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Published on: July 4, 2007
Clinical and Biochemical Characteristics of Dengue Infections in Children From Sri Lanka
Umesh Jayarajah1,2,3, Manohari Madarasinghe4, Damayanthi Hapugoda4
1Dengue Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Insights
Pediatric dengue patients in Sri Lanka showed abdominal symptoms, bleeding, and lower platelet/WBC counts were linked to severe Dengue Hemorrhagic Fever (DHF). Early prediction of the critical phase remains challenging.
Area of Science:
- Medical Research
- Epidemiology
- Pediatrics
Background:
- Analyzing global dengue patterns aids evidence-based treatment guidelines and resource allocation.
- This study describes dengue infection characteristics in hospitalized pediatric patients during Sri Lanka's 2017 epidemic.
Purpose of the Study:
- To characterize dengue disease patterns in hospitalized pediatric patients in Sri Lanka.
- To identify factors associated with Dengue Hemorrhagic Fever (DHF) in pediatric cases.
Main Methods:
- Retrospective analysis of clinical and biochemical data of pediatric dengue patients.
- Data collected from a secondary care hospital in Sri Lanka between June and August 2017.
- Comparison with previous pediatric dengue studies in Asia.
Main Results:
- Out of 305 patients (60% male, mean age 8.6 years), 80.3% had Dengue Fever (DF) and 19.7% had Dengue Hemorrhagic Fever (DHF).
- Abdominal symptoms/signs and bleeding manifestations were significantly associated with DHF (P < .001).
- Lower white-cell (WBC) and platelet counts were observed in DHF patients compared to DF patients; liver enzyme derangement was mild and similar in both groups.
Conclusions:
- Abdominal symptoms, bleeding, decreased WBC and platelet counts are significant indicators of DHF in Sri Lankan pediatric dengue patients.
- Liver enzyme derangement is not a reliable predictor of DHF.
- The onset of the critical phase in pediatric dengue is variable and difficult to predict accurately.
Introduction:
Analyzing dengue disease patterns from different parts of the world should help us formulate more evidence based treatment guidelines and appropriately allocate limited healthcare resources. Therefore, we described the disease characteristics of hospitalised pediatric patients with dengue infections from Sri Lanka during the 2017 dengue epidemic.
Methods:
Clinical and biochemical characteristics of pediatric dengue patients treated at a secondary care hospital in Sri Lanka from 1 June 2017 to 31 August 2017 were analyzed. Our findings were compared with previous pediatric dengue studies in Asia.
Results A Total Of 305:
patients (number of males = 184(60%); mean age = 8.6 years) were analyzed. DF (Dengue Fever)-245 (80.3%), DHF (Dengue Hemorrhagic fever)-I:52 (17%), DHF-II:7 (2.3%), and DHF-III:1 (0.3%). Significant associations were found between DHF and abdominal symptoms/signs and overt bleeding manifestations (P < .001). Time of onset of the critical phase was variable (Day 3: 12%, Day 4-5: 78%, Day 6: 5%, and Day 7: 5%). Platelet and white-cell counts (WBC) were significantly lower in DHF than DF; liver enzyme derangement was mild and was similar in the DHF and DF subgroups. None had cardiac, renal, or neurological manifestations and all recovered uneventfully.
Conclusion:
In Sri Lankan pediatric dengue patients, we found abdominal symptoms and signs, decreased WBC and platelet counts and bleeding manifestations were to be significantly associated with DHF. Liver enzyme derangement did not predict DHF. The time of onset of the critical phase was difficult to predict due to the considerable variations noted.
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