Management Approaches and Clinical Outcomes of Pediatric Dengue Fever in a Tertiary Care Setting – A Prospective Observational Study

Open Access

Abstract

Background: Dengue fever is a major public health concern in tropical and subtropical regions, with children being particularly susceptible to severe disease manifestations and complications. Early recognition and appropriate management are crucial for reducing morbidity and mortality. Aim of the study: The present study aimed to evaluate the clinical characteristics, management strategies, and outcomes of pediatric dengue patients admitted to a tertiary care hospital. Methods & Materials: A prospective observational study was conducted involving 210 children diagnosed with dengue fever, admitted to a tertiary care center. Demographic data, clinical presentations, laboratory findings, disease severity according to WHO 2009 classification, management approaches, and clinical outcomes were recorded and analyzed. Associations between disease severity, management strategies, and outcomes were assessed using appropriate statistical tests, with p-values <0.05 considered significant. Result: The mean age of patients was 8.9 ± 3.6 years, with a male predominance (58.1%). The majority presented with fever (100%), headache (64.8%), myalgia/arthralgia (56.2%), and vomiting (46.7%). Laboratory findings showed thrombocytopenia in 78.1% and elevated liver enzymes in 43.8% of cases. According to WHO classification, 44.8% had dengue without warning signs, 41.0% with warning signs, and 14.3% severe dengue. Management included oral fluids (29.5%), intravenous fluids (56.2%), blood transfusion (6.7%), and platelet transfusion (10.5%), with 9.5% requiring ICU admission. Overall recovery without complications was achieved in 87.6% of patients, while 9.5% experienced complications and 2.9% succumbed to the illness. Severe dengue was significantly associated with higher complication rates (40.0%), prolonged hospital stays (8.2 ± 2.1 days), and increased mortality (13.3%) (p < 0.001). Patients requiring transfusions had the highest morbidity and mortality compared to those managed with fluids alone. Conclusion: Pediatric dengue presents with variable severity, and severe cases are associated with substantial morbidity and mortality. Early identification of warning signs and prompt supportive care, guided by WHO recommendations, are critical to improving clinical outcomes in tertiary care settings.