Clinical Profile of Dengue and Predictors of Its Severity Among Children

Abstract

Dengue fever is a self-limiting, systemic viral illness that has a wide range of clinical manifestations. Last year dengue was severe in children with much mortality. This study was aimed to see the clinical profile of dengue and to find out the risk factors for developing severity. This cross sectional study was conducted over four months (June-September, 2018) in Department of Pediatrics of United Hospital Limited. All admitted dengue cases were analyzed. The predictors of developing severity were assessed by comparing variables between classical and severe dengue fever groups. A total of 106 children with Dengue fever were admitted. Mean age was 5.8±3 years with male predominance (60%). Common presentations include fever (100%), flushed appearance (72%), rash (43%), vomiting (39%), abdominal pain (36%), shock (28%) and respiratory distress (23%). In risk factor analysis, overweight (OR: 8.275, CI: 1.378-49.706) and massive serositis (OR: 17.86, CI: 4.733-67.399) were found statistically significant predictors of severe dengue. The overall mortality was 3%. So, overweight children and those patients who develop massive serositis are at increased risk of having severe dengue. Early identification of these features can help physicians to manage these cases judiciously.

Clinicopathological alteration of symptoms with serotype among dengue infected pediatric patients

“…2,3 Also, children have a 15 times higher risk of developing DHF/DSS due to secondary dengue infection in comparison to adults. 4 As per National Center for Vector-Borne Diseases Control data, 101192 cases and 172 deaths in 2018, and 157315 cases and 166 deaths in 2019 were reported due to dengue fever (DF) in India only (NVBDCP, India). 5 Dengue viruses belong to the family Flaviviridae and can be considered as ubiquitous with its four antigenically distinct serotypes recognized as DENV 1, DENV 2, DENV 3, and DENV 4.…”

“…Dengue virus affects almost every age group but a majority (nearly 90%) of dengue infection occur in children <15 years of age 2,3 . Also, children have a 15 times higher risk of developing DHF/DSS due to secondary dengue infection in comparison to adults 4 . As per National Center for Vector‐Borne Diseases Control data, 101192 cases and 172 deaths in 2018, and 157315 cases and 166 deaths in 2019 were reported due to dengue fever (DF) in India only (NVBDCP, India) 5 .…”

Pattern and Outcome of Dengue Fever in a Pediatric Tertiary Hospital: A Retrospective Report

“…In almost all of these studies, fever, abdominal pain, vomiting, and skin rash were the common clinical presentation of dengue fever in children. Thrombocytopenia was also extremely common [ 7 , 8 ]. The bleeding presentation was commonly reported in the form of petechiae, nose bleeds, hematuria, hemoptysis, bleeding gums, hematemesis, melena, menorrhagia, and subconjunctival hemorrhages [ 6 , 9 , 17 ].…”

“…Our results are on the lower end. Comparatively, in Afroze et al, 87% of children were DNS1 positive and 15% were IgM positive [ 7 ]. IgM was positive 41%, IgG in 24% while in 31 % of the children population both were found positive [ 18 ].…”

“…Dengue affects all age groups; however, 90% of dengue infections occur in children of age less than 18 years [ 6 ]. Children have a 15-times higher risk of dying during a second episode compared to adults [ 7 ]. Fever remains the most common presentation of dengue in children followed by vomiting, and abdominal pain [ 8 ].…”