Uzma Jabeen, Aisha Iftikhar, Muhammad Haroon Hamid, Adeela Chaudhry.
Comparison of Characteristics of Dengue Hemorrhagic Fever in Children during 2011 and 2013 Outbreaks.
Pak Paed J Jan ;42(2):95-100.

Objective: To compare the clinical, hematological, radiological and biochemical features of Dengue Hemorrhagic Fever (DHF) in children who presented during the dengue outbreak of 2011 with those presenting in year 2013. Study design: A descriptive study. Place and Duration of Study: Department of Pediatric Medicine, the Children`s Hospital and the Institute of Child Health Lahore. Methodology: Retrospective analysis of the patients` records was done. The data was analyzed by statistical software SPSS (version 20). Descriptive statistics were used to analyze means, proportions and percentiles. Results: Of the 125 cases of DHF treated in 2011 epidemic, complete records of 60 children were available. A total of 49 cases of DHF were admitted in 2013. Compared to 2011, relatively fewer (17% vs 27%) children were younger than 5 years of age. Vomiting, abdominal pain and loss of appetite had similar frequency in both years. Bleeding manifestations were less commonly seen (13 % vs 27%) in year 2013. Less than 15% patients had platelet count below 20 x 109/L during both years. At least 30% patients had TLC count of more than 5 x 109/L even during the febrile phase. For platelet count, TLC count and hematocrit the 50th centile was recorded at 38 x109/L, 4.25 x109/L and 43% respectively. Whereas 90th centile for all three were at 67 x109/L, 8.2 x109/L and 52.3% respectively. Dengue serology (Ig M) was positive in 33.80% and 23.19% cases in 2011 and 2013 respectively. In 2013, DEN-3 virus was isolated from few patients. Co-infection with enteric fever was seen in 6% and 4%; and with malaria in 3 % and 1.7% respectively in 2011 and 2013. Conclusion: Dengue Hemorrhagic Fever (DHF) in children may have protean manifestations as regards their relative frequency. Hematological parameters though can guide but may vary in certain subset of pediatric patients. Definite diagnosis would depend on the right choice of tests based on the time of doing these tests.

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