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Published on: April 28, 2019
Clinical and Laboratory Features and Treatment Outcomes of Dengue Fever in Pediatric Cases
Nadia Nusrat1, Kona Chowdhury2, Susmita Sinha3
1Department of Pediatrics, Delta Medical College and Hospital, Dhaka, BGD.
Insights
Dengue fever in children presents diverse symptoms and lab findings. Prompt, individualized treatment during critical phases is vital for recovery and preventing severe outcomes in pediatric dengue cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Dengue fever (DF) is a significant global arthropod-borne viral illness with a high mortality rate.
- DF is endemic in regions like Bangladesh, presenting varied clinical and laboratory features in children.
- Timely fluid resuscitation and appropriate healthcare referral are critical for managing DF, especially during its severe phases.
Purpose of the Study:
- To evaluate the clinical and laboratory characteristics of dengue fever in pediatric patients.
- To assess the treatment outcomes of pediatric dengue fever cases.
- To identify key indicators for managing severe dengue in children.
Main Methods:
- A prospective study involving 135 hospitalized pediatric dengue fever patients.
- Diagnosis confirmed by dengue nonstructural protein 1 (NS1) antigen or IgM/IgG antibody testing.
- Data collection on clinical presentation, laboratory results, and treatment outcomes from July to October 2023.
Main Results:
- The majority of patients were boys aged 5-10 years from lower-middle-class families.
- Common symptoms included fever, abdominal pain, vomiting, cough, headache, body aches, and diarrhea.
- Laboratory findings revealed high rates of dengue NS1 positivity (91.1%), leukopenia (47%), and thrombocytopenia (69.6%).
- Most cases were classified as dengue fever (68.1%), with significant proportions having warning signs (16.3%) or severe dengue (15.6%).
Conclusions:
- Dengue fever in children exhibits a wide spectrum of clinical and laboratory manifestations.
- Effective management requires tailored treatment based on individual clinical and laboratory profiles, particularly during critical phases.
- Appropriate medical intervention is crucial for improving outcomes and reducing mortality in pediatric dengue cases.
Abstract:
Background Globally, dengue fever (DF) is the leading cause of arthropod-borne viral illness, which considerably contributes to an atrocious death rate. The disease is now endemic in some parts of the world, including Bangladesh. The disorder exhibits a wide range of clinical and laboratory features in children. Judicial fluid resuscitation during the critical phase and prompt referral to the appropriate health facility can be lifesaving. Objectives This research appraised clinical and laboratory features and treatment outcomes of DF in pediatric cases. Methods This prospective investigative work was conducted at Islami Bank Hospital, Dhaka, India, from July to October 2023. The study included 135 admitted pediatric cases of DF, either dengue nonstructural protein 1 (NS1) or anti-dengue antibody IgM or IgG positive. Results Among the selected cases, boys were more predominant than girls, and most patients were in the age group of 5 to 10 years (n=46, 34%), most of them belonging to lower-middle-class families (n=56, 41.5%). All of the study participants had raised body temperatures, and most had abdominal pain (n=82, 60.7%), vomiting (n=77, 57%), cough (n=43, 31.9%), headache (n=38, 28.2%), body aches (n=32, 23.7%), and diarrhea (n=23, 17%). Dengue NS1 was positive in 91.1% (n=123) of cases. Raised hematocrit was found in 36.3% (n=49) of cases, leukopenia in 47% (n=63), and thrombocytopenia in 69.6% (n=94) of cases. Most of our patients were categorized as having DF (68.1%, n=92), followed by dengue with warning signs (16.3%, n=22), and severe dengue was present in 15.6% (n=21) of patients. Most were treated with crystalloid, and some with crystalloid and colloid solution. Fortunately, most of them recovered with no death. Conclusion DF may manifest with varied clinical and laboratory features in children. Appropriate treatment of critical phases, depending on clinical and laboratory features, is crucial to reducing dengue-induced miseries and fatal clinical outcomes among the pediatric population.
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