Clinical and laboratory profile of dengue fever in children during an outbreak - one year study at tertiary care hospital, Chennai, Tamilnadu, India

Sharma, Natwar Lal; Balasubramanyam, Vasuki; Kandati, Jithendra; Ponugoti, Munilakshmi

doi:10.18203/2349-3291.ijcp20164588

Cited by 11 publications

(15 citation statements)

References 12 publications

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“…The present study demonstrates the peak incidence of cases in the months, between August-October in contrast to a study done by Kabilan et al who found more cases in September-January. 9 The predominant age group in our study was between 6-10 years (52.9%) followed in order by 1month 5year (30.4%) and 11<15 years (16.6%) which is contrary with findings of Gurudeep et al who reported 59% of cases in children between 10-15 years but on par with findings of Sharma NL et al 10,11 Male were predominant than female (54.6%) in our study as similar to many studies. In our study 76.4% presented with dengue fever with warning signs, 9.2% without warning signs and 14.4% with severe dengue.…”

Section: Resultscontrasting

confidence: 85%

Clinical and laboratory profile and outcome of dengue cases among children attending a tertiary care hospital of South India

Nagaram

Piduru

Munagala

et al. 2017

Int J Contemp Pediatr

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INTRODUCTIONDengue is a mosquito borne febrile viral illness. Dengue virus belongs to the family Flaviviridae (single stranded non segmental RNA viruses) and has four distinct serotypes: DEN-1, DEN-2, DEN-3 and DEN-4. Humans are the main reservoir for the dengue virus. Urbanization, substandard living conditions, lack of vector control and climatic changes are some of the important causes for dengue infection. Once considered an urban problem, it ABSTRACT Background: Dengue fever is an arboviral disease which is endemic in tropical countries and is of major concern with its morbidity and mortality. WHO classified dengue into three categories: undifferentiated fever, dengue fever (DF) and dengue haemorrhagic fever (DHF). Severe dengue is also regularly observed during primary infection of infants born to dengue-immune mothers. The objective of present study was to assess the clinical profile, laboratory profile and associated risk factors related to outcome of children less than 15 years of age. The outcome of the children and their management protocols were also assessed in the study. Methods: A prospective cross sectional study with 174 confirmed cases of dengue in children <15 years were enrolled and classified as per WHO guidelines. The demographic data, clinical history, laboratory parameters were noted in a separate questionnaire form. Hematological parameters were noted, chest x-ray, ultra-sonogram in required cases was done and observations noted. Cases were managed as per WHO protocol and risk factors were observed. The outcomes of the cases were noted as discharge or death of the case. Results: A total of 174 children with 149 non-severe dengue and 25 severe dengue cases with 95 males and 79 females were enrolled in the study. 6-10 years was the most common age group. The mean age of children admitted with severe dengue fever was 5.81yrs.and without severe dengue fever was 7yrs.The mean duration of hospitalization was 5.21 days in severe dengue and 3.4 days in non-severe dengue cases. Fever was the most common presenting symptom and hepatomegaly was the common clinical finding in the study. Bleeding manifestations were seen in cases of severe dengue with raised haematocrit levels, raised SGOT levels and severe thrombocytopenia. Pleural effusion and gall bladder wall thickening with ascites was seen in severe dengue cases. Management was by administration of colloids and crystalloids. Conclusions: Dengue is a dreadful fever among pediatric age group which needs to be considered with great caution in management. Understanding the risk factors helps in predicting the mortality which helps in management and better outcome of the fever.

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Section: Resultscontrasting

confidence: 85%

Clinical and laboratory profile and outcome of dengue cases among children attending a tertiary care hospital of South India

Nagaram

Piduru

Munagala

et al. 2017

Int J Contemp Pediatr

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“…A cyclical pattern of increased transmission coinciding with monsoon and post monsoon as it is the breeding season for Aedes mosquitos. Similar finding was also seen in the studies done by Ahmad S et al and Sharma NL et al 8,5 Out of the 360 patients, 32 cases (37%) were from Vallioor and Panagudi which are urban areas. It is worth to note that only 84 cases (23%) from the rural areas which include Vellamadamand Thovalai.…”

Section: Discussionsupporting

confidence: 88%

“…In the study done by Sharma NL et al the ratio was 1.2:1. 5 This may be due to factors like traditional full body covering in females compared to males and males are more exposed to mosquito bites as they play more often in open fields.…”

Section: Discussionmentioning

confidence: 99%

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A study on the outbreak of dengue fever in a tertiary care children’s hospital in southern Tamil Nadu, India

Premkumar

Stephenson

Hepzibah³

et al. 2019

Int J Contemp Pediatr

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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.

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“…On the other hand, there are studies specifically performed in pediatric age group. Nagaram et al [20] and Sharma et al [21] performed their studies exclusively amongst children and reported the mean age of patients to be less than 10 years. However, workers like Patel et al (2016), [22] similar to present study did not impose any age restriction and reported the age range of patients from 1 to 76 years.…”

Section: Discussionmentioning

confidence: 99%

Haematological Profile in Different Clinical Spectrums of Dengue

Chaudri¹,

Ahmad²,

Dutta³

2018

AIMDR

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Background: To describe the hematological profile occurring at different clinical spectrums of dengue. Methods: Study was conducted in Department of Pathology, Teerthankar Mahaveer Medical College and Research Centre Moradabad, Uttar Pradesh. A total of 100 cases were enrolled with patients who were serologically positive for Dengue either by ELISA/Card(NS1, IgG, IgM) method. A blood specimen of 2 ml was obtained from all the patients under aseptic conditions and was sent for evaluation using Sysmex XS 800i automated counter. Various hematological and biochemical parameters were noted. All the patients were followed up till day 5. Results: Out of a total of 100 cases enrolled in the study a total of 55 (55%) did not have bleeding manifestations and comprised the Group I of study whereas remaining 45 (45%) patients presented with bleeding manifestations and were placed in Group II of study. Age of patients ranged from 4 to 80 years. Maximum number of patients were in age group 21 to 40 years (42%). Mean age of patients was 34.04±17.58 years. Majority of cases were detected on ELISA (54%). Mean TLC was 6549±4093/cumm. A total of 87% cases had platelet count <150,000/cumm. Group I where 34.5% patients had platelet count <50,000 in Group II this proportion was 62.2%, thus showing a significant difference between two groups (p=0.038). The proportion of patients with platelet count >100,000/cumm was 26%, 22% and 35% respectively on baseline, day 3 and day 5 where as proportion of those with platelet count <20,000/cumm was 16%, 10% and 6% respectively on baseline, day 3 and day 5 respectively. No significant difference between two groups with respect to any of the biochemical parameters (p>0.05) was observed. Conclusion: The findings in present study provide a deep insight into the hematological picture vis-à-vis the clinical and biochemical profile of dengue fever at a tertiary care centre. Considering the relevance of onset and hematological changes, the findings in present study were somewhat skewed as most of the patients included in the present study had delayed admission and as such the onset record was not available. The present study was also limited by the duration of follow-up and outcome evaluation, including relapse.

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Clinical and laboratory profile of dengue fever in children during an outbreak - one year study at tertiary care hospital, Chennai, Tamilnadu, India

Cited by 11 publications

References 12 publications

Clinical and laboratory profile and outcome of dengue cases among children attending a tertiary care hospital of South India

Clinical and laboratory profile and outcome of dengue cases among children attending a tertiary care hospital of South India

A study on the outbreak of dengue fever in a tertiary care children’s hospital in southern Tamil Nadu, India

Haematological Profile in Different Clinical Spectrums of Dengue

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