Epidemiology of Dengue Fever among clinically Suspected Febrile Patients at A Tertiary Care Center in Punjab

Yıl 2018, , 43 - 48, 20.06.2018

Shweta Chitkara Deepinder Chhina Veenu Gupta Rajesh Mahajan Daaman Sharma

https://doi.org/10.5799/jmid.434590

Cited By: 1

Öz

ABSTRACT

Objective: Dengue has emerged as a major public health concern
across the globe in terms of mortality and morbidity. The clinical and
epidemiological profile of dengue infection changes from time to time. The
study was conducted to determine the prevalence of dengue infection, to study
the seasonal variation and the clinical profile in these cases.

Methods: A
prospective, observational study conducted over a period from April 2015 to
March 2016. Patients with acute febrile illness with clinical suspicion of
dengue fever admitted in the hospital were included in the study. Serological
tests like Dengue IgM and NS1 antigen ELISA were performed to confirm the
diagnosis. Serologically confirmed patients of dengue fever were studied for
their clinical presentation and lab parameters.

Results: From
a total 4732 patients tested for dengue viral infection, 1165 (24.6%) tested
positive for dengue. The most affected age group was 26-35 years (25.7%) with
male predominance. Most dengue cases were seen in the months of August to December
2015. Commonly clinical symptoms and signs were myalgia (72.4%), arthralgia
(34.4%), vomiting (50%), abdominal pain (38.6%), hepatomegaly (27.4%) and
ascites (10.8%). Lab parameters revealed leukopenia (43%) and thrombocytopenia
(93.1%) in most cases. Transaminitis was seen in 84.1% cases. Common
complications were shock (4.8%) and encephalopathy (4.8%). Hepatic failure was
seen in 3.7% of patients and renal failure in 1.8% of patients.

Conclusion: Dengue fever has a very non-specific and variable presentation.
Knowledge of local prevalence and recent outbreaks can be very helpful in
recognizing the clinical entity. J
Microbiol Infect Dis 2018; 8(2):43-48

Anahtar Kelimeler

Dengue fever, prevalence, seasonality, clinical manifestations, tertiary care hospital

Kaynakça

• Centers for Disease Control and Prevention [Internet]. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention; 2016 [cited 2016 Nov 9]. Available from: http://www.cdc.gov/dengue/entomologyecology/index.html 2. World Health Organization. Dengue and Dengue Hemorrhagic fever [Internet]. WHO; March 2014 [cited 2016 Nov 9]. Available from http:// www.who.int/mediacentre/factsheets/fs117/en/ 3. Guzmán MG, Kouri G. Dengue: an update. The Lancet infectious diseases. 2002; 2(1):33-42. 4. Shamala DS. Laboratory diagnosis of Dengue: A review. The international medical Journal Malaysia. 2015; 14:17-28. 5. Peeling RW, Artsob H, Pelegrino JL, et al. Evaluation of diagnostic tests: dengue. Natur Rev Microbiol 2010; 8:30-37. 6. Subedi D, Taylor-Robinson AW. Laboratory Diagnosis of Dengue Infection: Current Techniques and Future Strategies. Open J Clin Diagn 2014; 4:63–70. 7. Dussart P, Labeau B, Lagathu G, et al. Evaluation of an Enzyme Immunoassay for Detection of Dengue Virus NS1 Antigen in Human Serum. Clinical and Vaccine Immunology. 2006;13(11):1185–9. 8. National Guidelines for Clinical Management of Dengue Fever [Internet]. [cited 2016Nov17]. Available from: http://nvbdcp.gov.in/doc/dengue-national-guidelines-2014.pdf 9. Lall H, Jais M, Gupta P. Sero-Prevalence of Dengue in Tertiary Care Hospital in Delhi. Int J Curr Microbiol App Sci 2016; 5(6):439-445. 10. Garg A, Garg J, Rao YK, Upadhyay GC, Sakhuja S. Prevalence of dengue among clinically suspected febrile episodes at a teaching hospital in North India. Journal of Infectious Diseases and Immunity. 2011; 3(5):85-89. 11. Ghosh G, Urhekar AD, Kosta S. A clinico-microbiological study of dengue fever cases in a tertiary care center of navi Mumbai. International Journal of Bioassays. 2013; 2(11):1462-1467. 12. Low JG, Ong A, Tan LK, et al. The early clinical features of dengue in adults: challenges for early clinical diagnosis. PLoS Negl Trop Dis 2011; 5(5):e1191. 13. Turbadkar D, Ramchandran A, Mathur M, Gaikwad S. Laboratory and clinical profile of dengue: A study from Mumbai. Annals of Tropical Medicine and Public Health. 2012; 5(1):20. 14. Chrispal A, Boorugu H, Gopinath KG, et al. Acute undifferentiated febrile illness in adult hospitalized patients: the disease spectrum and diagnostic predictors – an experience from a tertiary care hospital in South India. Trop Doctor 2010; 40(4):230-234. 15. Jena B, Prasad M, Murthy S, Ramanarao G. Demand pattern of Medical Emergency Services for Infectious Diseases in Andhra Pradesh-A Geo-spatial Temporal Analysis of Fever cases. Transforming Emergency Management. Indian Emergency Journal. 2010; 1(5):821. 16. Murdoch DR, Woods CW, Zimmerman MD, et al. The aetiology of febrile illness in adults presenting to Patan Hospital in Kathmandu, Nepal. Am J Trop Med Hyg 2004; 70(6):670-675. 17. Zimmerman MD, Murdoch DR, Rozmajzl PJ, et al. Murine typhus and febrile illness, Nepal. Emerg Infect Dis 2008; 14(10):1656-9. 18. Kashinkunti MD, Gundikeri SK, Dhananjaya M. Acute undifferentiated febrile illness- clinical spectrum and outcome from a tertiary care teaching hospital of north Karnataka. Int J Biol Med Res 2013; 4(2):3399-4002. 19. Ittyachen AM, Ramachandran R. Study of acute febrile illness: a 10-year descriptive study and a proposed algorithm from a tertiary care referral hospital in rural Kerala in Southern India. Trop Doct 2015; 45(2):114-117. 20. Ghosh G, Urhekar AD, Kosta S. A clinico-microbiological study of dengue fever cases in a tertiary care center of navi Mumbai. Int J Bioassay 2013; 2(11):1462-1467. 21. Low JG, Ong A, Tan LK, et al. The early clinical features of dengue in adults: challenges for early clinical diagnosis. PLoS Negl Trop Dis 2011; 5(5):e1191. 22. Turbadkar D, Ramchandran A, Mathur M, Gaikwad S. Laboratory and clinical profile of dengue: A study from Mumbai. Annals of Tropical Medicine and Public Health. 2012; 5(1):20. 23. Gupta P, Trikha A. The north Indian dengue outbreak 2006: a retrospective analysis of intensive care unit admissions in a tertiary care hospital. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008; 102(2):143-147. 24. Tejaswi CN, Patil SS, Shekharappa KR. Study of clinical manifestations of dengue cases in a tertiary care hospital, Bangalore, Karnataka. International Journal of Medical Science and Public Health 2016; 5(12). 25. Chatterjee N, Mukhopadhyay M, Ghosh S, Mondol M, Das C, Patar K. An observational study of dengue fever in a tertiary care hospital of Eastern India. JAPI 2014; 62:224-227. 26. Singh R, Singh SP, Ahmad N. A study of clinical and laboratory profile of dengue fever in a tertiary care centre of Uttarakhand, India. Int J Resear Med Sci 2014;2 (1):160-163.