Association of Co-Infection in Children with Dengue Fever

Abstract

Introduction: In developing countries like India Dengue, Malaria, and Typhoid are endemic and present as acute undifferentiated fever. In areas endemic for two or more infectious agents, co-infection is more common. In tropical countries, because of seasonal variation, there is a chance of coinfection of the host by dengue with another infectious disease such as rickettsia, malaria, and Enteric fever.  So, our study aimed to see the association of co-infection in children with Dengue.

 Methodology: This hospital-based retrospective study was conducted in Pediatric wards of NKPSIMS & LMH from 1.11.13 to 30.10.14. The case records of all cases diagnosed as Dengue & admitted to the hospital during the study period were scutinized.  All patients admitted in the Pediatric ward and PICU who were NS1 positive and or IgM, IgG positive was enrolled in the study. Dengue-like illnesses but serologically negative were excluded. A total of 218 patients were included in the study

Results: During the study period total of 218 patients were admitted as serologically positive Dengue cases. Among them 126 were female and 91 were male. 191 patients were from rural and 27 were from urban areas. Of the total 218 patients, 29 patients had co-infection. Among them 17(58.62%) had Enteric fever, 8(27.58%) had malarial fever, 2(6.9%) had rickettsial fever and 2(6.9%) patients had Urinary Tract Infection (UTI). Coinfection was more in patients of dengue with warning signs and severe dengue which was statistically significant p<0.001.   The duration of hospital stay was more in children with coinfections and mortality was more in patients of severe dengue with coinfection.

Conclusion: In patients with dengue fever co-infections with enteric fever, malaria, rickettsia, and UTI are not uncommon. Children with co-infection have a more severe presentation of dengue fever & also prolong the duration of hospital stay.