 2018 in a tertiary care hospital of Dhaka. Results: Out of 280 dengue cases, 187(66.78%) had thrombocytopenia and 88(47%) had raised hematocrit. Among the thrombocytopenic patients 44% had dengue fever, 47% had dengue hemorrhagic fever and 9% dengue shock syndrome. A significant co-relation was observed between the severities of thrombocytopenia and raised hematocrit with the appearance of dengue warning signs in case of dengue hemorrhagic fever. Conclusion: Thrombocytopenia and raised hematocrit were related to the severity of dengue hemorrhagic fever. Bangladesh J Child Health 2020; VOL 44 (2) :74-77


2018 ◽  
Vol 5 (1) ◽  
pp. 202 ◽  
Author(s):  
Sreenivasulu T. ◽  
Jahnavi K.

Background: Dengue is the most common fever. Among all flavi-viruses, it is the most common. It can cause around 50-100 million infections. Every year 2-5 lakh cases of Dengue hemorrhagic fever occur. The objective of the research was to study clinical profile of patients with Dengue fever at a tertiary care hospital.Methods: Present study was cross sectional study. The patients were interviewed and examined at one point of time and later they were never followed which is similar to the cross-sectional study design. Present study was carried out in the hospital. This was done in the department of General Medicine of a tertiary care hospital. Present study was carried out over a period of one year.Results: In the present study, there were 78 males and 22 females. The sex ratio was 3.5:1. Maximum number of males (29.5%) was in the age group of 15-25. Among females, the maximum (40.9%) were in the age group of 26-35 years and 46-55 years (9%). The most common presenting symptom was fever in all cases followed by headache in 90%. Among bleeding manifestations, epistaxis, gum bleeding and hematuria (15%) were the common symptoms. Most patients presented with generalized lymphadenopathy in 52%. 56 patients showed only hepatomegaly and 46 splenomegaly, and 30 patients showed hepato splenomegaly. 99 showed leucopenia and 10 were anemic and 25 showed platelet count less than 1,50,000cells/cumm.Conclusions: Males were commonly affected. Younger age group of 15-25 was most commonly affected and fever and headache were the most common presenting symptoms. These findings help physicians in early diagnosis of dengue by suspecting these features as of dengue and can prevent morbidity and mortality associated with dengue.


2021 ◽  
Vol 8 (4) ◽  
pp. 631
Author(s):  
S. V. S. Sreedhar ◽  
Ramishetty M. Umamahesh

Background: Dengue viral infection is the most common mosquito-borne disease in the world with varied presentations, high morbidity, and high mortality patterns. To study the clinical profile and outcome of dengue fever in children.  Methods: This analytical study was conducted in children less than 12 years of age with clinical features of dengue (any acute febrile illness with one of the following: myalgia, headache, retro-orbital pain, bleeding, altered sensorium, shock, or low platelet count) presented at Mahavir institute of medical sciences between February 2019 to January 2020 (12) months were included in the study. Children positive for IgM alone or both IgM and IgG were followed up for a clinical profile.Results: Seizures (9.5%), loose stools (8.5%), lymphadenopathy (15.2%), relative bradycardia (8.5%) were less common manifestations. Rashes were seen in 64.7% of children. Many children in this study were mildly anemic. Mean hemoglobin was slightly higher in dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Mean Hb in DSS was 11.28 g%. It was 10.02, 10.1, and 10.45 in DF, DFB, DHF respectively. But it was statistically not significant (P=0.27).Conclusions: Seizure was significant in DSS cases. Any dengue child throwing convulsions should hence be promptly evaluated for an unrecognized shock. The bleeding in dengue is not purely due to thrombocytopenia. There is no role for prophylactic platelet transfusion.


2019 ◽  
Vol 6 (3) ◽  
pp. 618
Author(s):  
Dhivya P. ◽  
Monica A. ◽  
Jayaramachandran S.

Background: Dengue is among the most common flavivirus infections in the world. Today dengue ranks as the most important mosquito- borne viral disease in the world. Current estimates report that, at least 112 countries are endemic for Dengue and about 40% of the world populations (2.5-3 billion people) are at risk in tropics and subtropics. Annually 100 million cases of dengue fever and half a million cases of DHF occur worldwide. The clinical features are noted to be different in varying demographics of the world outlining the importance of bringing out data from different parts of the world, so clinicians are better equipped to anticipate the problems associated with clinical dengue.Methods: The study was conducted over a period of 2 years at a tertiary care hospital in urban Bengaluru, India. A cross sectional study of a total of 250 patients was done. They were diagnosed to be positive for dengue serology (NS1 or IgM) before including them in the study. Clinical features, haematological, biochemical and radiological parameters were assessed.Results: Out of 250 patients with dengue fever, the most common symptoms were fever (100%), headache (94.4%) and myalgia (97.2%). Bleeding manifestations were noted in 11.6% of the patients. Bradycardia was noted in 14.8% of the study population. Leukopenia was noted in 36% of the study population. Increased SGOT was seen in 59.6% and increased SGPT in 52.8% of the 250 subjects. The clinical outcome of the 250 patients of dengue fever was classical dengue fever in 86.8%, DHF in 11.6%, DSS in 0.8% and death in 0.8%.Conclusions: All patients with dengue fever present with fever. Other common features noted were headache, myalgia. Bleeding manifestations are to be looked out for. Rare but important features that a clinician must be vigilant to look for are bradycardia and leucopenia.


2018 ◽  
Vol 5 (1) ◽  
pp. 137
Author(s):  
Jahnavi K. ◽  
Srinivasulu T.

Background: Dengue is endemic in India and epidemics are common. Due to poor availability of resources, there is increased morbidity and mortality related to dengue. The objective of the research to study the incidence, manifestations and complications of dengue fever.Methods: Patients admitted in medicine wards of a tertiary care hospital during the study period of two years with the history of fever with other nonspecific symptoms were included in the present study. Data was collected in a pre-tested proforma by meeting objectives of the present study. 100 patients who fulfilled World Health Organization criteria for dengue fever were selected by simple random sampling method.Results: In 75 patients the platelet count was above 150000cell/cumm. Most of them had dengue fever. 12 patients showed platelet count between 20000-100000cells/cumm. and among them 10 were DHF and 2 were simple dengue infection. Five patients showed platelet count less than 20000cells/cumm. and among them 2 were DHF and 3 were DSS. Most of the bleeding skin manifestations were seen when platelet count was below 50000cells/cumm. Mucosal bleeding was observed when the platelet count was below 30000cells/cumm. Abnormal coagulation profile was noted in 18% of the patients and 6% patients were in acute renal failure. Mortality was 0% in dengue fever, 44% in DHF and 100% in DSS.Conclusions: Platelet count was directly related to the number of complications. Dengue shock syndrome and dengue hemorrhagic fever was associated with increased mortality.


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