Feeding Pattern Followed by Hospitals for Patients with Dengue Fever: An Observational Study
Keywords:Dengue fever, Severity of disease, Food tolerance, Nutrient intake, Oral fluids, IV infusions, Adults and Children.
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.Conclusion: Presently, diet management of
DF patient is less judicious. In view of poor
tolerance and unconsciousness that prevail,
food selection should be carefully managed.
Easily digestible and nutritious drinks such
as fruits juices and soups should be included to complement for improving electrolyte
disturbance and dehydration. Data base should
be developed about feeding requirements for
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