Clinical profile of dengue and predictive severity variables among children at a secondary care hospital of Chilpancingo, Guerrero, Mexico: case series

Background: Dengue continues to increase globally. Currently, the highest incidence of first infection occurs in paediatric population, where severe dengue fever is potentially lethal. This study characterizes the clinical profile of paediatric patients with dengue fever in the South of Mexico. Methods: We undertook a series case study of 133 paediatric inpatients who presented clinical diagnosis of non-severe dengue and severe dengue fever. We described univariate analysis as means or percentages, using 0.05 as significance level. We estimated the prediction of severe dengue considering clinical signs and symptoms only using GLMM (Generalised Linear Mixed Models). Results: 58% (77/133) patients had severe dengue. There were significant differences among the dengue groups, in the following signs and symptoms: Fever, abdominal pain, epistaxis and platelet count. Children older than four years old had a higher proportion of severe dengue (p<0.05). GLMM identified a group of four clinical signs and symptoms (fever >= 39 degrees C, myalgia, arthralgia and abdominal pain) as predictors of severe dengue. Conclusions: The results of this exploratory study suggest changes in the frequency of clinical signs and symptoms among paediatric inpatients. Paediatric patients with a presumptive diagnosis of dengue, showing fever of >= 39 degrees C, myalgia, arthralgia and abdominal pain should be considered as potential cases of severe dengue. (C) 2016 Hospital Infantil de Mexico Federico Gomez. Published by Masson Doyma Mexico S.A.