|LETTER TO EDITOR
|Year : 2021 | Volume
| Issue : 3 | Page : 142
Clinicolaboratory and treatment profile of dengue in children: Observations from a tertiary care hospital
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
|Date of Submission||29-Mar-2021|
|Date of Decision||19-May-2021|
|Date of Acceptance||23-May-2021|
|Date of Web Publication||01-Oct-2021|
Mahmood Dhahir Al-Mendalawi
P. O. Box: 55302, Baghdad Post Office, Baghdad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Al-Mendalawi MD. Clinicolaboratory and treatment profile of dengue in children: Observations from a tertiary care hospital. Hamdan Med J 2021;14:142
I read with interest the study by George et al. published in the January-March 2021 issue of the Hamdan Medical Journal. George et al. studied the clinical and laboratory parameters of dengue fever (DF) among paediatric patients in India with an emphasis on various haematological ratios. They concluded that DF must be suspected when a school-going child in a dengue-endemic area presents clinically with fever, headache, myalgia and vomiting in addition to the blood picture of leucopenia, thrombocytopenia and elevated haematocrit. George et al. addressed few study limitations. I presume that the following methodological limitation is relevant. George et al. mentioned in the study methodology that the diagnosis of DF in the studied patients was based on the positivity for dengue NS1 antigen or immunoglobulin (Ig) M or IgG (rapid or ELISA test). It is obvious that establishing DF diagnosis is critical to improve patients' outcomes and implement timely public health measures. The surveillance of DF depends upon reverse transcription-polymerase chain reaction (RT-PCR) for confirmation of dengue virus (DV) serotypes. The RT-PCR has been shown to be specific and sensitive for detecting DV-1–4 RNA and appropriate for diagnostic use. The diagnostic rate using a combination of RNA and IgM detection was reported to constitute 99% compared to 95.9% using NS1 and IgM detection. Currently, RT-PCR assay is considered the most rapid molecular diagnostic tool available for detecting DV serotypes., As antigen positivity precedes seropositivity, relying exclusively on serology would miss the disease in its early stage. I wonder why George et al. referred entirely to serology rather than PCR in the study methodology to confirm DF in the studied cohort. Relying solely upon serology might result in missing a substantial number of DF cases and hence, it might limit the number of cases recruited in the study. Ultimately, this limitation might question the study results and conclusion addressed by George et al.
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Conflicts of interest
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| References|| |
George T, Pais M, Abraham S, Boloor R, Suresh S, Jakribettu RP, et al.
Clinicolaboratory and treatment profile of dengue in children: Observations from a tertiary care hospital. Hamdan Med J 2021;14:13-6. [Full text]
Huhtamo E, Hasu E, Uzcátegui NY, Erra E, Nikkari S, Kantele A, et al.
Early diagnosis of dengue in travelers: Comparison of a novel real-time RT-PCR, NS1 antigen detection and serology. J Clin Virol 2010;47:49-53.
Teoh BT, Sam SS, Tan KK, Danlami MB, Shu MH, Johari J, et al.
Early detection of dengue virus by use of reverse transcription-recombinase polymerase amplification. J Clin Microbiol 2015;53:830-7.
Ahamed SF, Vivek R, Kotabagi S, Nayak K, Chandele A, Kaja MK, et al.
Enhancing the sensitivity of Dengue virus serotype detection by RT-PCR among infected children in India. J Virol Methods 2017;244:46-54.