Abstract:
The aim of the present study was to understand some aspects of
epidemiology and clinical features of dengue fever (DF) and dengue haemorrhagic
fever (DHF) cases admitted to Teaching Hospital (TH), Jaffna and to assess the
accuracies of notification of DF/DHF to the Epidemiology Unit, Ministry of Health,
Sri Lanka. This is a hospital based, descriptive retrospective study on DF/DHF cases
admitted to TH, Jaffna. The data was collected from BHTs (Bed Head Ticket) of all
patients presented to TH, Jaffna with clinically suspected DF/DHF from September
2009 to August 2010. A questionnaire was designed to extract specific information
from BHTs. Variables categorized and analyzed using a basic statistical software
(SPSS version 17). Differences in the mean between variables was considered
significant when the p value was <0.05 with a CI of >95%. Details about the DF/DHF
notification was obtained from the infection control nurse TH, Jaffna. Based on
available records a total of 1085 DF/DHF were identified during the one year period. A
seasonal trend was noted with highest number of cases occurring during January to
March, 2010. Around half of the DF/DHF cases were males (n=535, 49.3%) and 640
(59%) were adults. Although all patients with DF/DHF presented with fever, fever
spikes were reported only by 129 cases (11.9%: 95% CI: 10.1-13.9%). On average most
of the DF/DHF cases were admitted to TH, Jaffna 8 days after the onset of symptoms
(mean: 7.9, median: 8, range: 1-24) and the fever lasted for 4.5 days. Five hundred and
forty eight (548) (50.5%) cases (range:47.5%-53.5%, CI:95%) were presented with
vomiting. The other common symptoms reported were myalgia, haemorrhages,
arthralgia, headache, flushing and retro orbital pain. Haemorrhagic manifestations
were noted in 266 (24.5%) patients. Of which gum bleeding (37.2%) was the most
common manifestation. Low counts of WBC and platelet were noted in 294 cases,
27.1% and 85.6%, respectively. Platelet count lower than 20,000 was observed in 7.4%
of cases. Out of 1086 DF/DHF suspected cases, 24(2.2%) were screened for Dengue
IgM/IgG antibodies and only 458 cases (42.2%) notified to health authority for the
one year study period. Unavailability of laboratory diagnostic tests for DF/DHF is the
major drawback noted in this study. More than half of DF/DHF cases were not
notified to the Epidemiology Unit, Ministry of Health based on the current study.
This is an important message to the public health authorities to consider in the
future.
