Clinical and hematological profiles of children with dengue residing in a non-endemic zone of Bangladesh

Abstract

Background 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. Methods 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. Results 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. Conclusions 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.