Occurrence of dengue infected patients in a tertiary care centre

Introduction

Dengue virus is a member of arbovirus (arthopods), family flaviviridae, genus flavivirus, these are found in common tropical areas of the world or the transmitted through bite of the female mosquito name Aedes aegypti and chiefly occurs during the rainy season.1, 2 This mosquito bites during the day time. 3

Dengue is the most immediately circulating mosquito-borne viral disease in the world. Dengue are endemic in more than hundred countries (American, African, south east or western pacific region etc). The main signs and symptoms of dengue like- fever, headache, retro orbital pain, muscles pain, joints pain, abdominal pain or rashes are usually seen between 3-7 days. The major complication are thrombocytopaenia and bleeding. The four main serotypes of dengue virus to based on antigenic and genetic characteristics are (DEN -1,2,3,4).3, 4, 5 The 5th serotype of dengue virus was found in Malaysia.6

This virus is ss encapsulated RNA virus and is composed of 3 structural protein genes, which encode the nucleocapsid or core C protein, a membrane-associated (M) protein, an enveloped (E) glycoprotein and 7 non-structural (NS) proteins. 7

Materials and Methods

The study was carried out in the department of microbiology, TMMC&RC. Samples were collected from clinically suspected patients of dengue attending medicine unit of all age groups. Patients were included as per the inclusion and exclusion criteria. Other diagnosed cases of fever like malaria, typhoid, chikungunya etc were excluded in this study.

Result

Total 161 suspected cases of dengue were included in this study among which 85 (53%) samples were found positive of dengue infection after performing ELISA test (NS1 Ag test & IgM Ab test).

Graph shows the Dengue positive cases. Out of 161 cases 85 (53%) positive for dengue infection and 76 (47%) samples were negative. All age groups were included in this study.

Out of 85 clinically diagnosed dengue, male 57 (67%) were more in number as compare to females 28 (33%).

This table and graph shows that the both NS1/IgM, NS1 Ag and IgM Ab distribution of dengue infection. Total 85 patients were positive in which 49 patients were NS1 & IgM positive, 20 patient were NS1 positive and 16 patients were IgM positive.

85(100%) of the patients were suffering from fever and symptoms such as orbital pain was seen in 25 (29%) cases, rash in 5 (6.25%) cases, headache in 18 (21%) cases, abdominal pain in 14 (17%) cases, vomiting in 3 (4%) cases, and muscle & joint pain in 20 (23%) cases.

Table 5 shows the gender wise distribution of NS1/IgM Ag /Ab, NS1 Ag and IgM Ab distribution of dengue patients. Out of 85 positive cases by ELISA test. 63% males were both NS1Ag and IgM Ab positive, 25% males were only NS1 positive and 12% males were IgM positive, while 50% females were both NS1Ag and IgM Ab positive, 19% females were NS1 positive, and 31% females were IgM positive.

Discussion

This study conducted in the department of microbiology TMMC & RC Moradabad, UP.

In our study 161 samples from patients with clinical findings of dengue were analysed for NS1Ag, DEN IgM Ab using ELISA method, of the 161 samples 85 cases (53%) were positive (+ve) for dengue infection. A similar study was conducted by Deshkar ST et al in Maharashtra10 whose prevalence was 3,822 (24.49%) positive and 11,784 (75.51%) negative respectively. Garg A. et al in 201111 tested 1227 samples of serum from suspected patients of dengue out of which 242 (19.7%) were positive for DV infection.

Gender wise distributions in our study showed that males affected were 57 (67%) and females were 28 (33%) similar study was conducted by Kumar M et al12 in which 53.71% were males and 19.51% were females. Males were affected more than females, due to more no. of males working predominantly and so were more prone to infection by mosquitoes. 11-20 years group showed maximum males (15) infected with dengue where as in females 21-30 age group showed maximum infection (9), Study done by Deshkar ST et al10 showed 26.71% of cases in age group of 11 to 20 years.

In our present study shows gender wise distribution of both NS1Ag/ IgM Ab, NS1 & IgM in positive cases of dengue. Out of 85 positive cases, 63% males were positive by both NS1 & IgM, 25% males were positive only by NS1 Ag and 7% were positive by only IgM Ab. While 58% females were positive by both NS1 & IgM, 23% females were positive only by NS1 Ag and 19% were positive by only IgM Ab.

A study conducted by Padhi S et al13 showed 21.2% of dengue IgM seropositivity was among females and 20.9% among males.

This study is analogous to the which was done by Racherla RG et al14 showed NS1 antigen positivity was significantly higher in males. Another study conducted by Chakravarti A et al15 NS1 Ag positivity was significantly associated with females while IgM Ab positivity was significantly associated with males. Our study is similar with the study done by Racherla RG et al.

Conclusion

Our result provided current information regarding the occurrence of dengue infected patients in our area, the incidence of dengue was 53% (85/161) during the outbreak.

The dengue infection was commonly found in males than females. Common age groups of patients presenting with dengue was 11-30years and fever was most common presenting symptom (100%), followed by muscles/joint pain (23%), headache (21%), pain behind the eyes (29%), abdominal pain (17%), rash (6.25%), vomiting (4%). Dengue infection was found to be increased during monsoon or post monsoon period. The result of our study focuses on continuous monitoring and community action for individuals and dengue controls.

Acknowledgment

Would like to thank entire microbiology department, TMMC&RC for their guidance and cooperative behavior

Conflicts of Interest

The authors declare no potential conflict of interest with respect to research, authorship, and/or publication of this article.

Source of Funding

None.