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Outcome of Dengue in Hospitalized Jamaican Children


Background: Dengue fever is hyper-endemic in Jamaica with exponential rates of infection in successive outbreaks. The absence of local data and the potential for massive outbreaks in a country where a third of the population are children formed the basis for this study. 

Methods: We evaluated the outcome of Dengue in children hospitalized at the University Hospital of the West Indies (UHWI), Mona, Jamaica, during the Island-wide Dengue fever epidemic of 2012. This retrospective study reports all physician-diagnosed cases of dengue in hospitalized children aged less than 15 years.

Results: A total of 134 hospitalized children with physician-diagnosed Dengue were included. One hundred and eighteen (88%) had a confirmatory Dengue laboratory test.  One hundred and twenty (90%) were uncomplicated and 14 (10%) had severe Dengue. Severe disease was significantly associated with a longer duration between disease onset and hospital admission (p = 0.0076). Main co-morbidities were sickle cell disease (14%) and asthma (13%), however, neither was associated with increased mortality. Duration of hospitalization was longer for patients with sickle cell disease. Children with short-stature were significantly more likely to have severe Dengue [Z-score height-for-age < 2.0; OR 6.46(1.61, 25.88), p = 0.016]. There were five deaths with a case fatality rate of 3.73%. Prior use of non-steroidal anti-inflammatory drugs (NSAIDS) was documented in four deaths.

Conclusion: Delayed presentation and short-stature were significantly associated with severe Dengue. Children with sickle cell disease had longer hospital stay. The case fatality rate was 3.73%. Use of safe and efficacious Dengue vaccines should mitigate the effects of dengue-attributable childhood morbidity and mortality.

December 26, 2015
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