Clinico-epidemiological study of dengue fever in Ajmer region

Abstract

Background: Dengue infection is a major challenge to public health, especially in South-East Asia. It present with a diverse clinical spectrum. Estimates suggest that annually over 50 million cases of dengue hemorrhagic fever (DHF) occur in Asian countries with a case fatality rate of less than 5%. Of those with DHF, at least 90% are children younger than 15 years old. In humans, dengue infection causes a spectrum of illness ranging from relatively mild, non-specific viral syndrome known as Dengue fever (DF) to severe hemorrhagic disease and death. Definitive early Dengue diagnosis requires laboratory tests and those suitable for use at this stage of illness are either costly, such as RT-PCR for Dengue; not sufficiently rapid, such as virus isolation. Currently test available are NS1 antigen detection and ELISA for dengue, IgM and IgG antibodies. Objective of this study is to study clinico-epidemiological and haematological features of Dengue infection.Methods: Prospective observational study involving initial 100 registered cases who were serologically confirmed dengue infection for a period of one year.Results: DF, DHF and DSS were found in 41%, 53% and 6% patients respectively. Most common presenting complaint and bleeding manifestation were fever and petechiae. Uncommonly altered sensorium and icterus were found in severe dengue infection. 6% patients had coagulopathy, 37 patients had hepatic involvement and 2 patients had deranged renal function who had DSS. Fever was present in (100%) cases of DF, DHF and DSS. 26% patients had their platelet count <50000/mm3.Conclusions: Dengue is a common disease in the India with wide spectrum of clinical presentations, affecting 5-15 years age group children commonly. It is one of the dreaded fevers but early diagnosis and management according to recent WHO guidelines can decrease case fatality rate significantly.

Dengue infection in Agra region, Uttar Pradesh: An observational study of seroprevalence, clinicoepidemiological profile, and serotype of dengue virus from tertiary care center

“…A study from North India showed similar observation of most cases of dengue from the age group of 0 to 15 years. 13 Dengue epidemic between 1990 and 2006 from Delhi, Tamil Nadu, Madhya Pradesh, Pondicherry, and Uttar Pradesh (2003)(2004)(2005)(2006) found most cases in the 5-12-year age group. 14,15 The lack of immunity among children could be the possible role of the high fatality rate.…”

“…7 Fever, myalgia, and thrombocytopenia were the most common clinical features reported by patients with dengue infection in our study and most studies from country. 11,13,25,26 DF was reported in 53.02% of patients, DHS in 40.49%, and DSS in 6.40% of patients infected with DENV. Almost similar findings were reported from Ajmer region in 2019.…”

“…Almost similar findings were reported from Ajmer region in 2019. 13 A comparison of year 2011-2013 NVBDCP (National Vector Borne Disease Control Program) data with that of previous years indicated a shift from mild illness towards a more severe manifestation of the disease, which could be interpreted as an epidemiologic transition pattern and is a sign of hyperendemicity of the DENV in UP. In addition, genotypic changes in dengue viruses may contribute further to emergence of severe dengue 8 .…”

“…This finding of more males being reported with dengue is consistent with studies from several other countries, 18,19 India and Uttar Pradesh also; similar finding was also observed in most studies from tertiary care hospitals in India. 3,11,13,20 Possible explanations for this male dominance are (i) greater exposure of males to dengue-carrying mosquitoes or (ii) differences in the healthcare-seeking behavior of males and females rather than the true burden or (iii) social and cultural biasing as India is male predominant country. Although most research mentioned male preponderance in dengue infection, there are studies with results of no difference in male and female distribution of cases.…”