Predictive diagnostic value of the Tourniquet Test and Correlation of Laboratory Profile for the Diagnosis of Dengue Infection among patients <18 years old admitted at San Lazaro Hospital from September 2015 to November 2015

ABSTRACT

@#<p style="text-align justify;"><strong>INTRODUCTION:</strong> Tourniquet test has been widely used locally and internationally as the cheapest, fastest and most efficient way of diagnosing dengue infection. This is so efficient that the World Health Organization has been active in promoting this as a diagnostic tool for tropical countries like the Philippines.<br /><strong>OBJECTIVE:</strong> To determine the accuracy of the tourniquet test in the diagnosis of dengue infection among patients aged<br /><strong>METHODOLOGY:</strong> The retrospective research design was utilized. These variables were included the socio-demographic and clinical variables as to the patients' age, gender, body mass index and the presence of co-morbid conditions, clinical manifestations (duration of fever, headache, abdominal pain, rashes and bleeding episodes, hemoglobin level, WBC, Platelets, NS1, IgG, IgM and Hematocri values). Once these were noted, the researcher coded the results. Coding was done in Microsoft Excel.<br /><strong>RESULTS:</strong> Patients were mostly in the 12 to 17 years age group, males (54.1%), in the normal weight category (88.1%) and had no co-morbid conditions (77.1%). Clinical manifestations of dengue included fever of ? 4 days (56%); abdominal pain (61.5%); and gum bleeding (56.4%). As regards laboratory profile of patients, low hemoglobin levels were observed (77.5%); low WBC count (78.9%); low platelet counts (100%); positive for NS1 (71.1%); positive for Immunoglobulin G (82.6%) and Immunoglobulin M (85.3%). There was a 65% accuracy of cases when tourniquet test was performed among patients with dengue. There was a strong correlation between dengue infection and WBC (r=0.915; p=0.028); platelets (r=0.663; p=0.003); hematocrit (r=0.57; p<0.01); Non-Structural Protein 1 (r=.753; p=.031); IgG (r=0.566;p=0.002); IgM (r=0.510; p=0.009) and Tourniquet test (r=0.513; p=0.045). No significant correlation was observed for cases of dengue infection and hemoglobin (r=0.026; p=0.702) and platelets (r=0.026; p=0.702).<br /><strong>CONCLUSIONS:</strong> The dengue infection was found mostly to be in the 12 to 17 years of age; predominantly males. BMI was not found to be significant factor for dengue infection since most cases were in the normal weight category. Clinical presentations of dengue infection commonly observed in this research were fever with a duration of 4 days and above, headache, abdominal pain and gum bleeding. Majority had abnormal levels of hemoglobin, low WBC, and low platelet count. Biomarkers for dengue infection noted in the study were positive NS1, presence of IgG and IgM. Tourniquet test yielded 655 accuracy if the number of petechiae cases is considered. This could indicate that as an initial tool foe diagnostics, presence of it could be considered for dengue infection. Strong correlation with tourniquet test, and laboratory parameters like WBC, platelets, hematocrit, NS1, IgG and IgM were found which are indicative that these variables have strong association to possible infection of dengue. Any abnormalities found within these laboratory parameters must be considered for dengue evaluation.</p>