A prospective observational study of the role of intravenous immunogloblins and managing children with severe dengue unresponsive to standard who protocol

Abstract

Dengue/severe dengue is a serious public health problem in Rayalaseema Districts of Andhra pradesh. Plasma leaks producing shock, bleeds due to dysfibrinogenemia and severe Thrombocytopenia and end organ dysfunction including hepatitis, Myocarditis, encephalopathy/ encephalitis and ARDS contribute to mortality in Dengue, Majority of children respond to standard WHO protocol. Role of Iv Ig in severe dengue non responsive to standard WHO protocol was studied. Over a period of four years from 2010 jan to 2014 jan around 936 cases of dengue who are serologically positive for IgM and IgG were admitted. 779 children were responsive to standard WHO protocol and 157 were unresponsive. Out of 157 children IvIg was administered to 97 children remaining 60 children did not receive IvIg. Chi square analysis was done using 2x2 contingency table to known the statistical significance of IvIg therapy. 157 children out of 936 children (16.77%) were unresponsive to who standard protocol. Out of 157 nonresponsive children to standard treatment, 97 children were administered IvIg and in the rest 60 no IvIg. The mortality as primary outcome was measured using chi square test. Chi square statistic is 7.0005. The ‘P’ value is 0.008149 which is statistically very significant. The role of IvIg was studied in severe dengue unresponsive to WHO standard protocol. IvIg is proved to have statistically significant value in decreasing the mortality in severe dengue.