Clinical profile of children with dengue and factors associated with severe dengue and dengue with warning signs

ORIGINAL ARTICLE

Clinical Profile of Children with Dengue and Factors Associated with Severe Dengue and Dengue with Warning Signs

Nishantkumar Pravinbhai Rathod, Nusrat Jahan Rafique Ansari, Dinesh Kumar Singh.

Hindu Hriday Samrat Balasaheb Thackeray Medical College and DR R N Cooper Hospital, Mumbai, India.

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Abstract
Aim: To study the clinical profile of children with dengue and determine risk factors associated with severe dengue.
Methods: An observational prospective study was conducted in the pediatric ward and Pediatric Intensive Care Unit (PICU) in a Medical College in Mumbai, India over 2 years duration. Patients were classified for their severity based on World Health Organization (WHO) 2009 criteria for dengue. Factors associated with severe dengue and dengue with warning signs were determined.
Results: Out of 100 patients enrolled, mean age of presentation was 5.82 years. Forty-five children had dengue without warning signs, 44 had dengue with warning signs and 11 had severe dengue. Fifty-three children were in the age group of 6 to 12 years. Male: Female ratio was 1.43: 1. Common clinical presentations were fever (100%), vomiting (57%), rash (50%), malaise (49%), hepatomegaly (46%), abdominal pain (44%), positive tourniquet test (45%), headache (45%), petechiae (37%) and bleeding manifestation (26%). Abdominal pain (79.5%) (p=0.0109), petechiae (62.2%) (p=0.0466), bleeding manifestations (65.4%) (p=0.0305), hepatomegaly (76.1%) (p=0.035) and splenomegaly (60%) (p=0.026) were more common with dengue with warning signs. Altered sensorium, convulsion, circulatory failure and hypotension were seen in children with severe dengue.
Conclusion: Most of the patients with dengue present in the age group of 6-12 years and have dengue with warning signs or severe dengue. There is a male preponderance mostly due to more outdoor activities. Abdominal pain, petechiae, bleeding manifestations and hepatosplenomegaly suggest dengue with warning signs and need more aggressive management.

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