Background: Dengue virus (DENV) infection is caused by an arboviral strain and is
transmitted by the mosquito Aedes Egyties which is found in Sudan especially
Red Sea and Kassala states in the east.In the year 2020 there was a
significant outbreak in the both states. The disease is known to cause renal
and electrolyte disturbances and a thorough understanding of that which will
potentially help in the prediction, diagnosis and treatment of the disease. Methods: This study is a prospective observational cross sectional study conducted
in the Eastern Sudan College of Medical Science and Technology and Port Sudan
Teaching Hospital. 200 confirmed Dengue virus infection patients along with 200
healthy appearing adults (as a control) were enrolled for the study. Statistical
analysis was carried out after the collection of patients’ demographic,
clinical, and investigational data including electrolyte values. Results: The
highest incidence of DENV infection was observed in individuals of the middle
age group (29%). Although fallen within reference ranges found in the literature,
mean serum electrolyte values differed significantly between patients and
controls and between different categories of the disease. For our patients, hyponatraemia
was seen in 43.5%, hypokalaemia in 37%, hypocalcaemia in 30%, hypophosphataemia
in 12% and low magnesium concentrations in 13%. Mean serum sodium concentration
differed in the control (138.2 mmol/l) from in the test (132.5 mmol/l) (P.
value 0.02). Similarly, mean serum potassium in the control (3.97 mmol/l)
differed significantly (P. value 0.01) from test (3.30 mmol/l). Mean calcium
and phosphorus (8.80 and 3.50 mg/dl) in the control were also differed from
test (8.51 and 3.30), (P. values 0.02 and 0.004, respectively). In contrast,
serum magnesium (mg/dl) in the control group (1.96) showed no significant
difference from that of test group (1.90) (P. value 0.08). The biochemical
parameters studied were neither affected by age nor by gender
References
[1]
Jayaratne, H.E., Wijeratne, D., Fernando, S., Kamaladasa, A., Gomes, L., Wijewickrama, A., Ogg, G.S. and Malavige, G.N. (2018) Regulatory T Cells in Acute Dengue Viral Infection. Immunology, 154, 89-97. https://doi.org/10.1111/imm.12863
[2]
John, D.V., Lin, Y.S. and Perng, G.C. (2015) Biomarker of Sever Dengue Disease—A Review. Journal of Biomedical Science, 22, Article No. 83. https://doi.org/10.1186/s12929-015-0191-6
[3]
Lizarraga, K.J. and Nayer, A. (2014) Dengue-Associated Kidney Disease. Journal of Nephropathology, 3, 57-62.
[4]
De la Hernández, S.I., Puerta-Guardo, H.N., Aguilar, H.F., et al. (2016) Primary Dengue Virus Infections Induce Differential Cytokine Production in Mexican Patients. Memorial Institute of Oswaldo Cruz, 111, 161-167. https://doi.org/10.1590/0074-02760150359
[5]
Ahmed, A., Elduma, A., Magboul, B., Higazi, T. and Ali, Y. (2019) The First Outbreak of Dengue Fever in Greater Darfur Western Sudan. Tropical Medicine of Infectious Disease, 4, Article No. 43. https://doi.org/10.3390/tropicalmed4010043
[6]
Soe, H.J., Yong, Y.K., Al-Obaidi, M.M.J., Raju, C.S., Gudimella, R., Manikam, R. and Sekaran, S.D. (2018) Identifying Protein Biomarkers in Predicting Disease Severity of Dengue Virus Infection Using Immune-Related Protein Microarray. Medicine, 97, e9713. https://doi.org/10.1097/MD.0000000000009713
[7]
Waggoner, J.J., et al. (2016) Clinical Presentation in Nicaraguan with Zika Virus, Chikunguna Virus, and Dengue Virus. Clinical Infectious Diseases, 63, 1584-1590. https://doi.org/10.1093/cid/ciw589
[8]
World Health Organization (2017) Dengue and Sever Dengue Fact Sheet.
[9]
Wlison, E.M. and Chen, L.H. (2015) Dengue: Update on Epidemiology. Current Infectious Disease Reports, 17, Article No. 457.
[10]
Cardenas, J.C., Giraldo-Parra, S.Y., Gonzalez, M.U., Gutierrez-Silva, L.Y. and Jaimes-Villamizar, L., et al. (2021) Laboratory Findings in Patients with Probable Dengue Diagnosis from an Endemic Area in Colombia in 2018. Viruses, 13, Article No. 1401. https://doi.org/10.3390/v13071401
[11]
Pan American Health Organization/World Health Organization (2020) Epidemiology Update: Dengue.
