Evaluation of world health organization grading system in estimating the severity of dengue in adults in a tertiary care centre

Abstract

Objectives: (1) To study the profile of dengue fever in patients admitted to a tertiary care centre. (2)To assess the performance of WHO classification in estimating the severity of dengue (3) To know the outcome of patients according to WHO grading for dengue fever. Background: Dengue virus infection causes a spectrum of clinical manifestations, usually classified according to the World Health Organization (WHO) grading system. We aimed to evaluate the WHO grading system in estimating the severity of dengue in adults in a tertiary centre. Methods: Our study included 88 laboratory confirmed cases of dengue infection. WHO criteria were applied to classify patients into Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS).Patients were followed up with clinical and laboratory monitoring until discharge or death. We also grouped patients on the basis of whether they received significant intervention based on fluid replacement or requirements for blood transfusion. Results: Out of 88 patients, 36.3% of patients were found to have dengue fever, 56.7% with DHF, 10.2% with DSS. Plasma leakage and thrombocytopenia were significant factors in differentiating dengue from DHF, DSS. Majority of patients with DHF, DSS required interventions like fluid resuscitation and blood transfusion. Mean duration of hospital stay was longer in DHF, DSS. Conclusion: In a tertiary care centre, WHO criteria for grading of dengue can estimate the severity of dengue, helps us to segregate the patients who need aggressive management.

Keywords

• Dengue Fever
• WHO classification and Grading
• Severity