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ORIGINAL ARTICLE
Year : 2014  |  Volume : 17  |  Issue : 3  |  Page : 83-86

A descriptive study on dengue fever reported in a Medical College Hospital


Department of Community Medicine, Department of Community Medicine, M.O.S.C Medical College, Kolenchery, Ernakulam District, Kerala State, India

Date of Web Publication6-Sep-2014

Correspondence Address:
Jimmy Antony
M.O.S.C Medical College, Kolenchery, Ernakulam, Kerala - 682 311
India
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DOI: 10.4103/1118-8561.140285

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  Abstract 

Background: Dengue fever is a serious public health problem in terms of its morbidity and mortality. It reports from almost all countries and it is endemic in the tropical countries. Aim: The present hospital study aims to describe  the frequency , distribution and case fatality of dengue fever based on the variables such as age, sex and year. Settings and Design: It is a hospital-based retrospective study of 5 years in tertiary care and teaching hospital in South India. Materials and Methods: The data were collected from the medical records department of the hospital and analyzed by using Microsoft excel. Result: Out of 341 reported cases of dengue, 60.70% were males and 39.29% were females. In both males and females, the high proportion of cases were reported in adult age groups (>20 years). Case fatality rate of dengue fever is 1.2%, with 0.97% in males and 1.49% in females. Out of 341 cases, 333 (97.65%) were Classical Dengue Fever and remaining 8 cases (2.34%) were dengue hemorrhagic fever. Conclusion: More cases of dengue fever were reported in the adult age group (20 years and above) and in males compared to low age groups (<20 years) and females. It highlights the involvement of work component in the occurrence of disease. Community-based action program is required for source reduction activities in the outdoor area for arresting the breeding and multiplication of Aedes mosquitoes and thereby to reduce the morbidity and mortality of dengue fever.

Keywords: Age, case fatality, dengue fever, sex and year


How to cite this article:
Antony J, Celine T M. A descriptive study on dengue fever reported in a Medical College Hospital. Sahel Med J 2014;17:83-6

How to cite this URL:
Antony J, Celine T M. A descriptive study on dengue fever reported in a Medical College Hospital. Sahel Med J [serial online] 2014 [cited 2019 Jun 19];17:83-6. Available from: http://www.smjonline.org/text.asp?2014/17/3/83/140285


  Introduction Top


Dengue fever is an infectious mosquito-borne disease caused by dengue virus. Its symptoms include fever, head ache, muscle and joint pains and rash resembles measles. The presence of muscle and joint paints gives an alternative name to the dengue fever as 'break bone fever'. [1] Classical dengue fever cases sometimes develop to more severe life-threatening stage of dengue hemorrhagic fever or dengue hemorrhagic fever with shock. The disease is transmitted by the bite of certain species of female Aedes mosquito. Subsequent infection with different serotypes increases the severity of this fatal infection. The control measures of dengue fever include source reduction activities and also the personal prophylaxis measures. This study aimed for finding out the frequency and distribution of dengue fever and its case fatality based on the variables such as age and sex during a time period of 5 years.


  Materials and methods Top


It is a retrospective study of five years conducted in the MOSC Medical College hospital, Kolenchery, Kerala State in South India.  The medical records department follows the guidelines of WHO ICD 10 for the classification of diseases. The data retrieved from the medical records department with the permission of institutional ethical committee and collected data were analyzed using Microsoft excel.


  Result Top


A total of 341 dengue cases were reported at the hospital during the time period from April 2005 to March 2010. Of 341 cases, 207 (60.70%) were males and 134 (39.29%) were females. The proportion of male cases was higher than females. High proportion of dengue cases were in 20 to 39 years (42.02%) in males while females showing high proportion of cases in the 40 to 59 years (41.04%). Dengue fever  in both males and females in different age groups has been shown in [Table 1]. Case fatality rate of dengue fever is 1.2%; with 0.97% in males and 1.49% in females. Out of 341 cases, 333 (97.65%) were due to classical dengue fever and remaining 8 cases (2.34%) were due to dengue hemorrhagic fever. The trend of case fatality of dengue fever in males and females from 2005 to 2010 has been given in [Figure 1].
Figure 1: Trend of case fatality of dengue fever in males and females from 2005 to 2010

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Table 1: Case infection of dengue fever: Age and sex wise distribution

