Changing patterns and outcome of Dengue infection; report from a tertiary care hospital in Pakistan.

OBJECTIVE To identify predictors of outcome in patients with Dengue Infections at a tertiary care hospital and to analyze that if pattern of Dengue infection is changing in the past two years. METHODS We reviewed 225 cases of confirmed dengue virus infection. The diagnosis was confirmed by presence of IgM antibodies against Dengue by ELISA in addition to fever according to WHO criteria. RESULTS From years 2000-2004, 30 (73%) had Dengue Fever (DF), 10 (24%) had Dengue Haemorrhagic Fever (DHF) and 1(2.4%) had Dengue shock syndrome (DSS) while after 2005, 107 (58%) had DF, 71 (39%) had DHF and 6 (3%) had DSS. Six patients (2.6%) died. Presence of shock (OR 2.9, 95% CI; 1.7-6.2), coma at presentation (OR 1.89, 95% CI; 1.02-3.3) and seizures (OR 1.6, 95% CI; 0.9-3.0) were important predictors of mortality. CONCLUSION These findings are suggestive of a change in pattern and outcome of Dengue at our institution. Larger data set from all around the country is needed to comment on epidemicity and endemicity pattern of the Dengue in Pakistan.

[1]  M. Turchi,et al.  Dengue and dengue hemorrhagic fever among adults: clinical outcomes related to viremia, serotypes, and antibody response. , 2008, The Journal of infectious diseases.

[2]  R. Hewson,et al.  Dengue Virus Serotype 3, Karachi, Pakistan , 2007, Emerging infectious diseases.

[3]  P. Potter.  Dengue virus serotype 3, Karachi, Pakistan. , 2007 .

[4]  T. Takasu,et al.  Dengue virus infection among children with undifferentiated fever in Karachi , 1998, Indian journal of pediatrics.

[5]  S. Fisher-Hoch,et al.  Expansion of epidemic dengue viral infections to Pakistan. , 1998, International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases.

[6]  N. Salahuddin,et al.  An epidemic of Dengue fever in Karachi--associated clinical manifestations. , 1997, JPMA. The Journal of the Pakistan Medical Association.

[7]  H. C. Tan,et al.  Dengue haemorrhagic fever outbreak in Karachi, Pakistan, 1994. , 1995, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[8]  W. Reisen,et al.  West Nile virus in Pakistan. 1. Sero-epidemiological studies in Punjab Province. , 1982, Transactions of the Royal Society of Tropical Medicine and Hygiene.