Objectives: To study the Clinical and Laboratory profile of children upto 12 years of age with Dengue fever and to study the predictors of Severe Dengue among these children. Methods: Design: Descriptive study over 1 year 9 months. Setting: SAT hospital, Thiruvananthapuram, a tertiary care center. Study Population: 204 children aged 1month to 12 years admitted with serologically confirmed dengue fever without any co-infections; consecutive sampling. Procedure: Relevant history, detailed physical examination and investigations were noted. Patients were classified for their severity based on DENGUE guidelines-WHO 2009. Children were followed up till discharge during hospital stay. Categorical values were expressed as proportions and quantitative variables in mean and standard deviation. Association between various study variables and severe dengue were statistically analysed. Results: Mild dengue was seen in 96 children(47.1%), moderate dengue in 78 children(38.2%) and severe dengue in 30 children(14.7%). Mean age of presentation was 6.4 years. Age distribution- infants were 4.4%, 38.7% were between 1 year and 5 years; 56.9% were between 6 and 12 years.51% of children were males. Common clinical presentation was fever (100%), vomiting(46.6%), abdominal pain(32.4%), lethargy(24.5%), myalgia(22%), headache(16.7%) and reduced appetite(15.7%). Mean fever duration was 5 days. Hypotension was noted in 13.2%, Tender hepatomegaly in 44%, signs of plasma leakage in 6%, hypoalbuminemia in 7.8%. Total number of death was 2(1%). Variables with significant association with severe dengue on univariate analysis were Lethargy (p-<0.001, OR- 11.6), reduced appetite (p- <0.001,OR- 17.14), mucosal bleed (p<0.001, OR- 15.45), Fever spike >39◦C (p- 0.001, OR- 4.3), tender hepatomegaly (p- 0.001, OR- 4.2), decreased urine output (p <0.001, OR- 23.04), hypoalbuminemia (p <0.001, OR-43.5), platelet count below 80,000 (p <0.001, OR-4.43), SGOT above 85 (p <0.001, OR-4.9). According to the maximum area under ROC curve, a cutoff of platelet count 80,000 had 75% sensitivity and 60% specificity for predicting severe dengue. Conclusion: Proportion of children developed severe dengue was 14.7%. Independent predictors of severe dengue after multiple logistic regression were Lethargy, Reduced appetite, Reduced urine output and Hypoalbuminemia. Keywords: severe dengue; urine output; shock; hypoalbuminemia.
People who inhabited a land before it was conquered by colonial societies and who consider themselves distinct from the societies currently governing those territories are called Indigenous peoples. Large areas of the earth’s surface are inhabited by substantial number of Indigenous Peoples. According to rough estimates, globally they account for about one sixth of the population; there are some 370 million indigenous people around the world, the rights of who are often ignored, yet, due to their geographical spread across continents and countries, Indigenous Peoples. They live in nearly all the countries on all the continents of the world and form a spectrum of humanity, ranging from traditional hunter gatherers and subsistence farmers to legal scholars. Despite the extensive diversity in indigenous communities throughout the world, all indigenous peoples have one thing in common- they all share a history of injustice. The nations of the world refuse to recognize that indigenous peoples have human rights. They have been denied the right to participate in governing process of the current state systems. Conquest and Colonization have attempted to steal their dignity and identity as indigenous peoples, as well as the fundamental right of selfdetermination.
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