Role of early warning signs in children with severe dengue infection

Pothapregada, Sriram; Sivapurapu, Vijayalakshmi; Kamalakannan, Banupriya; Thulasingham, Mahalakshmy

doi:10.18203/2349-3291.ijcp20182540

Cited by 4 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16 Our study also showed that in Severe Dengue, Vomiting (100%), Abdominal pain (60%) were most common presenting symptoms and low blood pressure (100%), hepatomegaly (60%) were common physical findings .Similarly,80 % had leukopenia and 60% had platelet count less than 75000 mm/3 among Severe Dengue cases. These finding are concordant with the study done by Pothapregada et al 17 and Jairaj et al . 18 In our study, more than three-fourth (77%) of patients were positive for only NS1 followed by NS1 and IgM were (17.6%) and IgM only were (5.4%) as most (77%) of the patients were presented within 3 days of fever while12.2 % of patient presented within 4-5 days of fever and 10.8% presented after 5 days of fever.…”

Section: Discussionsupporting

confidence: 94%

Clinical and laboratory profile of dengue fever in children from a tertiary care centre of Gandaki Province, Nepal

Namrata¹,

Thapa²,

Shrestha³

et al. 2020

J. Gandaki Med. Coll. Nepal

View full text Add to dashboard Cite

Introduction: Dengue, the arthropod borne viral disease is serious public health problem in Nepal. The clinical diagnosis of dengue has become challenging in children as it is presented with nonspecific symptoms. The objective of present study was to assess different clinical presentations and outcomes of dengue fever in tertiary care centre. Methods: A record based observational cross-sectional study was carried out on all dengue positive patients of aged 11 months to 15 years presented in Gandaki Medical College from July to November 2019. Total 74 patients with history of fever with dengue seropositive were included in the study. All the clinical and haematological findings were recorded in semi-structured questionnaire form. Results: Of 74 patients 40 (54.1%) males and 34 (45.9%) were females. Fiftyone (68.9%) were cases of dengue without warning sign, 18 (24.3%) were dengue with warning signs and 5(6.8%) cases had severe dengue symptoms. Most of the patients (78.38%) were from Kaski district. Fever (100%) was the most common clinical presentation followed by headache (36.5%), vomiting (25.7%), and retro orbital pain (20.3%). Common laboratory findings included thrombocytopenia (59.4%) and leukopenia (35.1%). Among 74 cases, 68 were in stable condition and treated in OPD or in ward, and 6 were admitted in ICU of which one developed warning signs and other 5 had severe dengue. All the enrolled children recovered well and there was no mortality during this period. Conclusions: Fever, headache, vomiting, thrombocytopenia and leukopenia were most common presentation of dengue fever among children. Appropriate clinico-laboratory diagnosis and management is relatively simple, inexpensive and very effective in saving lives as long as correct and timely interventions are instituted.

show abstract

Section: Discussionsupporting

confidence: 94%

Clinical and laboratory profile of dengue fever in children from a tertiary care centre of Gandaki Province, Nepal

Namrata¹,

Thapa²,

Shrestha³

et al. 2020

J. Gandaki Med. Coll. Nepal

View full text Add to dashboard Cite

show abstract

“…The prevalence of severe dengue in our pediatric cohort was about 34.4%, which was higher compared to another study from Medan, Indonesia, where the severe dengue prevalence was 25% among children less than 18 years old, 13 but lower than the estimate from another study among pediatric patients, by Pothapregada et al 14 in India, where severe dengue occurred in 40.6%. The high prevalence obtained in the present study is probably due to the fact that the subjects came from a national tertiary referral hospital, predominantly attracting severe pediatric dengue cases.…”

Section: Discussioncontrasting

confidence: 83%

The Value of Warning Signs From the WHO 2009 Dengue Classification in Detecting Severe Dengue in Children

