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Submitted: 22 October 2012
HERDIN Record #: R04A-DLSHSI-12102209452372

Early clinical and laboratory indicators of disease progression in Dengue virus infection among pediatric patients.

Department of Pediatrics - De La Salle Health Sciences Institute

Abstract

OBJECTIVES: To determine early clinical and laboratory indicators of disease progression in dengue virus infection among pediatric patients.
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DESIGN: Case Control study
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SUBJECT SELECTION: The study was conducted in DLSU Medical Center among pediatric patients admitted from 2003-2006 with a discharge diagnosis of any form of Dengue virus infection. Clinical data and laboratory parameters were obtained from the clinical charts of these cases. Re-diagnosis was done if necessary.
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OUTCOME MEASURES: The data obtained were analyzed using the fisher's exact test or chi-square analysis and analysis of variance was done using one-way ANOVA. Analysis of correlation between variables was done via Mutlivariate Regression analysis.
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RESULTS: Six hundred cases were included in the study. 63.2% of the cases showed disease progression. No significant associations were noted based on age, weight and gender among all cases. Multivariate analysis showed that, narrow pulse pressure, hypotension, epistaxis, hematemesis, loose bowel movement, throat pain, gum bleeding, and melena showed significant likelihood of contributing to the disease progression (p<0.05). Individual analysis for each progression showed that decrease breathsounds, rashes, drowsiness, vomiting, colds, and difficulty in breathing are symptoms that would increase likelihood of disease progression (p <0.05). Platelet count of <150, prolonged PTT, extremes of hematocrit and hemoglobin count of >160 were significant laboratory parameters among each type of disease progression and should be noted as possible predictors of disease progression.
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CONCLUSION: Significant correlation was found using patients complete blood count parameters. Signs and symptoms which generally correlates to progression includes narrow pulse pressure, hypotension, epistaxis, hematemesis, loose bowel movement, throat pain, gum bleeding, and melena (p<0.05).
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RECOMMENDATION: It is recommended that a prospective cohort be done to be able to follow-up the progression of the signs and symptoms of these patients. A prospective cohort may provide more detailed and accurate assignment of risk of progression among patients. This type of study design will also allow uniformity of standard laboratory test among patients since in the present study not all the parameters of the blood count was considered since some patients did not have a complete CBC profile. It will also provide uniformity in physical examination and other pertinent laboratory test.

Objectives

To determine early clinical and laboratory indicators of disease progression in dengue virus infection among pediatric patients.