EFFECT OF NUTRITIONAL STATUS ON OUTCOME OF DENGUE INFECTION IN CHILDREN
Creators: name: Dr. Vidhyasagar Krishnamoorthy
name: Dr. Thulasi
name: Dr. Vaanmathi Azhagar Nambi Santhi
name: Dr. Muthu Chidambaram Md Dm
name: Balamma Sujatha
name: Dr. Melachuru Sai Padma Charan
Publisher: name: Zenodo
Year: 2024
Subjects: Dengue Infection, Nutrition, Malnourishment.

description: Abstract 

Introduction: The anthropometric measurements are commonly used for nutritional assessment in children to classify nutritional status into four categories: normal, wasting, stunting and overweight. However, children can experience concurrent stunting and wasting. Similarly, they can also experience stunting and overweight. These conditions are associated with greater susceptibility to mortality and chronic diseases, and they are now seen as a specific problem requiring special attention. In patients with severe dengue infection, early diagnosis and proper supportive care can reduce the risk of mortality. Identifying risk factors associated with severe forms of dengue infection is crucial to accurately select patients most likely to benefit from appropriate early interventions. Previous studies have explored the impact of malnutrition, defined as a disorder of nutritional status, including undernutrition (wasting, stunting and underweight) and overnutrition (overweight and obesity) on dengue severity, but findings have been inconsistent. Hence, the present study was carried out to assess the effect of nutritional status on outcome of dengue infection in children. Methodology: This was a descriptive Cross-Sectional Study carried out over a period of 2 years from October 2020 to September 2022 amongst children of age between 1 year to 16 years admitted in the department of Paediatrics at Saveetha Medical College and Hospital, Thandalam with symptoms of fever, abdominal pain, vomiting and /or reduced urine output. Dengue infection was diagnosed based on clinical signs and symptoms with positive NS1antigen if they present within 5 days or IgM/IgG if they present after 5 days of illness. Anthropometric measurements were done and the children were classified as stunted/normal based on height, underweight/normal based on weight and obese, normal or malnourished based on BMI. Severity of illness was assessed based on days of hospital stay, PICU admission, shock. Standard statistical methods were used to determine the correlation between nutritional status and severity of dengue infection. Qualitative data was analysed by Chi Square test which express the frequency and percentage of the data.  Quantitative data was expressed as Mean and standard deviation which was analysed by student independent t test. A p value lower than 0.05 was considered as statistically significant. Results: The mean age of children in the present study was 8.9 years. Underweight children were found only in Low and Middle SES group and the percentage was 9% and 11% respectively. The percentage of children with obesity was more in the middle and upper SES 22.22% and 14.2% respectively. NS 1 Antigen was positive in 53.8%, Dengue IgM positivity rate was 84.6% and Dengue IgG was positive in 26.1% of the study population. Subjects who were stunted had more prevalence of shock and PICU admission as compared to subjects with normal height.9.2% children in the study population were underweight. PICU admission had no statistical significance with weight for age. Days of stay in hospital was found to be more in obese and normal weight children. 25% of children with under nutrition had PICU admission and 50% of children with under nutrition developed shock. Conclusion: Although undernourished children are more likely to suffer from severe dengue, there was no significant correlation between nutritional status of child with the severity of dengue infection.