Clinical profile and outcomes of dengue fever during monsoon season at a tertiary care hospital in South India
DOI:
https://doi.org/10.18203/2349-3933.ijam20214068Keywords:
Dengue, Complications, Mortality, PreventionAbstract
Background: Dengue is a mosquito-borne infectious disease of the tropical and subtropical countries which is rapidly becoming a global burden. It is caused by any of the four serotypes of dengue virus. Dengue disease presentation varies from mild fever with myalgia and fatigability to severe conditions of dengue haemorrhagic fever and shock syndrome. This study describes the clinical features, laboratory parameters and outcomes of the dengue fever patients during the monsoon season in a tertiary care hospital.
Methods: This is retrospective, single centre study carried out at Yenepoya medical college and hospital (YMCH), Mangalore a coastal town in southern India. All patients who were adults (aged>16 years), positive for rapid (NS1 antigen) test or dengue IgM Elisa and admitted from 1-5-2019 to 31-9-2019 (monsoon season) were included in this study. Data was collected from the medical records of YMCH.
Results: The male to female ratio of patients in this study was about 4:1. About 70.1% belonged to the age group between 16-35 years. The predominant symptoms on admission were fever, headache, myalgia, nausea and vomiting, abdominal pain, loose stools, bleeding manifestations and skin rashes. Average days of hospitalization are 5.88 days (SD 2.94). Thrombocytopenia leukopenia raised hematocrit and transaminases are the commonly observed laboratory findings. Ascites, pleural effusion, gall bladder wall edema, sepsis, bradycardia, hypotension, ARDS, and acute kidney injury are the complications observed during the illness. Mortality rate in this study is 1.9%.
Conclusions: As seen in this study dengue fever is predominantly affecting the younger age group. The early confirmation of diagnosis, identifying the warning signs and prompt supportive management will help in preventing the further complications and in reducing the mortality. Increased public awareness and vector control measures are important factors to be taken into consideration in the prevention of dengue.
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References
Gulati S, Maheshwari A. Atypical manifestations of dengue. Trop Med Int Health. 2007;12(9):1087-95.
World Health Organisation. Comprehensive guidelines for prevention and control of dengue and dengue hemorrhagic fever. Geneva: World Health Organization. Available at: http://apps.searo.who.int/pds_docs/B4751.pdf. Accessed on 23 Jan 2020.
The National Guideline for Dengue case management during COVID-19 pandemic has been approved by Joint Monitoring Group Chaired by Dr Sunil Kumar, Director General of Health Services, Ministry of Health and Family Welfare, Government of India. 2020;2-69.
Singh J, Dinkar A, Atam V, Himanshu D, Gupta KK, Usman K et al. Awareness and outcome of changing trends in clinical profile of dengue fever: A retrospective analysis of dengue epidemic from January to December 2014 at a tertiary care hospital. J Assoc Physicians India. 2017;65:42-6.
Kumar A. Clinical manifestations and trend of dengue cases admitted in a tertiary care hospital, Udupi district, Karnataka. Indian J Community Med. 2010;35(3):386-90.
Rabbani MU, Aslam M, Zaheer MS, Ashraf MU. Clinical and laboratory profile of dengue fever in a North Indian tertiary hospital. J Assoc Physicians India. 2018;66(4):37-9.
Padmaprakash KV, Jha VK, Bhushan S, Deepkamal, Sowmya KC. Demographic and clinical profile of dengue fever in a tertiary care hospital of South India. J Assoc Physicians India. 2020;68(11):24-7.
Mistry M, Chudasama RK, Goswami Y, Dalwadi C, Mitra A, Mehta G. Epidemiological characteristics of dengue disease in Saurashtra region, India, during year 2015. J Family Med Prim Care. 2017;6(2):249-53.
Dinkar A, Singh J. Dengue infection in North India: An experience of a tertiary care center from 2012 to 2017. Tzu Chi Med J. 2019;32(1):36-40.
Deshwal R, Qureshi MI, Singh R. Clinical and laboratory profile of dengue fever. J Assoc Physicians India. 2015;63:30-2.
Chatterjee N, Mukhopadhyay M, Ghosh S. An observational study of dengue fever in a tertiary care hospital of eastern India. J Assoc Physicians India. 2014;62:224-6.
Daniel R, Philip AZ. A study of clinical profile of dengue fever in Kollam, Kerala, India. Dengue Bull. 2005;29:197-202.
Jayadas TTP, Kumanan T. The clinical profile, hematological parameters and liver transaminases of dengue NS1 Ag positive patients admitted to Jaffna teaching hospital. BMC Res Notes. 2019;12(604):1-5.
Kittitrakul C, Silachamroon U. Liver function tests abnormality and clinical severity of dengue infection in adult patients. J Med Asso Thailand. 2015;98(1):S1-8.
Wong M, Shen E. The utility of liver function tests in dengue. Anna Academy Med. 2008;37(1):82-3.
Kuo CH, Tai D, Chang-Chien CS, Lan CK. Liver biochemical tests and dengue fever. Am J Trop Med Hygiene. 1992;47(3):265-70.
Karoli R, Fatima J, Siddiqi Z, Kazmi KI. Clinical profile of dengue infection at a teaching hospital in North India. J Infect Developing Countries. 2012;6(7):551-4.
Mohanty B, Sunder A, Pathak S. Clinico-laboratory profile of expanded dengue syndrome-Our experience in a teaching hospital. J Family Med Primary Care. 2019;8(3):1022-7.
Venkatasai PM, Dev B, Krishnan R. The role of ultrasound in dengue fever. Bri J Radiol. 2014;78(929):381-473.
Wu KL, CS Changchien CS. Early abdominal sonographic findings in patients with dengue fever. J Clin Ultrasound. 2004;32:386-8.