Clinical spectrum of dengue fever in patients admitted to a tertiary care hospital in Bangladesh

Authors

  • A. F. M. Helal Uddin Department of Medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh
  • M. Lutfur Rahman Department of Medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh
  • M. Abdul Alim Department of Medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh
  • M. Mahbub H. Khan Department of Medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh
  • Shams-El-Arefin Department of Medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh
  • Kamrun Nahar Department of Medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh
  • Mohammad M. Hossain Department of Medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3933.ijam20230320

Keywords:

Dengue, Fever, Spectrum

Abstract

Background: Dengue fever is a viral infection transmitted by mosquitoes and is a significant public health problem in many tropical and subtropical countries, including Bangladesh. The clinical spectrum of dengue fever can vary widely, ranging from asymptomatic infection to severe and potentially life-threatening illness. In this study, we aimed to describe the clinical spectrum of dengue fever in patients admitted to a tertiary care hospital in Bangladesh. The aim of the study was to observe the clinical spectrum of dengue fever patients.

Methods: This prospective observational study was conducted at the department of medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh. The study duration was 7 months, from June 2022 to December 2022. During this period, a total of 65 cases of dengue fever cases admitted to the hospital for treatment were included in the study, who had a hospital stay of at least 3 days.

Results: The mean age of the participants was 30.78 years, and the male: female ratio was 1:1.95. 86.15% of the participants had no comorbidities, while diabetes and hypertension were observed in 6.15% of patients each. Patients' mean temperature had been high at the first check-up and dropped slowly to normal levels throughout the following check-ups, but the mean platelet count had significantly dropped from the first check-up throughout the following check-ups, improving only at the 6th check-up. ≤20,000 platelet count was observed in 6.15% at the first check-up, 9.23% at the 2nd check-up, 15.38% at the 3rd, 5.41% at the 4th, 15% at the 5th, and 0% at the 6th check-up. The most common warning signs were a positive tourniquet test (21.54%), vomiting (16.92%), and abdominal pain (15.38%). Hospital stay duration was <1 week for 95.38% of participants, and during discharge, only 3 patients had minor complications, with 3.08% mortality.

Conclusions: The study observed a higher prevalence of dengue among younger age groups, and females had a higher prevalence in the study. The regular-interval check-ups revealed that dengue severity progressed slowly, and did not become worse immediately after the infection, rather continued to progress adversely slowly throughout the check-ups. Hospital stay was <1 week for the majority of the participants, and minor mortality was observed in the study.

References

Banu S, Hu W, Hurst C, Guo Y, Islam MZ, Tong S. Space‐time clusters of dengue fever in Bangladesh. Trop Med Int Health. 2012;17(9):1086-91.

Rafi A, Mousumi AN, Ahmed R, Chowdhury RH, Wadood A, Hossain G. Dengue epidemic in a non-endemic zone of Bangladesh: Clinical and laboratory profiles of patients. PLoS Negl Trop Dis. 2020;14(10):e0008567.

Rahman MS, Karamehic-Muratovic A, Baghbanzadeh M, Amrin M, Zafar S, Rahman NN, et al. Climate change and dengue fever knowledge, attitudes and practices in Bangladesh: A social media–based cross-sectional survey. Trans Royal Soc Trop Med Hygiene. 2021;115(1):85-93.

Centers for Disease Control and Prevention. Clinical Presentation. 2022. Available at: https://www. cdc.gov/dengue/healthcare-providers/clinical-presentation.html. Accessed on 22 December 2022.

Mayo Clinic. Dengue fever. Available at: https://www.mayoclinic.org/diseases-conditions/ dengue-fever/symptoms-causes/syc-20353078. Accessed on 22 December 2022.

Heilman JM, De Wolff J, Beards GM, Basden BJ. Dengue fever: a Wikipedia clinical review. Open Med. 2014;8(4):e105.

Garcia-Rejon J, Loroño-Pino MA, Farfan-Ale JA, Flores-Flores L, Rosado-Paredes ED, Rivero-Cardenas N, et al. Dengue virus–infected Aedes aegypti in the home environment. Am J Trop Med Hygiene. 2008;79(6):940-50.

Guarner J, Hale GL. Four human diseases with significant public health impact caused by mosquito-borne flaviviruses: West Nile, Zika, dengue and yellow fever. Semin Diagnost Pathol. 2019;36(3):170-6.

García-Rejón JE, Loroño-Pino MA, Farfán-Ale JA, Flores-Flores LF, López-Uribe MP, del Rosario Najera-Vazquez M, et al. Mosquito infestation and dengue virus infection in Aedes aegypti females in schools in Merida, Mexico. Am J Trop Med Hygiene. 2011;84(3):489.

