To Study Clinical Profile and Outcome of Dengue Fever with Reference to Serological Test (IgM & NS1) in a Tertiary Care Hospital
Background: Dengue is the most prevalent viral disease which is mosquito-borne in origin. Incidence of dengue has found to be increased and has become a major public health concern. The aim of the present study was to study clinical profile of dengue in the age group of one year to 14 years and to study certain environmental risk factors of dengue. Methods: In this prospective clinical study total patient selected were 250 attending in the Outpatient department of Paediatrics of Dr. V. M. Govt. Medical College, Solapur, Maharashtra, India from Sept.2016 to Aug-2018 i.e.2 Years. A detailed case history, a complete physical examination was carried out. The patients were subjected to following routine and special investigations. Clinical grading of disease severity was as done according to WHO guidelines. The data collected was compiled, tabulated, analyzed and subjected to statistical tests done using SPSS. Results: In present study total 7222 were hospitalized and out of 7222 patients 250 tested positive for dengue. Out of which 134 (53.60%) were males and 116 (46.40%) were females. Out of the 250 patients, 83 were aged between 1 to 5 years i.e. 33%, 90 were aged between 6 to 10 years i.e. 36.5%, 77 patients were aged between 11 to 14 years i.e. 30.4%. 100 patients (40%) belonged to urban population and 150 patients (60% ) belonged to rural population. 83 (33%) patients falls in the age group of 1 to 5 years out of which 42 were males and 41 were females. 90 patients were in the age group of 6 to 10 years out of which 50 were males and 40 females. 77 patients belong to the age group 11 to 14 years out of which 40 were males and 37 were females. In the month of Jan to March 42 cases reported i.e. 16.8%, April to June 23 cases were reported i.e. 9.2%, July to September 161 cases were reported i.e. 64.4% and 24 cases in the month of October to December i.e. 9.6%. Out of 250 patients all were having fever (100%) and nausea and vomiting 48 cases (19.5 %) were the least noted symptoms in the study. Out of 250 patient’s pallor was observed in 33 cases (13%), icterus in 10 cases (4%), lymphadenopathy in 5 cases (2%), Epistaxis in 22 cases (8.6%), petechiae in 87 cases (34.7%), malaena in 83 cases (33%), haematuria in 43 cases (17.4%). of 250 hepatomegaly was seen in 49 cases (19.5%), splenomegaly in 43 cases (17.3%), cold peripheral extremities was seen in 38 cases (15.2%), hypotension is seen in 60 (23.9%), mild hypotension in 22 cases (8.8%), moderate hypotension in 25 cases (20%) and severe in 13 cases (5.6%), pleural effusion in 28 cases (11%) and ascites in 25 cases (10 %). Leucopenia was seen in 88 cases (35 %), leucocytosis in 63 cases (25 %), thrombocytopenia in 120 cases (48 %), hyperbilirubinemia in 20 cases (08 %), haematocrit > 42 % in 75 cases (30 %). Out of 250 cases IgM positive was seen maximal in 153 cases (60.8%), only NS 1 was seen in 98 (39.10%), both IgM and NS 1 in 44 (17.3%). 30 cases (12%) were having gall bladder wall oedema, 25 cases (10%) having ascites and 28 case (11%) were having pleural effusion. Conclusions: Our study concluded that out of 7222 patients 250 patients were dengue positive and all were having fever as a predominant symptom. Thrombocytopenia was seen in 120 patients and out of that 24 required platelet rich plasma and only 8 required single donor platelet apheresis. In this study dengue IgM was positive in 153 cases and dengue NS1 was positive in 98 cases which shows that dengue IgM and NS1 are good serological markers of dengue fever.
2. Special Programme for Research. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. Geneva, Switzerland: World Health Organization; 2009.
3. Rigau-Pérez J. G., Clark G. G., Gubler D. J., Reiter P., Sanders E. J., Vorndam A. V. Dengue and dengue haemorrhagic fever. The Lancet. 1998;352(9132):971– 977.
4. WHO. Factsheet no. 117. Geneva, Switzerland: World Health Organization; 2008. Dengue and dengue haemorrhagic fever.
5. Brady OJ, Gething PW, Bhatt S, Messina JP, Brownstein JS, Hoen AG et al. Refining the global spatial limits of dengue virus transmission by evidence-based consensus. PLoS Negl Trop Dis. 2012;6:e1760.
6. World Health Organization, Regional Office for South-East Asia. Comprehensive Guidelines for Prevention and Control of Dengue and Dengue Hemorrhagic Fever, Revised and Expanded Edition. WHO-SEARO 2011. (SEARO Technical Publication Series No. 60) 2011.
