Comparison of the clinical and laboratory profile of dengue with and without warning signs in pediatric population.

Abstract

Introduction: Dengue is currently the most widespread arboviral disease worldwide. Over the last decade, there has been a sustained increase in cases in Bolivia, constituting a significant public health problem. Pediatric patients are a vulnerable population, hence the importance of understanding the clinical and laboratory characteristics that will guide us toward timely and early diagnosis, essential to reduce complications and decrease mortality in this population.

Objective: To compare the clinical and laboratory profile of dengue with and without warning signs in the pediatric population of the Albina R. Patiño Pediatric Hospital in Cochabamba, Bolivia, from 2022 to 2024.

Materials and Methods: An observational, analytical, and prospective study was conducted. Confirmed cases of dengue hospitalized with warning signs were included. Subsequently, patients were classified according to WHO criteria as having dengue without warning signs (DSSA) or dengue with warning signs (DCSA). Demographic, anthropometric, clinical, and laboratory variables were analyzed using STATA software, and the groups were compared based on the distribution of variables using chi-square, Fisher's exact, and Mann-Whitney U tests.

Results: Of all patients, 65.2% had DSSA and 34.8% had DCSA. Abdominal pain and bleeding showed a significant association with the presence of warning signs (p = 0.018 and p = 0.004, respectively). Overweight and obesity were associated with a higher probability of DCSA, with an approximate odds ratio of 2.7. In the laboratory profile, the elevation of transaminases (ALT and AST) was significantly higher in the group with warning signs (p = 0.018 and p = 0.004).

Conclusion: Abdominal pain, bleeding, and elevated transaminases are relevant clinical and laboratory predictors for the early identification of dengue with warning signs in the pediatric population. Nutritional status may influence progression to more severe forms; therefore, its assessment should be incorporated into clinical risk stratification.