Abstract
Objective: To determine the frequency and characteristics of dengue fever (DF) in patients of acute febrile illness presenting at a secondary care hospital. Methodology: The observational cross sectional study was carried out from May to October 2010 in Remedial Centre Karachi and included patients above the age of 12 years who presented with acute febrile illness. The WHO classification and case definitions were used to classify the disease as Dengue Fever (DF), dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Clinical, hematological and biochemical findings were recorded serially until discharge. Results: During the study period, 90 (34.75%) presented with typical features of DF, 28 (31.11%) were dengue proven, seven (7.7%) proved to be of malaria in which malarial parasites were found positive in the peripheral blood, while the remaining 55 (61.11%) patients were dengue probable. Age of the patients ranged from 13 to 76 years. Fever was the most common clinical presentation (100%) followed by vomiting 50 (55.56%), body ache 31 (34.44%) abdominal pain 17 (18.89%) and headache 9 (10%). Maculopapular rash was seen in 4(4.44%) patients. Laboratory findings included thrombocytopenia, leucopenia and raised alanine aminotransferase levels. Eighty one patients (90%) improved clinically and hematologically and were discharged in stable condition. Conclusion: Fever and thrombocytopenia were the most common presentation of dengue fever (DF). The overall mortality of DF is low, if treated appropriately. Awareness of health care professionals and public regarding preventive strategies is essential to fight against this disease.
Highlights
Dengue fever is a viral illness caused by one of the four serotypes of dengue viruses belonging to the flaiviviridae family.[1]
Dengue infection was first documented in Pakistan in 1982 from Punjab[5] and later the first reported outbreak of dengue haemorrhagic fever in Pakistan was in 19946 and another at upper parts of Punjab in 2003.7 Since it has almost become endemic in various parts of Pakistan with regular epidemic outbreaks especially during the rainy season.[8]
Patients with acute febrile illness and clinical features suggestive of dengue with positive serology of dengue specific IgM were labeled as Dengue Confirmed while patients with clinical features suggestive of dengue but negative for dengue serology, malarial parasites and negative blood cultures were considered as dengue probable
Summary
Dengue fever is a viral illness caused by one of the four serotypes of dengue viruses belonging to the flaiviviridae family.[1]. The spectrum of dengue infection includes dengue fever (DF), a flu like illness with headaches and myalgias, to Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS), Which is severe and at times fatal disease. DHF is characterized by appearance of hemorrhagic rash or heamorrhagic manifestations in addition to classical DF. Many studies have been published regarding various aspects of dengue fever in Pakistan[10,11,12] most of them are from tertiary care university hospitals, where patients are generally referred from other health care facilities. The present study was conducted in a secondary care hospital where patients reported early to determine the frequency of dengue fever in patients of acute febrile illness during the studied period
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