Karyanti,

Uiterwaal,

Hadinegoro

et al. 2024

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

Background: World Health Organization proposed 7 warning signs to identify the risk of severe dengue in 2009. This study aimed to evaluate the value of these warning signs in detecting severe dengue in children. Material and Methods: A cross-sectional study was conducted utilizing data of children with clinical dengue infection obtained from medical records between January 2009 and December 2018 in Jakarta. Children with confirmed dengue were analyzed and stratified into 3 age groups: infants less than 1 year old, children 1–14 years and adolescents 15–18 years of age. Positive predictive value, negative predictive value (NPV), sensitivity and specificity of each warning sign present or absent on admission in detecting severe dengue were computed. Results: Six hundred ninety-nine children with clinical dengue infection were enrolled, among whom 614 (87.8%) had confirmed dengue infection, either by antigen or antibody serological tests. Severe dengue occurred in 211/614 (34.4%) cases. In infants, important warning signs on admission to detect or exclude severe dengue were liver enlargement (NPV 80.8%) and clinical fluid accumulation (NPV 75%). In children and adolescents, warning sign with highest NPV (in children 76.6% and in adolescents 91.9%) was increase in hematocrit concurrent with a rapid decrease in platelet count. Other warning signs with high NPV values in children were abdominal pain (72%), vomiting (70%), clinical fluid accumulation (69.3%), and in adolescents’ abdominal pain (80.7%), vomiting (75.7%), clinical fluid accumulation (82.7%). NPVs increase with more than 1 warning sign in all age groups. Conclusion: In infants, liver enlargement or clinical fluid accumulation are important warning signs for severe dengue, when both are absent, severe dengue is unlikely. In older children and adolescents, an increase in hematocrit with the concurrent rapid decrease in platelet count is most discriminative; followed by the absence of abdominal pain, vomiting or fluid accumulation are unlikely severe dengue.

show abstract

“…Por otro lado, el estudio de Salgado et al, incluye pacientes con miocarditis por dengue, donde la mediana de edad fue de 72 meses (seis años) para este grupo de pacientes (15). Adicionalmente, la edad superior a seis años, como variable asociada a dengue severo, fue reportada en el estudio de Pothapregada S et al (16).…”

Section: Discussionunclassified

“…Similar a lo evidenciado en este estudio, Dhochak et al reportan que los síntomas gastrointestinales hacen parte de las manifestaciones mayormente asociadas a ingreso a unidad pediátrica de cuidados intensivos (24). Pothapregada S et al, describen que los signos de alarma más asociados a dengue severo en el estudio realizado en Puducherry, India, fueron dolor abdominal, hepatomegalia e hipotensión (16).…”

Section: Discussionunclassified

Factores de riesgo asociados al ingreso a unidad de cuidados intensivos en pacientes pediátricos hospitalizados por dengue en Cali, Colombia

Hernández

Bula

Hernández

et al. 2020

CES Med

View full text Add to dashboard Cite

Introducción: El dengue es la arbovirosis de propagación más rápida en todo el mundo; anualmente 390 millones de personas son infectadas. Objetivo: Identificar las manifestaciones clínicas y características demográficas asociadas a ingreso a unidad de cuidados intensivos en una institución pediátrica de Cali, Colombia, entre enero 2015 y diciembre 2016. Materiales y métodos: Estudio de casos y controles anidado en una cohorte. Caso: paciente mayor de 28 días y menor de 18 años, hospitalizado en la unidad de cuidados intensivos pediátricos con diagnóstico confirmado de dengue con signos de alarma o dengue grave, sumado a serología positiva para IgM y/o NS1. Control: paciente de igual edad y diagnóstico confirmado de dengue, sin ingreso a la unidad de cuidas intensivos.Resultados: Se evaluaron 24 casos y 176 controles, la mediana de edad en meses fue 142 vs.106 (RIC: 59-142). El 83 % procedía del área de urbana de Cali y 53 % era de sexo masculino. Presentar derrame pleural OR 3,4 (IC 1,2-9,8) y alteraciones cardiovasculares OR 4,7 (IC 1,7-13,1), incrementaron la probabilidad de ingreso a unidad de cuidados intensivos pediátricos. Tres pacientes fallecieron, todos pertenecían al grupo de casos. Conclusiones: El dengue en población pediátrica tiene un comportamiento clínico in específico; sin embargo, identificar derrame pleural o alteraciones cardiovasculares pueden explicar un ingreso a unidad de cuidados intensivos pediátricos y alertar sobre un posible desenlace fatal.

show abstract

Role of early warning signs in children with severe dengue infection

Cited by 4 publications

References 12 publications

Clinical and laboratory profile of dengue fever in children from a tertiary care centre of Gandaki Province, Nepal

Clinical and laboratory profile of dengue fever in children from a tertiary care centre of Gandaki Province, Nepal

The Value of Warning Signs From the WHO 2009 Dengue Classification in Detecting Severe Dengue in Children

Factores de riesgo asociados al ingreso a unidad de cuidados intensivos en pacientes pediátricos hospitalizados por dengue en Cali, Colombia

Contact Info

Product

Resources

About