An outbreak of dengue fever in children in the National Capital District of Papua New Guinea in 2016

ABSTRACT

Background

The first documented outbreak of dengue which included cases with haemorrhage occurred in Papua New Guinea in 2016.

Aim

To document the presentation and outcome of children with dengue in Port Moresby.

Methods

This prospective cross-sectional descriptive study was conducted in Port Moresby General Hospital during a 6-month period from 6 January to 6 July 2016. Altogether, 165 children aged 1–14 years who met the WHO criteria for probable dengue were assessed and treated. Clinical features, presence of warning signs and signs of severe dengue, date of onset, management and outcome were recorded. Blood specimens were collected for serological testing and full blood count.

Results

The median age was 6 years (interquartile range 3–8). Eighty-eight (53%) children had no warning signs and were managed as outpatients. Of the 165 patients, 42 (25%) had abdominal pain, 28 (17%) had bleeding and 3 (2%) had clinical evidence of fluid accumulation. The median (IQR) lowest platelet count in those tested was 34 × 10⁹/L (22–54). Two children were transfused with packed red blood cells and one received a platelet transfusion. No child developed dengue shock and none died. Non-structural protein 1 (NS1) and dengue IgM were positive in 122/144 (85%) and 36/111 (32%) of blood samples, respectively. 150/151 blood samples tested for dengue were positive on one or more tests.

Conclusion

There is the potential for future outbreaks of increased severity in Papua New Guinea. Surveillance, mosquito reduction initiatives and health education programmes are needed to reduce the impact of future outbreaks.

KEYWORDS:

• Dengue fever
• children
• Port Moresby General Hospital
• Papua New Guinea

Disclosure statement

The authors report no conflicts of interest.

Additional information

Notes on contributors

John Vince

Francis Pulsan is a lecturer in Child Health at the School of Medicine and Health Sciences, University of Papua New Guinea; Kone Sobi is a paediatrician, formerly Paediatric Coordinator and currently Director of Medical Services for Port Moresby General Hospital; Gwenda Anga is the Paediatric Coordinator for Port Moresby General Hospital; John Vince, former Professor of Child Health, is currently Deputy Dean (Academic and Research), School of Medicine and Health Sciences, University of Papua New Guinea; Trevor Duke is the Director of the Centre for International Child Health at the University of Melbourne, Clinical Director of General Intensive Care Unit at the Royal Children’s Hospital Melbourne, and Adjunct Professor of Child Health, School of Medicine and Health Sciences, University of Papua New Guinea.