A preliminary study on clinical profiles of dengue and dengue haemorrhagic fever suspected patients from two hospitals in the Western Province of Sri Lanka

Abstract

Objective: Dengue fever (DF) is one of the most common public health problems in Sri Lanka. A pilot study was undertaken to investigate the clinical profiles of DF and dengue haemorrhagic fever (DHF) in patients admitted to two hospitals from July 2011 to July 2012. The objective of the study was to evaluate clinical patterns to improve pattern recognition and to determine whether these profiles have changed in recent times. Study design: The clinical profile was collected using a CDC style questionnaire and analyzed (Minitab, V14). Blood samples were collected from 50 patients from Gampaha and 204 patients from Negombo hospitals with a clinical suspicion of DF/DHF, between fever days 2 to 7. Laboratory data included a complete blood count (CBC) with haemoglobin, haematocrit, total leukocyte and platelet countsand liver function. CBC was repeated daily during the acute phase of the illness. Chest x-ray or ultrasound scanning was done to assess pleural and abdominal fluid accumulation. Results: The sample consisted of 168 (66.1%) males and 86 (33.8%) females. The age of the patients ranged from 6 months to 66 years with a mean of 12 (SD = 13.4). Fever was the major presenting complaint (100%) with headache in 90.1%. Retro orbital pain was present in 27.6% of patients and 78 % and 79.1 % experienced arthralgia and myalgia respectively. Rash and pleural effusion were present in 20% and 10.6 % respectively. Ascites and hepatomegaly were noted in 6.2% and 1.1%. Of the 254 patients, 69% had DF and 31% had DHF. The lowest WBC was 0.98 x 10 3 /mL. Platelet count of <100,000 was seen in 65.3% cases. Only 35 patients (21 DF and 14 DHF) were tested for IgM/IgG. Based on these results, 38% (8/21) of DF cases were primary and 62 % (13/21) were either secondary or with past flavivirus infections. Primary dengue infection resulted in 43% (6/14) of DHF cases with 57% (8/14) resulting from secondary or with past flavivirus infections.

Serological evidence for chikungunya and Zika virus infections in patients clinically diagnosed as dengue in Northern Sri Lanka

“…14,15 Dyspnoea, hepatomegaly and headache were found to be the prominent signs in CHIKV infection whereas retroorbital pain and flushed skin were noted as marked signs in dengue as has been observed in previous studies. 16,17,18,19 In both mono-and co-infections, hepatomegaly was associated with CHIKV infection which is in agreement with a previous study. 5 Females were more affected by both CHIKV and DENV infections in the study sample compared to males.…”

Frequency and trend of dengue fever in a tertiary care hospital in Kancheepuram, Tamilnadu: three-year retrospective study

“…In present study the variables significantly associated with dengue infection are male sex, lower socioeconomic status and platelet count at the time of admission and about 67.9% of the dengue patients had a platelet count of <1 lakh mm 3 at the time of admission which is similar to studies by Sirisena et al and Guzmán et al 25,26…”

Clinical and Biochemical Characteristics of Dengue Infections in Children From Sri Lanka

“…Table 4 12 , 13 , 26 - 28 summarizes the data presented in similar pediatric dengue publications from Sri Lanka. The distribution of gender was comparable.…”

“… 10 , 11 Although children are commonly affected by dengue, published data on dengue infections in children living in Sri Lanka are limited. 12 - 14 Following the study by Malavige et al, no study in Sri Lanka has described the patterns of dengue infections specifically in the pediatric population. 12 In 2017, Sri Lanka faced its largest dengue epidemic, requiring reallocation of resources and specialized dengue treatment units to combat the large epidemic.…”