Objective:

To prospectively characterize the clinical profile and identify predictors of adverse outcomes among children presenting with febrile illness suspected of dengue in Burao, Somaliland.

Approach:

• Statistical Analysis: Descriptive statistics summarized demographic and clinical characteristics; multinomial logistic regression identified factors associated with recovery, complications, and death, using a prespecified causal framework.

Key Findings:

• Of 186 participants, 83.9% recovered, 12.4% developed complications, and 3.7% died. Bleeding manifestations were associated with a higher likelihood of complications (RRR = 5.07, 95% CI: 1.42–18.05). Longer fever duration was linked to a higher likelihood of death (RRR = 1.34, 95% CI: 1.07–1.68). Higher maximum recorded temperature was associated with increased likelihood of complications (RRR = 1.65, 95% CI: 1.01–2.68). Abdominal pain was associated with a lower likelihood of complications (RRR = 0.28, 95% CI: 0.08–1.00). Age, sex, and residence did not predict outcomes.

Interpretation:

Pediatric dengue in Burao generally has favorable outcomes, but certain clinical indicators like bleeding and prolonged fever can predict adverse outcomes.

Limitations:

• The study is limited to a specific geographic area, which may affect the generalizability of the findings. The reliance on rapid diagnostic tests may also impact the accuracy of dengue confirmation.

Conclusion:

The study highlights the importance of recognizing bleeding signs and prolonged fever in pediatric dengue cases.