Soomar Sarmad Muhammad, Issani Ali, Moin Ghazal, Dhalla Zeyanna, Adnan Ahmer, Soomar Salman Muhammad
Aga Khan University, Karachi, Pakistan.
Vital Pakistan Trust, Karachi, Pakistan.
Glob Pediatr Health. 2022 Dec 26;9:2333794X221138434. doi: 10.1177/2333794X221138434. eCollection 2022.
In the emergency department, it is very uncommon perform a differential diagnosis to serologically differentiate between dengue, dengue hemorrhagic fever, and dengue shock syndrome. Prompt differential diagnosis and treatment is essential with the presentation of dengue. This study aims to determine the serological confirmation and outcome of the dengue epidemic in the pediatric population presenting to the ED in a tertiary care hospital.
A single-center cross-sectional study was conducted. All pediatric patients aged less than 18 years presented to ED with clinical features suggestive of DF, DFF, and DSS while also doing the serological confirmation for the dengue were enrolled in the study. Data was collected on demographics, clinical characteristics, diagnosis, and outcomes of 324 pediatric patients. Multivariable binary logistic regression was applied for the analysis.
Out of 324 patients, 191 (59.13%) underwent NS1 testing and 132 (40.87%) did the IgM test. Most participants were in the age range of 13 to 18 years in both groups. Fever was the most common complaint in both groups 191 (100%) and 132 (100%). In each group, around one-third of the participants complained about body aches 69 (36.13%) and 44 (33.33%). The patient having a history of traveling within the past 14 days created a 1.51 (95% CI: 1.27-2.25) times higher odds of contracting dengue fever as compared to no history of travel.
The serologic confirmation of dengue in the ED helps in both the adequate and timely treatment as well as patient disposition and ultimately saves lives.
在急诊科,通过血清学方法对登革热、登革出血热和登革休克综合征进行鉴别诊断的情况非常少见。对于登革热病例,及时进行鉴别诊断和治疗至关重要。本研究旨在确定在一家三级护理医院急诊科就诊的儿科患者中登革热流行的血清学确诊情况及转归。
进行了一项单中心横断面研究。所有年龄小于18岁、因临床特征提示登革热、登革出血热和登革休克综合征而就诊于急诊科且同时进行登革热血清学确诊的儿科患者纳入本研究。收集了324例儿科患者的人口统计学、临床特征、诊断及转归数据。采用多变量二元逻辑回归进行分析。
在324例患者中,191例(59.13%)进行了NS1检测,132例(40.87%)进行了IgM检测。两组中大多数参与者年龄在13至18岁之间。发热是两组中最常见的主诉,191例(100%)和132例(100%)。在每组中,约三分之一的参与者主诉身体疼痛,分别为69例(36.13%)和44例(33.33%)。与无旅行史相比,过去14天内有旅行史的患者感染登革热的几率高出1.51倍(95%可信区间:1.27 - 2.25)。
在急诊科对登革热进行血清学确诊有助于进行充分及时的治疗以及患者处置,最终挽救生命。