Caracterização demográfica e formas clínicas apresentadas por crianças internadas com dengue em um hospital de referência da Amazônia

Abstract

Dengue has been causing epidemics of different magnitudes in recent decades, and is present in almost all States of Brazil with movement of four different serotypes, from the introduction in the country of the serotype 4 in January, 2011. The current epidemiological scenario of the country indicates the elevation of severe forms of dengue in the pediatric age group. However, descriptive studies of cases of the disease in children, which make reference to epidemiological and clinical features, are infrequent. The present work is meant to show the demographic characteristics and clinical forms submitted by children under the age of twelve years, interned with dengue, in a referral hospital from Amazon. In this study, we used a methodology that would allow a search through retrospective analysis of hospitalized children with dengue, 154 patient records in the period between 2009 to 2011, in João de Barros Barreto University Hospital, in Belém, Pará. The variables examined were: age, gender, area of residence, distribution by municipalities, signs and symptoms, date of hospitalization, date of onset of symptoms, clinical form of the disease and platelet and hematocrit values, liver enzymes. In this study, there was no statistically significant difference between gender, most confirmed cases of dengue fever were coming from municipalities in the interior State of Pará (57.6%). Fever was the sign most often found (98.7%). Petechia was the hemorrhagic manifestation referred to as more frequent in this study (76.6%). Among the warning signs for Dengue Hemorrhagic Fever, abdominal pain and vomiting were present in 77.3% of patients. On the date of hospital admission, revealed that only after five to seven days from the beginning of the clinical symptoms, the patients had access to treatment in hospital. In this respect, it is known that the prognosis of patient with early recognition depends on dengue warning signals and immediate treatment with appropriate electrolytes spares. These results show that it is necessary to strengthen the basic health services in order to provide early diagnosis and appropriate care in the pediatric age group, in particular where dengue cases eventually are confused with other virus diseases prevalent in childhood. Certainly, there is a need to evaluate the efficiency of dengue control programs and application of specific measures to areas identified as priorities.