A study on the outbreak of dengue fever in a tertiary care children’s hospital in southern Tamil Nadu, India

Authors

  • Belgin Premkumar Department of Paediatrics, Dr SMCSI Medical College, Thiruvananthapuram, Kerala, India
  • Baburaj S. Department of Paediatrics, Dr SMCSI Medical College, Thiruvananthapuram, Kerala, India
  • Margaret Hepzibah N. Consultant Paediatrician, Gerde Gutperle Agasthiapurmuni Child Care Centre, Vellamadam, Kanyakumari, Tamil Nadu, India
  • Misha K. P. Department of Paediatrics, Dr SMCSI Medical College, Thiruvananthapuram, Kerala, India
  • Binu Abraham Department of Paediatrics, Government Medical College Kollam, Kerala, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20192011

Keywords:

Dengue fever, Dengue haemorrhagic fever, Dengue shock syndrome, Mechanical ventilation

Abstract

Background: Dengue fever is the most rapidly spreading mosquito-borne viral disease in the world.Incidence has increased 230-fold with increasing geographic expansion with potential for further spread. The rapidly expanding global footprint of dengue is a public health challenge with an economic burden. This study’s objective is to assess the outbreak of epidemic of dengue fever in a tertiary care children hospital and to describe their socio-demographic, clinical outcome and serological profile.

Methods: It is an observational descriptive study conducted for a period of 1 year in less than 12 years old children in a tertiary care hospital at Southern Tamil Nadu.

Results: Among the 360 children admitted with dengue fever, there were 198 boys (55%) and 162 (45%) were girls. Maximum incidence of dengue incidence was seen in infants less than 1 year (25%). The highest number of cases were admitted during September and October. The most common affected age group was less than 3 years with 179 (49%). Among the cases, 297 (82%) were of severe dengue which constitute dengue haemorrhagic fever-183(38%) and Dengue shock syndrome 114 (62%). Serological analysis showed NS1 Ag was positive in 144 children (40%), Dengue IgM was positive in 54 children (15%), both IgM and IgG positive in 126 children (35%) and IgG was positive in 36 children (10%). Out of the total children admitted with dengue fever, the case fatality was 0.5% (2 children).

Conclusions: This study highlights the importance of WHO clinical criteria for early diagnosis of severe dengue. Moreover, the early and intensive management reduces the mortality significantly.

References

Simmons CP, Farrar JJ, Nguyen V, Wills B: Dengue. N Engl J Med. 2012;366(15):1423-32.

Guzman MG, Halstead SB, Artsob H, Buchy P, Farrar J, Gubler DJ, Hunsperger E, Kroeger A, Margolis HS, Martinez E et al: Dengue: a continuing global threat. Nat Rev Microbiol. 2010;8(12 Suppl):S7-16.

Balmaseda A, Hammond SN, Perez L, Tellez Y, Saborio SI, Mercado JC, et al. Serotype-specific differences in clinical manifestations of dengue. Am J Trop Med Hyg. 2006;74(3):449-56

Special programme for research, training in tropical diseases, and World Health Organization, dengue: guidelines for diagnosis, treatment, prevention and control, World Health Organization, Geneva, Switzerland; 2009.

Sharma NL, Balasubramanyam V, Kandati J, Ponugoti M. Clinical and laboratory profile of dengue fever in children during an outbreak-one year study at tertiary care hospital, Chennai, Tamilnadu, India. Int J Contemp Pediatr. 2016;4(1):110-5.

Selvan T, Nagaraj MV, Saravanan P, Somashekar. A Study of clinical profile of dengue fever in children. Int J Contemp Pediatr. 2017 Mar;4(2):534-7.

Chandralekha, Gupta P, Trikha A. The north Indian dengue outbreak 2006: a retrospective analysis of intensive care units admissions in a tertiary care hospital. Trans R Soc Trop Med Hyg. 2008;102:143-7.

Ahmed S, Arif F, Yahya Y, Rehman A, Abbas K, Ashraf S, et al. Dengue fever outbreak in Karachi 2006: a study of profile and outcome of children under 15 years of age. J Pakistan Med Assoc. 2008;58(1):4-8.

Mittal H, Faridi MMA, Arora SK, Patil R. Clinicohematological profile and platelet trends in children with dengue during 2010 epidemic in north India. Indian J Pediatr. 2012;79(4):467-71.

Kumar CM, Vyas KSK, Krishna YS. Clinical profile of dengue fever with severe thrombocytopenia and its complications: a retrospective study at a tertiary care hospital in South India. Int J Res Med Sci. 2017;5(5):1751-5.

Jain S, Mittal A, Sharma SK, Upadhyay AD, Pandey RM, Sinha S, et al. Predictors of dengue-related mortality and disease severity in a tertiary care center in North India. In: Open Forum Infect Dis. 2017;4(2):ofx056.

Changal KH, Raina A, Raina M, Bashir R, Latief M, Mir T, et al. Differentiating secondary from primary dengue using IgG to IgM ratio in early dengue: an observational hospital based clinico-serological study from North India. BMC Infec Dis. 2016;16(1):715.

Vikram K, Nagpal BN, Pande V, Srivastava A, Saxena R, Anvikar A, et al. An epidemiological study of dengue in Delhi, India. Acta Trop. 2016;153:21-7.

Sharma G, Bhatt D, Garg GK, Sharma D, Gulati RK. A prospective seroepidemiologic study on dengue in children in South eastern Rajasthan, India. Pediatric Review. Int J Pediatr. 2016;3(10):12-7.

Krishnamoorthy S, Bhatt AN, Mathew CT, Ittyachen AM. Hepatitis and thrombocytopenia: markers of dengue mortality. Trop Doc. 2017;47(2):136-41.

World Health Organization. Handbook for clinical management of dengue. Geneva: WHO, 2012. Available at http:// www.who.int/tdr/publications/ handbook_dengue/en/. Accessed on 17 November 2018.

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Published

2019-04-30

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Original Research Articles