CLINICAL CHARACTERISTICS OF SEVERE DENGUE IN CHILDREN DURING 2017 OUTBREAK

Objective: To study the clinical features of severe dengue in children during the 2017 outbreak, at the National Hospital for Tropical Diseases. Subjects and Methods: Retrospective study on all children diagnosed with severe dengue. Results: The proportion of children classified with severe dengue was 6.6% (49/742). Among the categories of severe dengue, severe plasma leakage (shock or fluid accumulation with respiratory distress) was 42.9% (21/49), severe organ impairment 30.6% (15/49) and severe bleeding 26.5% (13/49). Ratio of men/women = 1.04/1, with background disease 4.1%. The age group > 12 ÷ ≤18 years accounts for the highest proportion (63.3%), followed by > 5 ÷ ≤ 12 years (32.7%) and the age from 13 to 60 months (4.1%). The most common clinical manifestations were hemorrhage (79.5%), fever > 39oC (51%), nausea or vomiting (48.9%) and abdominal pain (44.9%). Hematocrit > 0.42 l/l (71.4%); platelet < 50G/l (77.5%), the rate of AST ≥ 1000U/l was 12.2%, ALT ≥ 1000U/l was 8.2%, acute renal failure 18.3%. Two deaths were associated with shock and severe organ impairment. Conclusion: In the 2017 outbreak, in children with severe dengue, there were 3 clinical manifestations (severe plasma leakage, severe organ impairment, severe bleeding). The rate of severe organ impairment is more common than in previous outbreaks. Shock patients present with severe organ failure and vice versa. Further studies are needed to evaluate severe organ impairment in children.