DENGUE FEVER

ROLE OF NON STRUCTURAL PROTIEN-1 (NS-1) POSITIVITY IN DENGUE CASES: AN EXPERIENCE FROM A QAZI HUSSAIN AHMED MEDICAL COMPLEX NOWSHERA.

Abstract

Objectives: To determine the frequency and characteristics of dengue patients.
Study Design: Cross sectional observational study. Setting: Qazi Hussain Ahmed Medical
Complex Nowshera. Period: 5th July to 25th Sept 2017. Material and Methods: A total of
72 cases were received for dengue serology. Relevant information’s were collected on a predesigned
questionnaire prepared in accordance with the objectives of the study. Results: A
total of 117 patients were referred from fever clinic and emergency OPD for dengue serology.
72(61.5%) were males and 45(38.5%) were females. 24(20.5%) cases were dengue positive.
14(12%) were NSL1 positive, 8(8.8%) were IgM positive and 2 (1.7%) were IgM&IgG positive.
We received patient in the range of 4 years to 60 years, Mean with SD was 27 +3 years. Out of
14 NSL1 positive cases 8 were males and 6 females. 2 females were IgG positive. The spectrum
of dengue in correlation with gender was significantly positive with p value .026. In two cases
platelet at first visit were 58000/cmm3 that were both IgM&IgG positive. Out of 24 positive
dengue cases two cases were also positive for plasmodium vivax (ring tropozoites). 6 cases
were managed in hospital and discharged home with an average stay of 3 days and 4 cases
referred to Lady Reading Hospital Peshawar for repeated platelet transfusion. Mortality was
zero in our cases. Conclusion: The suspicion rate of the clinician for dengue from fever clinic
was 1:7. The cause of poor rate can be contributed to the patient insist for doing the dengue
test before they are screened for MP and FBC etc. NSL1 was positive in 6 cases that shows
that people reach the health care facility for screening well in time and patient are educated
about the dengue. Females 50% positive cases were IGM and IGG positive that shows female
receive the health care later than males as NSL1 positivity in female gender is less than males.
The spectrum of dengue in correlation with gender was significantly positive with p value .025
that shows mosquito has some affinity for specific gender, or dengue virus has it for difference
in gender or the inside immunity of the both gender is involved that causes different mode of
presentation and activation of antibodies.