Early predictors of dengue hemorrhagic fever in children with dengue fever: a comparative study

Abstract

Background: Dengue fever is a viral disease carried by Aedes mosquitoes. A high-grade fever, body pains, rash, and gastrointestinal symptoms are common in symptomatic cases, while many infections are asymptomatic. The disease is associated with any complications. This study was designed to find out and contrast early clinical and hematological indicators of dengue hemorrhagic fever in pediatric patients.

Methods: A prospective comparative study was performed from September to December 2022, at Federal Government Polyclinic Hospital, Islamabad. A total of sixty children (aged 1-12 years) from Islamabad and its premises were enrolled with confirmed Dengue Fever. They were then divided into two groups: Dengue hemorrhagic fever patients (Leakers) and Dengue fever patients (non-leakers) based on clinical signs, NS1 test, serology and Complete Blood Count on day 3, 5 and 7. In 28 (46.7%) patients, dengue was diagnosed through NS1 whereas in the remaining 32 (53.3%) cases dengue was diagnosed through Serology.

Results: Plasma leakage, decrease in urine out flow, severe abdominal pain and dizziness were more common in Dengue hemorrhagic fever as compared to Dengue fever (p < 0.05). whereas hematological predictors like White Blood Cells, Platelet count, Neutrophil count and Hemoglobin were significantly low in patients with Dengue hemorrhagic fever as compared to the patients with Dengue fever on day 3. But by day 7, White Blood Count and neutrophil counts remained significantly different, whereas differences in platelet count and hemoglobin narrowed. It was found that there was no association between gender (p =0.795) or age (p= 0.966) and the development of Dengue hemorrhagic fever.

Conclusion: Complete Blood Count can predict dengue hemorrhagic fever in children with dengue fever. The variation in the parameters of full blood count was related with dengue severity.