[12]
Cucunnawangish and Lugito, N.P.H. (2017) Trends of Dengue Disease Epidemiology. Virology: Research and Treatment, 8, 6 p. https://doi.org/10.1177/1178122X17695836
[13]
World Health Organization (2019) Ten Threats to Global Health in 2019. https://www.who.int/emergencies
[14]
Relwani, P.R., Redkar, N.N. and Garg, D. (2019) Study of Electrolytes in Patients of Dengue in a Tertiary Care Hospital in India. International Journal of Advances in Medicine, 6, 763-768. https://doi.org/10.18203/2349-3933.ijam20192114
[15]
Narayanan, M., Aravind, M.A., Thilothammal, N., Prema, R. and Ramanrty, N. (2002) Dengue Fever Epidemic in Chennai—A Study of Clinical Profile and Outcome. Indian Pediatrics, 39, 1027-1033.
[16]
Vuong, N.L., Manh, D.H., Mai, N.T., Luong, V.I., Quan, V.D., Van Thuong, N., et al. (2016) Criteria of “Persistent Vomiting” in the WHO 2009 Warning Signs for Dengue Case Classification. Tropical Medicine and Health, 44, Article No. 14. https://doi.org/10.1186/s41182-016-0014-9
[17]
Shankar, P., Nithya, E. and Kavya, C. (2019) Study on Electrolytes Disturbances in Dengue Fever in a Tertiary Center. International Journal of Contemporary Pediatrics, 6, 2504-2508. https://doi.org/10.18203/2349-3291.ijcp20194725
[18]
Unniklishnam, R., Faizal, B.P., Vijaya Kumar, P., Panl, G. and Sharma, R.N. (2015) Clinical and Laboratory Profile of Dengue in the Elderly. Journal of Family Medicine and Primary Care, 4, 369-378.
[19]
Mekmullica, J., Suwanphatra, A., Thienpaitoon, H. and Chansongsaknl, T. (2005) Serum and Urine Sodium Levels in Dengue Patients South East Asia. Journal of Tropical Medicine and Public Health, 36, 197-199.
[20]
Domingo, K.M.G., Nazareth-Duque, C.L. and Blanco, C.C. (2021) Significance of Hypocalcemia in Predicting Dengue Severity in the Pediatric Population: A Systematic Review and Meta-Analysis. Health Sciences Journal, 10, 55-62.
[21]
Sheshan, V.S., Deepali, Shenoy, G.C., Sudheendra and Kavya, S.T. (2021) Analysis of Hypocalcaemia in Dengue and Correlation of Serum Calcium Levels with Severity of Dengue Disease. Academia Journal of Medicine, 4, 74-77.
[22]
Guzman, M.G., et al. (2010) Dengue: A Continuing Global Threat. Nature Reviews Microbiology, 8, S7-S16. https://doi.org/10.1038/nrmicro2460
[23]
Mallhi, T.H., Khan, A.H., Adnan, A.S., Sarriff, A., Khan, Y.H. and Jummaat, F. (2015) Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: A Retrospective Analysis. PLoS ONE, 10, e0138465. https://doi.org/10.1371/journal.pone.0138465
[24]
Khan, A.H. and Mallhi, T.H. (2016) Dengue Induced Nephropathies. SM Group.
[25]
Gancia, G., Gonzalec, N., Pérez, A.B., Sierra, B., et al. (2011) Long Term Persistence of Clinical Symptoms in Dengue Infected Person and It Is Association with Immunological Disorders. International Journal of Infectious Diseases, 15, E38-E43. https://doi.org/10.1016/j.ijid.2010.09.008
[26]
Widodo, D., Setiewan, B., Chen, K., Nainggolanl, L. and Santoso, W.D. (2018) The Prevalence of Hypokalemia in Hospitalized Patients with Infection Disease Problem at Cipto Mangunkusumo Hospital, Jakarta. Acta Medica Indonesiana, 38, 202-205.
[27]
Kalit, J., Misrauk, U.K., Mahadevan, A. and Shankar, S.K. (2018) Acute Pure Motor Quadriplegia: Is It Dengue Myositis? Electroencephalography and Clinical Neurophysiology, 45, 357-361.
[28]
Manjunath, V.G., Balla, S. and Kumar, J. (2019) Serum Ionic Calcium Levels and Hypocalcemia in Dengue Fever in Children and Its Correlation with Its Severity: Case Control Study. International Journal of Contemporary Pediatrics, 6, 1289-1293. https://doi.org/10.18203/2349-3291.ijcp20192030