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  Discussion Top


Dengue fever reports from many parts of the world including Africa, America, Eastern Mediterranean, Western pacific and South East Asia [2] (WHO). The last decade witnessed this pandemic in different countries of the world such as Bangladesh in 2000, [3] Hawaii in 2001, [4] Rio de Janeiro of Brazil in 2002, [5] Texas [6] and Singapore [7] in 2005, India [8] and Pakistan [9] in 2006, Paraguay in 2007, [10] Cairns in the Queensland state of Australia in 2008, [11] Bolivia [12] and Argentina [13] in 2009, Florida [14] in 2010, Latin America [15] in 2012 and Brazil [16] in 2013. As far as India is concerned the dengue fever cases reporting from all states of the country such as Rajasthan, [17] Punjab, [18] Uttar Pradesh, [19] Madhya Pradesh, [20] Maharashtra, [21] Andhra Pradesh, [22] West Bengal, [23] Assam and Nagaland, [24] Karnataka, [25] Tamil Nadu, [26] and Kerala. [27]

In the present study 341 confirmed dengue cases were reported at the medical college hospital during the time period. Out of 341 cases, 4 deaths reported with a case fatality rate of 1.17%; it is 0.97% in males and 1.49% in females. The case fatality rate of dengue fever in the present study is higher than in Jakarta [28] (0.04%) and West Bengal [29] (0.54%) and less than a study conducted (1.5%) in India [29] and 3.2% of other South Indian study in 2005. [30] In the present study, case fatality rate of classical dengue fever is 0.90% and the dengue hemorrhagic fever is 12.5%. Dengue hemorrhagic fever reports high case fatality rate in the study area compared to the other regions, 0.76% in Jakarta, [28] 1.4% in Indonesia, 2.8% in West Java and 8.5% in West Bengal. [29]

Studies show that dengue fever report more in adult age group (>20 years) compared to the low age group (<20 years). In the present study also dengue fever is higher in adult age groups (>20 years) than the low age groups (<20 years) in both males and females. A study conducted by Chia-Hsien Lin et al. in Taiwan [31] reports that dengue fever is higher in adult age groups compared to lower age groups. Another study conducted by Adriana et al. in Brazil [32] also reveals that adult age group shows the predominance in dengue fever. Studies conducted by Ooi et al., [33] and Yew et al. in Singapore, [34] Anker et al. in six Asian countries, [35] Qureshi et al. in Pakistan, [36] Lin et al. in Taiwan [37] also proves the same. Study reports from England, Wales and Northern Island [35] also support this fact in their studies as dengue fever reports higher in the adult population (>20 years). This predominance of adults may be due to involvement of adult groups in outdoor works compared to low age group as they have the more chances of exposing infected mosquitoes than the low age groups.

In the present study, the proportion of male cases is higher than the female cases. In males, it is 60.70% and in females it is 39.29% of total dengue fever cases. A study conducted by Eong [38] in Singapore supports that proportion of males was higher than females in their study. Ruel Perez [39] also support that in his study in Manila, Philippines, males are more prone to dengue fever than females. But a South American study conducted by Kaplan et al. [40] reports in their study that more cases were in females compared to males. Study reports from Asian countries such as Cambodia, Malaysia, Sri Lanka, Singapore and Philippines [35] and India [41] reveal the high preponderance of males in dengue fever and pointing out the fact that it may be due to the outdoor work habit of men compared to females. A majority of the studies points out the fact that males have more outdoor work habits compared to females. They are more exposed to the mosquito bite during their day time work or while travelling to the work site in the early morning or returning from the work site in the late evening. Study reports from Pakistan by Qureshi et al., [36] an Indian study by Vijayakumar et al., [42] and Thailand study by Tharava et al. [43] uniformly support that the male preponderance in the dengue fever and it is mainly due to the outdoor work nature of males compared to females. So the high number of infected dengue cases in adult age groups and in males is strongly indicating the involvement of work component in this infection because children and women are spending much time in indoors and less exposed to the vectors of dengue infection. [44] Thus, more infection in the adult age groups and males compared to the low age groups and females in the present study highlights the possibility of occupational exposure of the dengue infection. While dengue fever vectors show much outdoor habitats, the people work in the outdoors are high risk groups and much emphasize to be given for personal prophylaxis and also for source reduction activities to control the breeding and multiplication of Aedes mosquitoes.


  Conclusion Top


As the prevention of dengue fever lacks proper vaccine, the main preventive strategy is the awareness building in the community regarding the source reduction process by emptying the man made containers or dispose those in a systematic or in a proper way. Much efforts to be taken to promote the participation of the community in the action program for eliminating vector-breeding sites.

 
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    Figures

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    Tables

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