Distribution and Severity of Dengue Serotypes in Pediatric Cases: Analysis of Clinical Outcomes in Children 1-12 Years in Endemic Regions

Abstract

Background: Dengue fever remains a significant public health concern in pediatric populations across endemic regions. Understanding serotype-specific disease patterns and their correlation with clinical outcomes is crucial for improving patient care and reducing mortality.

Objective: To analyze the distribution of dengue serotypes and their relationship with disease severity in pediatric cases aged 1-12 years, examining clinical manifestations, laboratory parameters, and outcomes across different serotypes.

Methods: This prospective observational study enrolled 100 children (ages 1-12 years) with laboratory-confirmed dengue infection. Serotype identification was performed using RT-PCR, and patients were classified according to WHO 2009 guidelines. Clinical features, laboratory parameters, and outcomes were systematically documented and analyzed in relation to viral serotypes.

Results: DENV-2 emerged as the predominant serotype (38%), followed by DENV-1 (30%), DENV-3 (22%), and DENV-4 (10%). The 6–9-year age group represented 45% of cases, with a slight male predominance (54%). DENV-2 infections showed the highest rate of severe dengue (21%) and demonstrated more severe clinical manifestations, including significant thrombocytopenia (mean nadir: 35,000 ± 15,000/μL) and elevated hematocrit levels (mean peak: 45 ± 5%). The overall mortality rate was 2%, exclusively associated with DENV-2 infections.

Conclusion: The study reveals significant associations between dengue serotypes and disease severity in children, with DENV-2 consistently associated with more severe clinical manifestations and poorer outcomes. These findings emphasize the importance of early serotype identification in clinical settings and suggest the need for serotype-specific management approaches in pediatric dengue cases.