Clinical profile of dengue fever and utility of WHO classification in the assessment of its severity

 

 

Abstract              Background: Over the past few years, dengue has emerged as a serious public health concern especially in India. It is estimated that around 2.5 billion people, in urban areas of tropical countries, are at a risk of developing dengue infection. DF presents a broad clinical spectrum, ranging from a benign self-limiting infection (85–90% of cases) to the most severe forms (approximately 10–15% of cases) such as dengue shock syndrome (DSS) and dengue hemorrhagic fever (DHF). Aims and objectives: To study the clinical profile of Dengue Fever and utility of Who Classification in the assessment of its severity. Materials and method: The study included all diagnosed dengue on Dengue Card Test of 12 years or older admitted to medical wards from January 2017 to December 2018. Study was performed on 100 patients admitted in the study institute. A prestructured proforma was used to collect the information of patients. Detail history and clinical examination was done and the findings were recorded. Patients were classified as dengue fever, dengue hemorrhagic fever or dengue shock syndrome according to WHO guidelines and laboratory diagnosis of dengue is established by demonstration of specific NS1/IgM/IgG antibodies to dengue in serum (Dengue Card Test). Results: Majority of the patients belonged to the age group 20-29 years age group (38%) followed by 13-19 years (28%) and then 30-39 years age group (18%). Males were affected more (62%). Most common positive serology test which was NS1 in 61%, IgM was positive in 29% patients and 10% patients had mixed positivity (NS1/IgM ± IgG). Fever was the most common clinical feature (96%) followed by headache 82%, myalgia 78%, backache 52%, nausea and vomiting 36%, arthralgia 25%, abdominal pain 21%. Dehydration was the most common clinical sign (41%) followed by ascites 29%. Conclusion: Thus we conclude that Majority of the patients suffering from dengue were young male. Fever, headache, myalgia, backache, rash along with thrombocytopenia, leukopenia, elevated liver enzymes with signs of plasma cell leakage should prompt a clinician on the possibility of dengue fever. Statistically significant association was observed association was observed platelet count and HCT with sever type of dengue. Mortality of dengue was observed in Severe Dengue cases as compared to Dengue without Warning Signs and Dengue with Warning Signs. Thus WHO classification helps to predict the outcome of Dengue.

Key Word: Dengue Fever, clinical profile, Dengue with warning Signs.