Centers for Disease Control and Prevention. Symptoms and Treatment. 2022. Available at: https://www.cdc.gov/dengue/symptoms/index.html. Accessed on 22 December 2022.

World Health Organization. Dengue and severe dengue. Available at: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue. Accessed on 22 December 2022.

Biswas HH, Gordon A, Nunez A, Perez MA, Balmaseda A, Harris E. Lower low-density lipoprotein cholesterol levels are associated with severe dengue outcome. PLoS Neglect Trop Dis. 2015;9(9):e0003904.

The Daily Star. Why is dengue becoming such a serious public health threat? 2022. Available at: https://www.thedailystar.net/opinion/views/news/why-dengue-becoming-such-serious-public-health-threat-3162941. Accessed on 22 December 2022.

World Health Organization. Dengue – Bangladesh. Available at: https://www.who.int/emergencies/ disease-outbreak-news/item/2022-DON424. Accessed on 22 December 2022.

Hasan MM, Sahito AM, Muzzamil M, Mohanan P, Islam Z, Billah M, et al. Devastating dengue outbreak amidst COVID-19 pandemic in Bangladesh: an alarming situation. Trop Med Health. 2022;50(1):1-5.

Rahman MM, Bodrud-Doza M, Shammi M, Islam AR, Khan AS. COVID-19 pandemic, dengue epidemic, and climate change vulnerability in Bangladesh: Scenario assessment for strategic management and policy implications. Env Res. 2021;192:110303.

Rahman M, Islam AR, Khan SJ, Tanni KN, Roy T, Islam M, et al. Dengue Fever Responses in Dhaka City, Bangladesh: A Cross-Sectional Survey. Int J Public Health. 2022;190.

Kalappanvar NK, VinodKumar CS, Basavarajappa KG, Gouli C, Sanjay D, Chandana R. Clinical spectrum of dengue fever and dengue like infection in children, Central Karnataka, India. J Pure Appl Microbiol. 2012;6(3):1321-6.

Bhattnagar R, Nanda J, Singh A. Clinical Spectrum and Laboratory Profile of Patients with Dengue Fever in a Tertiary Care Centre of Eastern UP, India-An Observational Study. J Adv Med. 2017;6(1):1-7.

Humayoun MA, Waseem T, Jawa AA, Hashmi MS, Akram J. Multiple dengue serotypes and high frequency of dengue hemorrhagic fever at two tertiary care hospitals in Lahore during the 2008 dengue virus outbreak in Punjab, Pakistan. Int J Infect Dis. 2010;14:e54-9.

Shah I, Deshpande GC, Tardeja P. Outbreak of dengue in Mumbai and predictive markers for dengue shock syndrome. J Trop Pediatr. 2004;50(5):301-5.

Prasith N, Keosavanh O, Phengxay M, Stone S, Lewis HC, Tsuyuoka R, et al. Assessment of gender distribution in dengue surveillance data, the Lao People's Democratic Republic. Western Pacific Surveillance and Response J. 2013;4(2):17.

Anders KL, Nguyet NM, Chau NV, Hung NT, Thuy TT, Farrar J, et al. Epidemiological factors associated with dengue shock syndrome and mortality in hospitalized dengue patients in Ho Chi Minh City, Vietnam. Am J Trop Med Hygiene. 2011;84(1):127.

Biswas T, Islam AS, Rawal LB, Islam SM. Increasing prevalence of diabetes in Bangladesh: a scoping review. Public Health. 2016;138:4-11.

Khan M, Saeed A, Al Mosabbir A, Raheem E, Ahmed A, Rouf RR, et al. Clinical spectrum and predictors of severity of dengue among children in 2019 outbreak: a multicenter hospital-based study in Bangladesh. BMC Pediatr. 2021;21(1):1-0.

Morra ME, Altibi AM, Iqtadar S, Minh LH, Elawady SS, Hallab A, et al. Definitions for warning signs and signs of severe dengue according to the WHO 2009 classification: Systematic review of literature. Rev Med Virol. 2018;28(4):e1979.

Verhagen LM, de Groot R. Dengue in children. J Infect. 2014;69:S77-86.

Rigau-Pérez JG, Laufer MK. Dengue-related deaths in Puerto Rico, 1992–1996: diagnosis and clinical alarm signals. Clin Infect Dis. 2006;42(9):1241-6.

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Published

2023-02-09

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Original Research Articles