Tuladhar Eans Tara, Kandel Pratibha, Baidya Sujata, Rajkarnikar Smrity, Tamrakar Moniya, Rijal Gautam, Dubey Raju Kumar, Bhattarai Aseem, Raut Mithileshwer, Niraula Apeksha, Maharjan Ramesh Kumar, Sharma Vijay Kumar
Department of Clinical Biochemistry, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
Department of Emergency Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
J Trop Med. 2024 Dec 24;2024:7786856. doi: 10.1155/jotm/7786856. eCollection 2024.
Dengue virus infection is a major source of morbidity and mortality in the majority of tropical and subtropical nations. In Nepal, the first case of dengue was reported in 2004, followed by numerous outbreaks exerting a critical impact on public health. This study aims to describe the clinical and laboratory characteristics of dengue patients visiting a tertiary care hospital to see the trend of presentation. Hospital based cross-sectional study was conducted among diagnosed cases of dengue from April 2023 to September 2023. A total of 692 patients undergoing testing by commercially available dengue rapid diagnostic tests were recruited and categorized dengue positive (if NS1 and/or IgM positive) and dengue negative (NS1, IgM, and IgG all negative or only IgG positive). The dengue-positive cases were further subdivided into three groups (only NS1 positive, only IgM positive, both NS1 and IgM positive). Additionally, biochemical and hematological analyses were performed, and results were compared between positive and negative cases by using Mann-Whitney U test while subgroups of dengue-positive cases were compared using Kruskal-Wallis H test. Most common symptoms were fever (94.5%) followed by headache (79.8%) and myalgia (74.7%). Among 346 dengue-positive subjects, 53.2% ( = 184) were NS1-only positive, 21.7% ( = 75) were IgM-only positive, and 25.1% ( = 87) were both NS1+IgM positive. Thrombocytopenia ( = 179, 51.7%), leucopenia ( = 99, 28.6%), increased SGPT ( = 182, 52.6%), increased SGOT ( = 188, 54.3%) were seen among dengue positive patients. Leukopenia was more severe in patients with only NS1 positive cases ( = 0.008) whereas thrombocytopenia ( ≤ 0.001) was more severe in patients with both IgM and NS1 positive cases. Our study depicted there is a marked alteration in biochemical and hematological parameters specifically thrombocytopenia, leukopenia, increased transaminase levels, and high prothrombin time seen in dengue positive cases.
登革病毒感染是大多数热带和亚热带国家发病和死亡的主要原因。在尼泊尔，2004年报告了首例登革热病例，随后多次爆发疫情，对公众健康产生了严重影响。本研究旨在描述前往三级护理医院就诊的登革热患者的临床和实验室特征，以了解其临床表现趋势。2023年4月至2023年9月，对确诊的登革热病例进行了一项基于医院的横断面研究。共招募了692名接受市售登革热快速诊断检测的患者，并将其分为登革热阳性（如果NS1和/或IgM呈阳性）和登革热阴性（NS1、IgM和IgG均为阴性或仅IgG呈阳性）。登革热阳性病例进一步细分为三组（仅NS1阳性、仅IgM阳性、NS1和IgM均阳性）。此外，进行了生化和血液学分析，阳性和阴性病例的结果采用Mann-Whitney U检验进行比较，登革热阳性病例的亚组采用Kruskal-Wallis H检验进行比较。最常见的症状是发热（94.5%），其次是头痛（79.8%）和肌痛（74.7%）。在346名登革热阳性受试者中，53.2%（=184）仅NS1呈阳性，21.7%（=75）仅IgM呈阳性，25.1%（=87）NS1+IgM均呈阳性。登革热阳性患者中出现血小板减少（=179，51.7%）、白细胞减少（=99，28.6%）、SGPT升高（=182，52.6%）、SGOT升高（=188，54.3%）。仅NS1阳性病例的患者白细胞减少更严重（=0.008），而IgM和NS1均阳性病例的患者血小板减少更严重（≤0.001）。我们的研究表明，登革热阳性病例的生化和血液学参数有明显改变，特别是血小板减少、白细胞减少、转氨酶水平升高和凝血酶原时间延长。
