Feeding pattern followed by Hospitals for patents with dengue fever: An Observational study.

Abstract

Background: Dengue is an acute viral infection and occurs in three different conditions- Dengue fever (DF), dengue hemorrhagic fever (DHF) and dengue shock syndrome. Supportive and symptomatic treatment is indicated during infection, however less is known about feeding care obligatory in its management. Objective: it was aimed to study feeding care offered to DF patients admitted to hospitals. Materials and Method: An observational study was conducted on 48 patients (16 children and 32 adults) diagnosed for dengue fever and admitted to hospital (3 -government and 2-private hospitals were included) during the months of January to May. Details regarding medical symptoms, body temperature, state of consciousness, food tolerance and food intake from day 1 to day 5 was obtained. Oral intake of water and IV infused were recorded. Results: Relationship existed between symptoms, state of consciousness and tolerance to food and water; accordingly patients were classified as seriously sick, moderately sick and mildly sick. Patients with body temperature ˃102°F, abdomen pain, hepatomegaly and dehydration was associated with food intolerance and non-responsiveness (seriously sick), they took significantly longer time to develop food tolerance compared to their counterpart with less serious conditions (p ˂ 0.0001). Severity of sickness affected hospital stay, severely sick patients stayed longer as compared to the mildly sick (children 4.67±0.94 vs 4±0; adults 6.43±3.16 vs 3.67± 1.11 days). Majority of adults (71.9%) and children (56.3%) received normal diet. Energy and protein intake of patients (adults and children) in all the three groups were markedly lower than the RDA. Energy intake increased significantly from 1st to 5th day in all three groups. Differences in energy intake (adults-5.0±2.6 Kcals to 18.0±6.5 and children 10.0±3.8 - 29.0±6.8 Kcal/kg/day) was extremely significant (p˂ 0.001) among severely sick compared to the moderately (adults 11.0±1.6- 17.0±4.9 and children 20.0±2.9- 23.0±6.9 Kcal/kg/day) and mildly sick patients (adults 17.0±2.1- 21.0±3.8 and children 38.0±7.8- 39.0±5.7 Kcal/kg/day). Protein intake among both adults and children was very low. All patients regardless of the conditions received IV fluids at time of hospital admission. Severely sick received higher volumes of IV infusions and less quantity of oral fluids compared to the moderate and mildly sick. With improvement in conditions, it crisscrossed with reduced IV infusions and increased oral intakes. Each patient had different fluid needs and varied each day.