DENGUE INFECTION IN CHILDREN WITH THALASSEMIA– IS IT DIFFERENT?

Josmy Joseph; Vandana Bharadwaj; Tarangini D; Ranjini Srinivasan; Vinay M V; Anand Prakash; Fulton D‘Souza

Volume : IX, Issue : VI, June - 2019

DENGUE INFECTION IN CHILDREN WITH THALASSEMIA– IS IT DIFFERENT?

Josmy Joseph, Vandana Bharadwaj, Tarangini D, Ranjini Srinivasan, Vinay M V, Anand Prakash, Fulton D Souza

Abstract :

Background: Children with thalassemia are at equal risk of getting dengue. Atypical manifestations of dengue in children with thalassemia are highlighted in studies from South Asia. Burden of suboptimal transfusion and chelation in children with thalassemia prompted us to undertake this study Objectives: To study the clinical course and short term outcome of children with thalassemia affected by dengue, and compare them to dengue infection in children without chronic illness. Methods: Retrospective case note review of children with thalassemia, admitted with dengue from April 2013 to April 2018. Comparison group included children without chronic disease admitted with dengue from November 2012 to April 2014. Severity, complications, hematological/ biochemical parameters, treatment given were analysed. Management was according to ‘WHO 2009 Guideline on Dengue’ Results: 15 children with Thalassemia (n=207) had confirmed dengue (NSI positive/ Dengue IgM positive), M: F=1:1.1, median age 6 years (interquartile range IQR 3–11). Median duration of hospital stay 6 (IQR 4–6) days. WHO Group A, B and C had 5, 6 and 4 patients respectively. Clinical features included fever in 15 (100%), persistent vomiting in 9 (60%), abdominal pain in 4 (26.7%) and excessive fluid accumulation in 2 (13.3%). 12 (80%) had anemia at presentation, median Hb 83 (IQR 70–101) g/l, while 2 (13.3%) had hematocrit >36%. 14 (93%) patients had platelets