Concurrent Infections And Proportional Analysis Of Etiological Agents In Pediatric Tropical Fevers: A Tertiary Care Perspective
Keywords:
Tropical fevers, Pediatric infections, Dengue, Scrub typhus, Concurrent infections, EtiologyAbstract
Background: Pediatric tropical fevers represent a significant burden in many low- and middle-income countries, with multiple pathogens—viral, bacterial, and parasitic—coexisting in endemic regions. Co-infections further complicate clinical presentation and outcomes. Understanding the proportional etiology, clinical profiles, and outcomes among pediatric populations is essential for guiding diagnostic algorithms, targeted therapeutic interventions, and effective public health strategies.
Methods: This observational descriptive study was conducted in the pediatric wards of Malda Medical College and Hospital, West Bengal, over one year (December 2022–November 2023). We enrolled 100 children (up to 12 years of age) presenting with fever and at least one of the following: rash/thrombocytopenia, respiratory distress, renal failure, encephalopathy, jaundice, or multi-organ dysfunction syndrome (MODS). Laboratory diagnoses included malaria smears, ELISA for scrub typhus, leptospirosis, chikungunya, dengue (NS1, IgM, IgG), bacterial blood cultures, and other relevant tests. Descriptive and inferential statistics were performed using SPSS version 26.0.
Results: Of the 100 enrolled children, the most common confirmed infection was dengue (42%), followed by scrub typhus (31%), enteric fever (3%), malaria (1%), and leptospirosis (1%). Notably, 22% of children presented with concurrent co-infections; dengue plus scrub typhus was the most prevalent combination (14%). The majority of cases (62%) occurred in children aged 5–12 years, and 60% were male. Median fever duration was 8 days. Common clinical features included vomiting (92%) and abdominal pain (82%). Overall mortality was 3% (3/100), predominantly linked to severe co-infections and complications such as hemophagocytic lymphohistiocytosis (HLH) or severe hepatitis with encephalopathy.
Conclusion: Dengue and scrub typhus emerged as the major contributors to pediatric tropical fevers in our setting, frequently co-existing and contributing to severe disease. Prompt recognition of co-infections is crucial to avert adverse outcomes. Further large-scale studies are warranted to optimize diagnostic protocols and management pathways in resource-limited settings.
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