小儿至重症登革热感染各种因素的回顾性研究

Mohammad Sazzad Hossain Chowdhury, Md. Obaidul Islam, Md. Asaduzzaman
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引用次数: 0

摘要

导言:据了解,在过去的三个世纪中,登革热在世界热带、亚热带和温带地区流行。全世界每年发生 1 亿例登革热病例和 50 万例登革出血热(DHF)病例,亚洲国家的病死率为 0.5%-3.5%。 目的评估儿童感染严重登革热的各种因素。方法2023 年 10 月至 12 月,孟加拉国达卡 Mugda 医学院医院儿科开展了一项基于医院的回顾性研究。参与研究的患者人数为 50 人。对临床高度怀疑感染登革热的儿童进行 NS 1 抗原检测(发烧 48 小时内)和/或登革热抗体 IgM、IgG 检测(发烧五天后)。登革热阳性病例需获得书面知情同意,并就登革热感染的风险因素接受访谈。患者的人口统计、风险因素、临床表现、登革热感染模式和结果等相关数据均记录在预先设计好的问卷中。研究结果研究共招募了 100 名疑似登革热患者,其中 50 人(50.0%)经血清学证实感染了登革热。30名(60%)患者为男性,20名(40%)为女性。38名(76%)患者为典型登革热,12名(24%)患者符合登革出血热的标准。在登革出血热患者中,有 6 名患者出现了登革休克综合征。其中 44 名(88%)来自城市地区,6 名(12%)来自农村地区。所有病例中,和是最常见的症状,其次是头痛、肌痛、呕吐等。出血表现包括瘀斑、瘀点、牙龈出血、血尿、便血、吐血和鼻衄。最常见的并发症是肝功能障碍、肾功能衰竭、多器官功能衰竭、脑病和急性呼吸衰竭。在 50 例登革热疑似病例中,38 例(76.0%)血清登革热抗体呈阳性。在 38 例登革热血清学阳性患者中,17 例(44.7%)NS1 抗原阳性,13 例(34.2%)IgM 抗体阳性,8 例(21.0%)IgM 和 IgG 抗体均阳性。在 50 个临床疑似登革热病例中,血清登革热抗体阳性患者的分布情况。结论登革热是引起分化型发热的主要原因之一。它的发病范围极广,几乎不被初级保健医生视为临床实体。本研究强调了断骨热在医学专业、表现、并发症和健康结果等方面对临床医生的重要性。
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Retrospective Study of Various Factors In Pediatric To Severe Dengue Infection
Introduction: Dengue epidemics are known to have occurred over the last three centuries in tropical, subtropical and temperate areas of the world. Annually a 100 million cases of Dengue fever and half a million cases of dengue hemorrhagic fever (DHF) occur in the world with a case fatality in Asian countries of 0.5%–3.5%.  Objective: To assess the various factors in pediatric to severe dengue infection. Methods: A hospital-based Retrospective study was conducted at Department Of Paediatric, Mugda Medical College Hospital, Dhaka, Bangladesh from October to December 2023. Number of patients included in the study was 50. In children with high degree clinical suspicion of Dengue infection NS 1 antigen (who came within first 48 hours of fever) and/or Dengue antibody IgM, IgG (who came after five days of fever) were performed. Positive Dengue cases were taken written informed consent & interviewed on the risk factors of Dengue infection. Data related to patients demography, risk factors, clinical presentation, pattern of Dengue infection and outcome were documented on the pre-structured questionnaire. Results: The study was enrolled 100 patients of suspected dengue fever of whom 50 (50.0%) were serologically confirmed to have dengue infection. 30 (60%) patients were males and 20 (40%) were females. 38 (76%) patients had classic dengue fever while 12 (24%) fulfilled the criteria of dengue hemorrhagic fever. Of those patients with dengue hemorrhagic fever, 6 patients had developed dengue shock syndrome. Among the study 44 (88%) from urban and 6 (12%) rural area patients. All cases and is the most common symptom followed by headache, myalgia, vomiting etc. Hemorrhagic manifestations were seen that included petechiae, ecchymosis, gum bleeding, hematuria, malena, hematemesis and epistaxis. Most common complicationswere hepatic dysfunction, renal failure, multi organ failure, encephalopathy and ARDS. Among 50 suspected dengue cases 38 (76.0%) cases were serologically dengue positive. Among the 38 serologically dengue positive patients 17 (44.7%) were NS1 antigen positive, 13 (34.2%) IgM antibodies and 8(21.0%) both IgM and IgG antibodies positive. The distribution of the serologically dengue positive patients out of 50 clinically suspected cases. Conclusion: Dengue is one amongst the key causes of dedifferentiated fever. It presents as an extremely broad wellness and is hardly recognized as a clinical entity by primary health care physicians. This study highlights the practician the importance of break bone fever to clinicians within the areas of medical specialty, manifestations, complications and outcome of the wellness
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