Mishra Sukriti, Ambey Ravi, Khare Ayush, Gaur Ajay
Paediatrics, Gajra Raja Medical College, Gwalior, IND.
Cureus. 2025 Jun 30;17(6):e87027. doi: 10.7759/cureus.87027. eCollection 2025 Jun.
Background Dengue has emerged as the most common arboviral infection in India and worldwide. Dengue presents with a varied clinical spectrum in different age groups. The changing epidemiology and presentation are a challenge for early diagnosis and management. This prospective observational study aimed to determine the epidemiological profile of hospitalized dengue-positive children aged 0-14 years and correlate their clinical and hematological profiles. Methodology One hundred and five children with laboratory-confirmed dengue were enrolled in this study over a six-month study period. They were categorized into severe and non-severe dengue according to the World Health Organization (WHO) classification. Detailed clinical examination and laboratory investigations, including complete blood count, liver enzymes, coagulation profile, and imaging (chest X-ray and abdominal ultrasound), were performed. Data were analyzed using descriptive statistics, chi-square test, and logistic regression analysis. Results Out of the total 105 cases, 90 children (85.7%) had non-severe dengue and only 15 (14.3%) had severe dengue. The mean age of children was 92.02 months, with a male predominance (72, 68.6%). The most commonly identified symptoms were fever (105, 100%), vomiting (47, 44.76%), and abdominal pain (46, 43.81%). It was found that although thrombocytopenia was seen in 79 children (75.2%), it was not significantly associated with the severity of the disease ( = 0.2364). The study found a high recovery rate (101, 96.3%) with a mortality of 3 patients (2.8%) in severe cases. Elevated serum glutamate pyruvate transaminase (SGPT) levels ( = 0.0025), pleural effusion on chest X-ray ( = 0.000452), abdominal pain ( = 0.0041), and a positive tourniquet test ( < 0.0001) were found to be significantly associated with severe dengue. Non-structural protein 1 (NS1) antigen and immunoglobulin M (IgM) antibodies were both found to be positive more frequently in severe cases compared to non-severe cases ( = 0.0361). Conclusions This study observed a high rate of recovery and low mortality, owing to the timely management. A possible shift in the seasonal distribution of dengue was observed, with many cases occurring in the winter season. While thrombocytopenia was prevalent, it was not found to be significantly associated with disease severity or bleeding. On the other hand, elevated liver enzymes, pleural effusion, abdominal pain, and a positive tourniquet test were found to be more strongly associated with severe dengue. They may serve as valuable early clinical indicators for the severity of the disease.
登革热已成为印度乃至全球最常见的虫媒病毒感染。登革热在不同年龄组呈现出多样的临床谱。不断变化的流行病学特征和临床表现对早期诊断和管理构成挑战。这项前瞻性观察性研究旨在确定0至14岁住院登革热阳性儿童的流行病学特征，并将其临床和血液学特征进行关联分析。
在为期6个月的研究期间，105名实验室确诊为登革热的儿童纳入本研究。根据世界卫生组织（WHO）分类，将他们分为重症和非重症登革热。进行了详细的临床检查和实验室检查，包括全血细胞计数、肝酶、凝血指标以及影像学检查（胸部X光和腹部超声）。数据采用描述性统计、卡方检验和逻辑回归分析进行分析。
在总共105例病例中，90名儿童（85.7%）为非重症登革热，仅15例（14.3%）为重症登革热。儿童的平均年龄为92.02个月，男性占主导（72例，68.6%）。最常见的症状是发热（105例，100%）、呕吐（47例，44.76%）和腹痛（46例，43.81%）。研究发现，尽管79名儿童（75.2%）出现血小板减少，但它与疾病严重程度无显著相关性（P = 0.2364）。该研究发现恢复率较高（101例，96.3%），重症病例中有3例死亡（2.8%）。血清谷丙转氨酶（SGPT）水平升高（P = 0.0025）、胸部X光显示胸腔积液（P = 0.000452）、腹痛（P = 0.0041）和束臂试验阳性（P < 0.0001）与重症登革热显著相关。与非重症病例相比，重症病例中非结构蛋白1（NS1）抗原和免疫球蛋白M（IgM）抗体阳性更为常见（P = 0.0361）。
本研究观察到由于及时管理，恢复率高且死亡率低。观察到登革热的季节性分布可能发生变化，许多病例出现在冬季。虽然血小板减少普遍存在，但未发现它与疾病严重程度或出血有显著相关性。另一方面，肝酶升高、胸腔积液、腹痛和束臂试验阳性与重症登革热的相关性更强。它们可能是疾病严重程度有价值的早期临床指标。
