Arterial Hypertension and Skin Allergy Are Risk Factors for Progression from Dengue to Dengue Hemorrhagic Fever: A Case Control Study

Abstract

BackgroundCurrently, knowledge does not allow early prediction of which cases of dengue fever (DF) will progress to dengue hemorrhagic fever (DHF), to allow early intervention to prevent progression or to limit severity. The objective of this study is to investigate the hypothesis that some specific comorbidities increase the likelihood of a DF case progressing to DHF.MethodsA concurrent case-control study, conducted during dengue epidemics, from 2009 to 2012. Cases were patients with dengue fever that progressed to DHF, and controls were patients of dengue fever who did not progress to DHF. Logistic regression was used to estimate the association between DHF and comorbidities.ResultsThere were 490 cases of DHF and 1,316 controls. Among adults, progression to DHF was associated with self-reported hypertension (OR = 1.6; 95% CI 1.1-2.1) and skin allergy (OR = 1.8; 95% CI 1.1-3.2) with DHF after adjusting for ethnicity and socio-economic variables. There was no statistically significant association between any chronic disease and progression to DHF in those younger than 15 years.ConclusionsPhysicians attending patients with dengue fever should keep those with hypertension or skin allergies in health units to monitor progression for early intervention. This would reduce mortality by dengue.

Relevance of Non-communicable Comorbidities for the Development of the Severe Forms of Dengue: A Systematic Literature Review

“…Sixteen articles, describing studies conducted from 2002 to 2012 met the eligibility criteria [ 12 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. All studies included in the analysis were observational studies: nine retrospective cohort studies [ 12 , 15 , 18 , 20 , 21 , 22 , 23 , 26 , 29 ] and seven case-control studies [ 16 , 17 , 19 , 24 , 25 , 27 , 28 ].…”

A clinical and epidemiological survey of the largest dengue outbreak in Southern Taiwan in 2015

“…Regarding the clinical comorbidities of DF or DHF patients, the study results indicated that old age, hypertension, and diabetes were significantly correlated with the development of DHF (Table 3). Hypertension and diabetes are two important comorbidities that have been reported to correlate with DHF previously (Htun et al, 2015;Teixeira et al, 2015). Hypertension prompts vascular damage and endothelial dysfunction, inducing inflammatory activation of the endothelium, and altering the regulation of vascular tone and flow.…”

NTD and NCD Co-morbidities: The Example of Dengue Fever

“…Hypertensive individuals often have elevated C-reactive protein levels in the blood, which increases capillary permeability and risk of coagulopathy [17]. In Kerala State, India, patients with underlying hypertension were found to be 44 times more likely to die from dengue [11].…”