Clinical and Laboratory Features and Treatment Outcomes of Dengue Fever in Pediatric 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.

Keywords: aedes mosquito; breakbone fever; clinical attribute; dengue virus; febrile illness; high body temperature; hospitalized pediatric cases; laboratory findings; low- and middle-income countries (lmics); therapeutic intervention and consequence.

Figure 1. Illustration of the study methodology

Note: This figure was drawn using the premium version of BioRender (https://BioRender.com/d36w685) [76] with agreement license number EM27ID6VNP. Illustration Credit: Susmita Sinha NS1: nonstructural protein 1

Figure 2. Various laboratory findings of the study group

Note: The premium version of BioRender (https://biorender.com/) [76] was used to draw this figure and was accessed on November 20, 2024 with license number VQ27KJR8UH. Illustration Credit: Susmita Sinha NS1: nonstructural protein 1; SGPT: serum glutamate pyruvate transaminase