Introduction Dengue is a major public health concern in tropical regions, with children at increased risk of severe disease. Early identification of predictors is essential for timely intervention. Methods This hospital-based cross-sectional study was conducted from January to December 2024 at a tertiary care hospital in Dhaka, Bangladesh. A total of 346 children aged 0-14 years with confirmed dengue infection were included. Clinical, laboratory, radiological, and comorbidity data were analyzed. Variables associated with severe dengue were identified using the chi-square test and multivariate logistic regressio. Results Severe dengue was observed in 53 (15.3%) cases, with one mortality (0.3%). Common clinical features included fever in 346 (100%), vomiting in 97 (28.0%), abdominal pain in 73 (21.1%), and diarrhea in 59 (17.1%) patients. On univariate analysis, several clinical, laboratory, and radiological variables were significantly associated with severe dengue. Multivariate analysis identified elevated hematocrit (adjusted odds ratio (AOR): 9.2) as the strongest predictor, followed by pleural effusion (AOR: 7.4), ascites (AOR: 6.3), thrombocytopenia (AOR: 5.6), hypoalbuminemia (AOR: 4.8), elevated aspartate aminotransferase (AST, AOR: 4.2), and elevated alanine transaminase (ALT, AOR: 3.5). Conclusion Severe dengue in children is primarily associated with markers of plasma leakage and organ involvement. Early risk stratification using laboratory and radiological parameters can improve clinical outcomes.
Chowdhury et al. (Sun,) studied this question.