Características clínico-epidemiológicas del dengue con signos de alarma y dengue grave
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2020
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Introducción: El dengue es una enfermedad infecciosa, de origen viral, causada por Dengue Virus, cualquiera de sus 4 serotipos (DENV1-DENV2-DENV3-DENV4). Transmitida por picadura del mosquito hembra del genero Aedes. Cursa tres fases, febril, crítica y convalecencia, luego del periodo de incubación de 3-7 días. La presentación clínica es variada, la OMS la clasifica en: dengue sin signos de alarma (DSSA), dengue con signos de alarma (DCSA) y dengue grave (DG).
Objetivo: Establecer las características clínico-epidemiológicas del DCSA y DG en pacientes del Hospital del niño Dr. Francisco Icaza Bustamante y Hospital de Infectología Dr. José Rodríguez Maridueña durante 2017-2019.
Metodología: Trabajo de investigación de enfoque cuantitativo, diseño no experimental, corte transversal, observacional, analítico y correlacional.
Resultados: Se evidenció en 226 casos estudiados, que el DCSA fue más frecuente 79,6%, seguido DG 11.1% y DSSA 9.3%. En la caracterización epidemiológica, predomina sexo femenino, grupo etario 5-18 años, procedencia urbana, instrucción primaria, normopeso, sin comorbilidades, sin antecedente de dengue, ni consumo de AINES. En la caracterización clínica, prevalece el dolor abdominal y vómitos, en las alteraciones de laboratorio aumento de transaminasas 83.7%, reducción de plaquetas 67.9% y aumento del hematocrito 11.8 %. El DG reflejó un perfil diferente, sexo masculino, consumo de AINES con clínica de dolor abdominal y acumulación de líquidos, su presentación más frecuente fue disfunción de órganos.
Conclusiones: Existe asociación estadísticamente significativa con 95% de probabilidad, entre consumo de AINES, dolor abdominal y acumulación de líquido, con el desarrollo de DG.
Introduction: Dengue is an infectious disease of viral origin, caused by Dengue Virus, any of its 4 serotypes (DENV1-DENV2-DENV3-DENV4). Transmitted by the bite of the female mosquito of the genus Aedes. It goes through three phases, febrile, critical and convalescence, after the incubation period of 3-7 days. The clinical presentation is varied, the WHO classifies it as: dengue without warning signs (DwoWS), dengue with warning signs (DwWS) and severe dengue (SD). Objective: To establish the clinical-epidemiological characteristics of DwWS and SD in patients from the “Hospital del Niño Dr. Francisco Icaza Bustamante and Hospital de Infectología Dr. José Rodríguez Maridueña during 2017-2019. Methodology: Research work with a quantitative approach, non-experimental design, cross-sectional, observational, analytical and correlational. Results: It was evidenced in 226 cases studied, that the DwWS was more frequent 79.6%, followed by SD 11.1% and DwoWS 9.3%. In the epidemiological characterization, the female sex predominated, age group 5-18 years, urban origin, primary education, normal weight, without comorbidities, without a history of dengue, or consumption of NSAIDs. In the clinical characterization, abdominal pain and vomiting prevail, in laboratory alterations an increase in transaminases 83.7%, a reduction in platelets 67.9% and an increase in hematocrit 11.8%. The SD reflected a different profile, male sex, consumption of NSAIDs with symptoms of abdominal pain and fluid accumulation, its most frequent presentation was organ dysfunction. Conclusions: There is a statistically significant association with 95% probability, between NSAID consumption, abdominal pain and fluid accumulation, with the development of SD.
Introduction: Dengue is an infectious disease of viral origin, caused by Dengue Virus, any of its 4 serotypes (DENV1-DENV2-DENV3-DENV4). Transmitted by the bite of the female mosquito of the genus Aedes. It goes through three phases, febrile, critical and convalescence, after the incubation period of 3-7 days. The clinical presentation is varied, the WHO classifies it as: dengue without warning signs (DwoWS), dengue with warning signs (DwWS) and severe dengue (SD). Objective: To establish the clinical-epidemiological characteristics of DwWS and SD in patients from the “Hospital del Niño Dr. Francisco Icaza Bustamante and Hospital de Infectología Dr. José Rodríguez Maridueña during 2017-2019. Methodology: Research work with a quantitative approach, non-experimental design, cross-sectional, observational, analytical and correlational. Results: It was evidenced in 226 cases studied, that the DwWS was more frequent 79.6%, followed by SD 11.1% and DwoWS 9.3%. In the epidemiological characterization, the female sex predominated, age group 5-18 years, urban origin, primary education, normal weight, without comorbidities, without a history of dengue, or consumption of NSAIDs. In the clinical characterization, abdominal pain and vomiting prevail, in laboratory alterations an increase in transaminases 83.7%, a reduction in platelets 67.9% and an increase in hematocrit 11.8%. The SD reflected a different profile, male sex, consumption of NSAIDs with symptoms of abdominal pain and fluid accumulation, its most frequent presentation was organ dysfunction. Conclusions: There is a statistically significant association with 95% probability, between NSAID consumption, abdominal pain and fluid accumulation, with the development of SD.
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Dengue, Epidemiologia analítica, Hospital del Niño Francisco de Icaza Bustamante, Hospital de Infectología Dr. José Rodríguez Maridueña, Cantón Guayaquil, Ecuador, Signos y síntomas