Abstract
Introduction: Dengue infection is increasing proportionally to increased urbanization and compromised sanitation measures. Dengue infection poses a huge burden to the health-care system. Dengue infection vary in severity, ranging from influenza-like self-limiting illness to life-threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) which, if left untreated, are associated with mortality as high as 20%. Early diagnosis and management can decrease case fatality rate significantly.
Objective: To assess the clinical profile of dengue infection and to evaluate the outcome of dengue fever.
Material and Method: In this prospective observational study 129 patients who visited to Rohilkhand Medical College And Hospital between 1st Jan 2018 to 31st Dec 2018 were included. Those patients with confirmed dengue, with NS1 antigen and/or IgM dengue antibody positive were included in this study. Detailed history was taken and clinical examination was performed and laboratory investigations were done.
Results: 129 patients were studied, majority were males. Fever was present in 100% of patients followed by headache, myalgia. In 90 cases platelet count was less than 50,000/cumm of which bleeding manifestation was found in 9 patients. Plerual effusion and ascitis were observed in 26 and 21 cases respectively. Hepatomegaly was noted in 19 cases and splenomegaly in 17. Leucopenia was present in 26 cases whereas raised liver enzymes were present in 114cases. The mortality rate was 1.55 %.
Conclusion: Dengue epidemic has increased in recent past probably due to unplanned urbanization with rapid construction activities, unhygienic condition and poor sanitation facilities contributing fertile breeding soil for mosquitoes. Early diagnosis and management can decrease mortality and morbidity of illness. Platelet transfusions have little role in management of dengue patients.
References
- Halstead SB (2007) Dengue. Lancet 370: 1644-1652.
- WHO (2009) Dengue Guidelines for Diagnosis, Treatment, Prevention and Control WHO (2009) http://whqlibdoc.who.int/publications/2009/9789241547871 _eng.pdf. Last accessed 5 July 2012.
- Kabra SK, Jain Y, Pandey RM, Madhulika, Singhal T, Tripathi P, Broor S, Seth P, Seth V (1999) Dengue hemorrhagic fever in children in the 1996 Delhi epidemic. Trans R Soc Trop Med Hyg 73: 435-440.
- Narayan M, Aravind MA, Thilothammal N, Prema R, Sargunam CS, Ramamurty N (2002) Dengue fever epidemic in Chennai: a clinical profile and outcome. Indian Pediatr 39: 1027-1033.
- Shah I, Deshpande GC, Tardeja PN (2002). Outbreak of dengue in Mumbai and predictive markers for dengue shock syndrome. J Trop Pediatr 50: 301-305.
- Gupta P, Khare V, Tripathi S, Nag VL, Kumar R, Khan MY, Dhole TK (2010) Assessment of WHO definition of dengue hemorrhagic fever in North India. J Infect Dev Ctries 4: 150-155.
- Kumar A, Sharma SK, Padbidri VS, Thakrey JP, Jain DC and Dutta KK (2001) An outbreak of dengue fever in rural areas of northern India. J Commun Dis 233: 274-281.
- Arunachalam N, Murty US, Kabilan L Studies on dengue in rural areas of Kurnool District, Andhra Pradesh, India. J Am Mosq Control Assoc 20: 87-90.
- World Health Organization. Prevention and control of dengueand dengue hemorrhagic fever: comprehensive guidelines. WHO Regional publication, SEARO 1999; 29.
- Imported dengue--United States, 1997 and 1998. Morb Mortal Wkly Rep. 2000;49:248-5.
- Engelthaler DM, Fink TM, Levy CE, LeslieMJ. The reemergence of Aedes aegypti inArizona. Emerg Infect Dis 1997; 3:241-2.
- Kumaria R, Chakravarti A. Molecular detection and serotypiccharacterization of dengue viruses by single tube multiplex RT-PCR. Diagn Microbiol Infect Dis 2005; 52(4):311-6.
- Chakravarti A, Kumaria R. Eco-epidemiological analysis of dengue infection during an outbreak of dengue fever, India. Virology J 2005; 2:32; 1-7. (Online).
- Endy TP, Nisalak A, Chunsuttiwat S et al. Spatial and temporalcirculation of dengue virus serotypes: a prospective study of primary school children in Kamphaeng Phet, Thailand. Am JEpidemiol 2002; 56:52–9.
- Graham RR, Juffrie M, Tan R et al. A prospective seroepidemiologicstudy on dengue in children four to nine years of age in Yogyakarta, Indonesia Studies in 1995-1996. Am J Trop MedHyg 1999; 61:412-19.
- Ahmed S., Arif F., Yahya Y., et al. Dengue fever outbreak in Karachi 2006-a study of profile and outcome of children under 15 years of age. Journal of the Pakistan Medical Association. 2008;58 (1):4–8.
- Mittal H., Faridi M. M. A., Arora S. K., Patil R. Clinicohematological profile and platelet trends inchildren with dengue during 2010 epidemic in North India. Indian Journal of Pediatrics. 2012;79(4): 467–471. doi: 10.1007/s12098-011-0586-7.
- Wanigasuriya K., Gurugama P., Wijewickrama A., Seneviratne S. L., Gunatilake S. B. Usefulness of World Health Organization (WHO) dengue case classifications in a Sri Lankan clinical setting.Journal of the Ceylon college of Physicians. 2012;42(1-2):21–27. doi: 10.4038/jccp.v42i1-2.4550.
Corresponding Author
Kamlesh Taori
Junior Resident, MD Medicine, Rohilkhand Medical College, Bareilly, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.48
