A Retrospective Study of Paediatric Dengue Cases in a Tertiary Care Hospital in Southern India

Introduction: Dengue is an important arthropod-borne viral infection in humans and is the second most important reemerging tropical disease. Children are particularly at risk of developing severe dengue and clinically identifying such cases are often a challenge. Aim: To characterise the clinical and laboratory risk factors of dengue fever and its severity in children. Materials and Methods: Retrospective evaluation of demographics, clinical, laboratory findings and outcome of suspected dengue fever in children admitted to the hospital between Jan 2015 - Feb 2017 was performed to identify risk factors of dengue fever and its severity. Results: During the study period, a total of 211 children were clinically suspected on the admission as dengue fever, 34 of these were serologically confirmed dengue positive. A 74% (27/34) of these were primary dengue infections. The mean age of the dengue cohort was 7.6 years (+/- s.d. 4.8) with 59% (20/34) being boys. Based on 2009 WHO clinical criteria, 16 were identified as Dengue with warning Signs (DS), 7 as Dengue Without warning Signs (DWS) while 11 were identified as Severe Dengue (SD). Some of the frequently observed clinical features were fever (31/34), headache (5/34), thrombocytopenia (9/34), leukopenia (4/34) and rash (5/34). The mean WBC in children with severe dengue was 7.9 % (s.d.+/- 5.0) with elevated monocytes 12.2 % (s.d.+/- 3.5) compared to 11.3% (s.d.+/- 5.8) and 6.6% (s.d.+/- 2.0) in children with DS and DWS respectively. Transaminitis was more frequently observed in severe dengue. Conclusion: Clinical and laboratory parameters of acute febrile illness in children can act as early prognosticators of dengue fever and its severity.