Feeding Pattern Followed by Hospitals for Patients 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 isindicated 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 ofconsciousness, food tolerance and food intake from day 1 to day 5 was obtained. Oral intake of water andIV 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 bodytemperature ?102°F, abdomen pain, hepatomegaly and dehydration was associated with food intolerance andnon-responsiveness (seriously sick), they took significantly longer time to develop food tolerance comparedto 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; adults6.43±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 increasedsignificantly from 1st to 5th day in all three groups. Differences in energy intake (adults-5.0±2.6 Kcals to18.0±6.5 and children 10.0±3.8 - 29.0±6.8 Kcal/kg/day) was extremely significant (p? 0.001) among severelysick 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). Proteinintake among both adults and children was very low. All patients regardless of the conditions received IVfluids at time of hospital admission. Severely sick received higher volumes of IV infusions and less quantityof oral fluids compared to the moderate and mildly sick. With improvement in conditions, it crisscrossedwith reduced IV infusions and increased oral intakes. Each patient had different fluid needs and varied eachday.Conclusion: Presently, diet management ofDF patient is less judicious. In view of poortolerance and unconsciousness that prevail,food selection should be carefully managed.Easily digestible and nutritious drinks suchas fruits juices and soups should be included to complement for improving electrolytedisturbance and dehydration. Data base shouldbe developed about feeding requirements forDF patients.