250 Bedded General Hospital, Tangail, Bangladesh.
Pi Research Consultancy Center, Dhaka, Bangladesh.
PLoS Negl Trop Dis. 2022 Oct 10;16(10):e0010847. doi: 10.1371/journal.pntd.0010847. eCollection 2022 Oct.
The clinical and hematological parameters of children with dengue during an outbreak in a non-endemic region have not been well described. To delineate the clinical profile of pediatric cases from a tertiary care center located in a non-endemic zone (Tangail district) in Bangladesh was the objective of the study.
A cross-sectional observational study was conducted in the Department of Pediatrics of a 250-bed general hospital in Tangail, Bangladesh, between June 2019 to September 2019. Data collection was done using a pre-structured case record form. All patients underwent detailed history taking, physical examination, and hematological profiling. A total of 123 confirmed dengue cases were analyzed.
The average age of patients was 7.3±4.1 (SD) years, with nearly two-thirds being male (61.8%) and the majority living in rural areas (76.4%). Fever (100%), body ache (57.7%), headache (56.9%), and rash (55.3%) were the four common clinical manifestations. NS1 antigen and anti-dengue IgM antibody tests were positive in 86% (102 out of 119) and 37.7% (20 out of 53) of cases, respectively. Thrombocytopenia was present in 42% of cases. The majority of the cases had dengue fever (73.2%), and the remaining cases were either dengue hemorrhagic fever or dengue shock syndrome (26.8%). Clinical and hematological parameters varied with the type of dengue. Particularly, rash (p = <0.001), bleeding manifestation (p = <0.001), vomiting (p = 0.012), hypotension (p = 0.018), pleural effusion (p = 0.018), ascites (p = 0.018), hepatomegaly (p = <0.001) and low platelet count (<150 x 103cells/μL) (p = 0.038) were significantly more common among dengue hemorrhagic fever or dengue shock syndrome cases.
The present study documented the clinical features of dengue in a pediatric group of patients from a non-endemic zone of Bangladesh. This vulnerable patient group requires earlier identification and keen attention during management.
在非流行地区，儿童登革热的临床和血液学参数尚未得到很好的描述。本研究旨在描述位于孟加拉国非流行区（达卡区）的三级保健中心儿科病例的临床特征。
本横断面观察性研究于 2019 年 6 月至 9 月在孟加拉国达卡的一家 250 张病床的综合医院的儿科学系进行。使用预先设计的病例记录表格进行数据收集。所有患者均接受详细的病史询问、体格检查和血液学分析。共分析了 123 例确诊的登革热病例。
患者的平均年龄为 7.3±4.1（标准差）岁，近三分之二为男性（61.8%），大多数居住在农村地区（76.4%）。发热（100%）、身体疼痛（57.7%）、头痛（56.9%）和皮疹（55.3%）是四种常见的临床表现。86%（102/119）和 37.7%（20/53）的病例 NS1 抗原和抗登革热 IgM 抗体检测阳性。血小板减少见于 42%的病例。大多数病例为登革热（73.2%），其余病例为登革出血热或登革休克综合征（26.8%）。临床和血液学参数随登革热的类型而变化。特别是皮疹（p <0.001）、出血表现（p <0.001）、呕吐（p = 0.012）、低血压（p = 0.018）、胸腔积液（p = 0.018）、腹水（p = 0.018）、肝肿大（p <0.001）和血小板计数低（<150 x 103cells/μL）（p = 0.038）在登革出血热或登革休克综合征病例中更为常见。
本研究记录了孟加拉国非流行区儿科登革热患者的临床特征。这一脆弱的患者群体在管理过程中需要更早的识别和密切关注。
