Assessment of risk factors and early warning signs for mortality in children with severe dengue at tertiary care hospital, Dhaka, Bangladesh: a prospective observational study

Background: Dengue remains a significant public health challenge, especially in pediatric populations. This study aims to analyze the demographic distribution, clinical presentation, and outcomes of severe dengue in children, with a focus on identifying key factors associated with recovery and mortality. Methods: This cross-sectional analytical study was conducted on 300 children diagnosed with severe dengue at Dhaka Shishu (Children) hospital, Bangladesh, from January 2019 to December 2020. Participants were selected using convenient sampling, and data on demographic characteristics, clinical symptoms, and physical examination findings were collected and analyzed using SPSS V. 22. Result: The study included a majority in the 6-10 years age group (56.67%), with a male predominance (59.33%). Major bleeding was observed in 27.33% of participants. The mortality rate was 4.67%. No significant differences in age and gender distribution were found between the recovery and mortality groups. Symptoms like cough, breathlessness, and abdominal pain, along with physical findings such as increased hematocrit, pleural effusion, and hepatomegaly, were significantly associated with mortality. Conclusions: Severe dengue in children presents with a range of symptoms, with major bleeding being a critical indicator of disease severity. The study highlights the need for comprehensive clinical assessment and vigilant monitoring, emphasizing the importance of recognizing both common and severe symptoms in pediatric dengue for effective management and improved outcomes.