Comparison of clinical and laboratory characteristics between children and adults with dengue

Abstract

Over the past several years, the epidemiological profile of dengue has been changing progressively and is currently characterized by an increase in the number of cases in children under 15 years of age. This study was aimed at comparing the clinical and laboratory features between adults and children with dengue; therefore, we performed a cross-sectional analysis of 5686 individuals with laboratory-confirmed dengue who sought treatment at a healthcare facility in Rio de Janeiro, Brazil from 2010 to 2011. A multivariate analysis indicated that myalgia (OR=2.58; CI 95%=2.08-3.18), retro-orbital pain (OR=1.36; CI 95%=1.15-1.62), nausea (OR=1.92; CI 95%=1.60-2.30), and arthralgia (OR=3.64; CI 95%=2.72-4.89) were the most frequent clinical symptoms in adults, whereas vomiting (OR=0.52; CI 95%=0.43-0.61) and skin rash (OR=0.46; CI 95%=0.25-0.85) were the most prevalent symptoms in children. Adults exhibited a higher hemoconcentration (OR=3.04; CI 95%=2.53-3.65), thrombocytopenia (OR=2.17; CI 95%=1.80-2.60), increased erythrocyte sedimentation rate (OR=1.81; CI 95%=1.53-2.14), and increased ALT (OR=3.13; CI 95%=2.44-4.02) than did children. In addition, adults exhibited a higher frequency of the severe forms of the disease (OR=1.74; CI 95%=1.12-2.72) and hospitalization (OR=2.21; CI 95%=1.59-3.06) relative to children. Based on these results, this study demonstrated significant differences in the clinical and laboratory presentations and disease severity between adults and children affected by dengue.

Impact of Reactive Dengue NS1 Antigen with Time for Hospital Admission in Dengue Viral Infection Patient

“…Adults apparently acquire immunity from primary infection and avoid DHF. [13,14] Furthermore, the case fatality rate (CFR) among children during late admission exceeded 1%. This can emphasizes practice of early admission among children patient.…”

Arbovirus en Latinoamérica

“…21 En los niños, el dengue puede ser asintomático o polisintomático, lo que dificulta el diagnóstico diferencial. 22 Se ha observado que los pacientes pediátricos son más propensos a desarrollar shock debido a su micro-vasculatura mucho más permeable. La cefalea, melena, petequias, dolor retro-orbital, mialgias, artralgias, náuseas y los vómitos son mucho más frecuentes en adultos, en contraste con la ocurrencia más frecuente de epistaxis, oliguria y hepatomegalia en niños.…”

Dengue in Children: Prolife of Hematological and Biochemical parameters.

“…Dengue is the most common arthropod borne viral disease transmitted by mosquito of the genus Aedes aegypti and is one of the most significant diseases because it is associated with high rates of morbidity and mortality [1,2,3. ] This disease currently represents a major public health issue especially in tropical and subtropical countries, where environmental conditions enable the development and proliferation of mosquito which breeds exclusively in domestic man made water receptacles [2,4] .…”

“…The WHO organization revised it's case definitions in 2009 and now distinguishes as Dengue fever, Dengue fever with warning signs and severe dengue fever [1] .In children dengue can be asymptomatic or polysymptomatic,which may hinder the differential diagnosis . [2] The study by RochaLA etal observed the changing epidemiological trend in Brazil with shift being observed in the age group of the affected population [6] .There are few reports on the clinical and laboratory differences in children and adults with dengue [2,7,8] The intial febrile illness begins with rapid onset of high grade fever which is accompanied by retroorbital headache, severe myalgia , arthralgia, nausea, vomiting (more common in children) and general fatigue. A confluent maculopapular rash (more common in children) appear during end of febrile stage.…”