Clinical Manifestations, Laboratory Profile And Outcome Of Dengue Fever In Children In A Tertiary Care Hospital In Odisha- A Prospective Observational Study
Keywords:
Bleeding, dengue fever, multi-organ failure, shockAbstract
Background. In India, dengue epidemics are becoming more frequent (WHO, 2008). The majority of dengue viral infections are self-limiting, but complications may cause high morbidity and mortality.
Aims and Objectives: To study the clinical manifestations, laboratory profile and outcome of Dengue fever in children less than 14 years of age and to determine the seasonal trend of the disease during our study period.
Materials and Methods: It was descriptive Longitudinal Hospital base study. The study was conducted on total number of 150 dengue positive patients, admitted in the department of Paediatrics of IMS & SUM hospital. A systematic sampling method was used for the purpose of this study using the formula for calculating sampling interval (sampling frame/sample size. A total 1178 number of the patient admitted with suspected dengue like fever during the study period, out of which dengue positive found 150 cases(either positive NS1 antigen or positive IgM antibody by ELISA).
Results: The incidence of dengue fever was 12.7%. Age distribution among study population we have found maximum number of the patients belonged to 10 to <14 years of age group i.e. 71(49.3%), followed by 52(34.7%) patients who belonged to 5 to 10 years of age group and 24(16.0%) patients were between 1 to 5 years of age group respectively. Most of the dengue cases were found at the months of august to December i.e. 127(84.7%) cases, mostly during monsoons and sometime stretching till mid of December. Out of 150 cases ELISA for NS1 positive 126(84.0%), and negative found 24(16.0%) cases. Dengue with/without warning sign was 79(52.7%) & Severe Dengue was found 21(14.0%) cases respectively. Fever was the common symptoms among all the patients (150). Petechiae/rash-73.3%, Bleeding Manifestation-73.3%, Altered sensorium / Drowsiness- 10.7%,Out of 150 cases 31(20.6%) cases had rise in SGPT, out of which 23(15.3%) cases had rise in SGPT from 50-200 IU/L. 6(4.0%) cases had rise in SGPT from 200-1000IU/L.We have found SGPT level was very high (200-1000IU/L) & (>1000IU/L) in severe dengue cases compare to non severe dengue case. i.e. 9.5% each. It was statistically significant different between the groups. p value was 0.0008.On USG findings out of 150 patients, we found that 36 (24.0%) had ascites. And 4(2.6%) patients had GB wall edema. Out of 150 cases 2(1.3%) cases died from severe dengue cases (D.H.F & D.S.S.) and another 148(98.7%) cases survived.
Conclusion: Dengue fever is a cause of great apprehension among paediatric age group fever, and is also cause of fear among parents. Vomiting,skin bleeding, altered sensorium, hepatomegaly, and fever defervescences after a period of fever strongly suggest a diagnosis of severe Dengue. Raised SGOT, hepatomegaly, pleural effusion and shock are few of the certain symptoms that can help distinguish between severe and non-severe dengue. Early detection, precise assessment, and proper treatment have all helped to reduce morbidity and mortality
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