Madhavi K1, Seshu Kumari G2
BACKGROUND
Dengue fever(DF) with its severe manifestations such as DHF and DSS has emerged as a major public health problem of international concern.The geographical distribution has greatly expanded over the last 30 years, because of increased potential for breeding of Aedes aegypti. This has been prompted by demographic explosion, rapid growth of urban centers with strain on public services, such as potable water and augmented by rain water harvesting in diverse types of containers resulting in multiple storage practices. Today, Dengue ranks as the most important mosquito-borne viral disease in the world. Current estimates report that at least 112 countries are endemic for Dengue and about 40% of the world populations (2.5-3 billion people) are at risk in tropics and sub-tropics. Annually, 100 million cases of dengue fever and half a million cases of DHF occur worldwide. Early recognition and prompt initiation of treatment are vital if disease related morbidity and mortality are to be limited.
METHODS
A total of 100 patients admitted to our hospital with fever (>38.50F) and IgM Dengue positive were studied at our institute, Rangaraya Medical College, Kakinada during Jan 2013 to Jan 2015. Out of 100 patients, 73(73%) patients were diagnosed to have DF, 22(22%) patients were diagnosed to have DHF and 5(5%) patients were diagnosed to have DSS based on WHO criteria. The present study was conducted in Government General Hospital, Kakinada during 2013-2015. Informed consent was taken from all the patients during the study.
STUDY DESIGN
It is a prospective cohort study over a period of two years through sample and sampling techniques. A total of 100 patients admitted to the hospital with history of fever of more than 38.5 0 C and IgM Dengue positive cases were selected using purposive sampling techniques. They were followed from the onset of fever to time of recovery or discharge according to WHO discharge criteria whichever is earlier. The following investigations were done: Blood counts, IgM Dengue. Clinically, patients were monitored and platelet count, haematocrit, Hess test were repeated daily.
DATA ANALYSIS
Data collected will be analysed by frequency, percentage and mean.
Dengue-IgM Capture ELISA
Detection of dengue virus specific IgM Antibodies in serum.
RESULTS
Male to female ratio was 1.5:1. Majority of the cases having dengue infection belong to the age group of 21-30 years, wherein 48% belong to 21-30 years’ group and 24% belong to 31-40 years’ group. All the cases had fever (100%). Other common signs and symptoms included are myalgia (85%), headache (80%), joint pains (76%), vomiting (60%), pain abdomen (54%), rash (46%), hepatomegaly (25%), bleeding (21%) and shock (5%). Signs suggestive of plasma leakage such as pedal oedema (12%), ascites (20%), pleural effusion (26%) were present. Hess test was positive in 20% of the patients. Thrombocytopenia was found in 76% patients. Bradycardia was found in 41 %.
CONCLUSIONS
The present study had an objective of studying clinical manifestations and haematological profile associated with dengue fever. A positive Hess test should prompt close observation and early hospital referral, but a negative test does not exclude dengue infection. Bleeding tendencies should be closely watched for. When features of plasma leakage such as pedal oedema, pleural effusion, ascites are present, the patient should be closely watched for and should be immediately managed. The treatment of dengue is mainly supportive. However, appropriate fluid management plays a major role in outcome of the disease. Dengue sero-surveillance studies may give some idea about advent, intensity, transmission season, seasonal incidence, waxing and waning, and impending epidemic of dengue and DHF. A large-scale active longitudinal sero-survey along with the study of vector capacity and vector competence would provide more correct information.
A total of 100 patients admitted to our hospital with fever (>38.50 F) and IgM Dengue positive were studied at our Institute, Rangaraya Medical College, Kakinada during Jan 2013 to Jan 2015. Out of 100 patients, 73(73%) patients were diagnosed to have DF, 22(22%) patients were diagnosed to have DHF and 5(5%) patients were diagnosed to have DSS based on WHO criteria. Male to female ratio was 1.5:1. Majority of the cases having dengue infection belong to the age group of 21-30 years, wherein 48% belong to 21-30 years’ group and 24% belong to 31-40 years’ group. All the cases had fever (100%). Other common signs and symptoms included are myalgia (85%), headache (80%), joint pains (76%), vomiting (60%), pain in abdomen (54%), rash (46%), hepatomegaly (25%), bleeding (21%) and shock (5%). Signs suggestive of plasma leakage such as pedal oedema (12%), ascites (20%), pleural effusion (26%) were present. Hess test was positive in 20% of the patients. Thrombocytopenia was found in 76% patients. Bradycardia was found in 41%.