7. Ahmed FU, Mahmood CB, Sharma JD, Hoque SM, Zaman R, Hasan MH. Dengue fever and dengue haemorrhagic fever in chidren the 2000 out break in Chittatong, Bangladesh. Dengue Bulletin. 2001;25:33–9.
8. S. Swaminathan and N. Khanna, “Experimental dengue vaccines,” Molecular Vaccines: From Prophylaxis to Therapy, vol. 1, pp. 135–151, 2013.
9. . Itoda I, Masuda G, Suganuma A, Imamura A, Ajisawa A, Yamada K, et al. Clinical features of 62 imported cases of dengue fever in Japan. Am J Trop Med Hyg. 2006;75:470–4.
10. World Health Organization. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. [Last accessed on 2012 Jun.
11. R. Chen and N. Vasilakis, “Dengue-Quo Tu et Quo Vadis?” Viruses, vol. 3, no. 9, pp. 1562–1608, 2011.
12. Siddharth NS, Yash PM, Surendra KS, et al. API Textbook of Medicine. 7th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2003.
13. Changa K, Fredrico D, Diana LTT, David CL. When less is more: can we abandon prophylactic platelettransfusion in Dengue fever? Ann Acad Med Singapore 2011; 40: 539-545.
14. MM Kauser et al A Study of Clinical and Laboratory Profile of Dengue Fever in Tertiary Care Hospital in Central Karnataka, India. Global Journal of Medical Research: B Pharma, Drug Discovery, Toxicology and Medicine. 2014;14:5.
15. Kumar A1, Sharma SK, Padbidri VS, Thakare JP, Jain DC, Datta KK. An outbreak of dengue fever in rural areas of northern India. J Commun Dis. 2001 Dec;33(4):274-81.
16. S. Ahmed, F. Arif, Y. Yahya et al., “Dengue fever outbreak in Karachi 2006-a study of profile and outcome of children under15 years of age,” Journal of the PakistanMedical Association, vol. 58, no. 1, pp. 4–8, 2008.
17. Faridi MM1, Aggarwal A, Kumar M, Sarafrazul A. Clinical and biochemical profile of dengue haemorrhagic fever in children in Delhi. Trop Doct. 2008 Jan;38(1):28-30.
18. Iqtadar S1, Akbar N2, Mehmood M3, Abaidullah S4Clinical Audit of Dengue Related Deaths in 2011-Mayo Hospital Lahore Pakistan. . Pak J Med Sci. 2017 Sep-Oct;33(5).
19. Cheng Hoon Chew, et al Rural-urban comparisons of dengue seroprevalence in Malaysia. BMC Public Health. 2016; 16: 824.
20. Gubler DJ. Dengue, Urbanization and Globalization: The Unholy Trinity of the 21(st) Century. Trop Med Health. 2011;39(4 Suppl):3–11. doi:10.2149/tmh.2011-S05
21. S. Padhi, M. Dash, P. Panda et al., “A three year retrospective study on the increasing trend in seroprevalence of dengue infection from southern Odisha,India,” The Indian Journal of Medical Research, vol. 140, pp. 660–664, 2014.
22. Mittal H1, Faridi MM, Arora SK, Patil R. Clinicohematological profile and platelet trends in children with dengue during 2010 epidemic in north India. Indian J Pediatr. 2012 Apr;79(4):467-71.
23. Pothapregada S1, Kamalakannan B1, Thulasingham M2, Sampath S3. Clinically Profiling Pediatric Patients with Dengue. J Glob Infect Dis. 2016 Jul- Sep;8(3):115-20
24. Sharma G.K.1, Bhatt D. 2, Garg G.K. 3, Sharma D. 4, Gulati R.K. 5 A prospective seroepidemiologic study on dengue in children in Southeastern Rajasthan, India. Ijpd Vol 3, No 10 (2016)
25. Mishra S1, Ramanathan R1, Agarwalla SK1. Clinical Profile of Dengue Fever in Children: A Study from Southern Odisha, India Scientifica (Cairo). 2016;2016:6391594.
26. Hati AK1. Studies on dengue and dengue haemorrhagic fever (DHF) in West Bengal State, India. J Commun Dis. 2006 Mar;38(2):124-9.
27. Sahana KS1, Sujatha R. Clinical profile of dengue among children according to revised WHO classification: analysis of a 2012 outbreak from Southern India. Indian J Pediatr. 2012 Feb;82(2):109-13.
28. Zulkarnain IGallbladder edema in Dengue hemorrhagic fever and its association with haematocrit levels and type of infections. Acta Med Indones. 2004;36(2):84-6.
29. Tewari K1, Tewari VV2, Mehta R3. Clinical and Hematological Profile of Patients with Dengue Fever at a Tertiary Care Hospital - An Observational Study.
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