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Asian-Oceanian Journal of Pediatrics and Child Health Volume Three December 2004 Number Two CLINICO-LABORATORY PROFILE OF DENGUE HAEMORRHAGIC FEVER IN MALAYSIA CHILDREN Norlijah O, MBBS,MRCP (1) ;Kamarudin NB, MD (1) ;Kamarul AR MD,MPaeds (2)
Contact for corresponding author: Dr Norlijah Othman Division of Paediatrics, Dept. of Human Growth and Development, Faculty of Medicine and Health Sciences, University Putra Malaysia Jln. Masjid, 50586 Kuala Lumpur, Malaysia Objectives: To evaluate the demographic data and clinical manifestations of dengue haemorrhagic fever (DHF) in children and study the laboratory investigations and outcome of DHF. Methodology: A cross-sectional retrospective study of children less than 12 years old admitted with DHF to Institute of Paediatrics, Hospital Kuala Lumpur from January 1999 to May 2001. Cases were selected based on World Health Organization (WHO) criteria for DHF. Results: Demographic data: 121 children were included, 57 (47.1%) were boys and 64 (52.9%) were girls. The mean age was 6.9 years. All ethnic groups were affected. Mean hospital stay was 4.7 days ranging from 1-13 days. Clinical features: Fever was seen in all patients. Vomiting was also a significant finding where it was present in half of the cases. 59 (48.8%) patients manifested bleeding tendencies, of which bleeding into the skin was the commonest (38, 31.4%). Severe bleeding such as gastrointestinal (GIT) bleed was observed in those with profound shock. Tourniquet test was positive in 40 (33.1%) patients. Hepatomegaly was also present in the majority of patients (90, 74.4%), palpable on day six of illness. Leaking syndrome evidenced from presence of pleural effusion and/or ascites were seen in 69 (57%) cases. Twelve (9.9%) patients required ventilation. 11(9%) patients required blood product transfusions; indications for transfusion were thrombocytopenia (4, 3.3%), disseminated intravascular coagulation (DIVC) (5, 4.1%) and the remaining 2 for haemoconcentration and severe thrombocytopaenia. Mortality was observed in 5 (2.8%) patients, giving rise to a mortality of 4.1%. Laboratory Findings: Dengue IgM was detected in 81 (66.9%) patients. Leucopaenia was seen in 55 (48.2%) cases, leucocytosis in 8 (7.0%) while the count was normal on admission for the remaining patients. Lowest mean platelet count was 41,785 /µL, observed on the sixth day of illness, which coincided with shock in majority of patients. In this study, hyponatraemia was a significant electrolyte imbalance observed (54, 65.9%). Conclusion: DHF remains a significant disease with high morbidity and significant mortality in Malaysia. Keywords: Dengue haemorrhagic fever (DHF), Dengue fever (DF) |
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Latest Journal Volume Three December 2004 Number Two
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