Comparison of presentation, clinical course and outcomes of dengue among infants and older children in India

Abstract

OBJECTIVE: There is limited literature regarding the clinical symptoms and laboratory parameters in infants with dengue infection, especially from north India. We aim to study the symptomatology, laboratory findings and clinical outcomes of dengue infection in infants. PATIENTS AND METHODS: Records of 802 children admitted with dengue infection, based on NS-1 antigen and/or IgM ELISA testing, were collected. Among these, 51 children belonged to the infant (0-12 months) age group. Clinical characteristics, hematological parameters and clinical outcomes were compared between infant and non-infant groups. RESULTS: A significantly higher proportion of infants with dengue fever had loose stool (35.3% vs. 3%), cough (31.4% vs. 1.7%) and seizure (17.6% vs. 1%) at presentation. Severe thrombocytopenia (35.2% vs. 57%) and platelet transfusion requirement (13.7% vs. 27%) was significantly lower in the infant group. The hemoglobin concentration [g%, mean (SD)] at presentation was significantly lower among infants [10.7 (2.25) vs. 11.8 (2.3)]. A significantly lower hematocrit (%) [34.5 (6.63) vs. 39.1 (7.18)] was recorded at presentation in infants. Mean platelet volume (fL) was significantly lower among infants in our study [10.4 (3.1) vs. 11.3 (2.49)]. Among liver function parameters, serum albumin (g/dL) level was significantly lower in older children [4.0 (0.72)], compared to infants [4.3 (0.68)]. CONCLUSIONS: Our study findings suggest that infant dengue infection can present like any other acute viral illness. Also, infants have an overall milder course of illness due to dengue infection, compared to older children.

Keywords

• dengue
• infants
• severity
• clinical outcome
• india