Dengue epidemic in a non-endemic zone of Bangladesh: clinical and laboratory profiles of patients

Abstract

Backgrounds: Approximately, half of the population in the world including tropical and sub-tropical climates region is at risk of dengue. Being an endemic country, Bangladesh has experienced the largest dengue epidemic in 2019. The present study aimed at evaluating the clinical and laboratory profile of dengue patients in northern Bangladesh during the epidemic. Methods: This cross-sectional study included 319 serologically confirmed dengue patients admitted in Shaheed Ziaur Rahman Medical College Hospital in Bogra district. It is one of the main tertiary care hospitals in northern Bangladesh. Data were collected from July to September 2019. Patients clinical and laboratory data were extracted from clinical records. Patients were classified into two classes according to the WHO 2009 dengue classification such as (i) non-severe dengue and (ii) severe dengue. Chi-square test and independent t-test were used in this study. Results: Of the 319 patients, 94.1% had non-severe dengue and the remaining 5.9% had severe dengue (severe plasma leakage 68.4%, severe organ involvement 68.4%, and severe clinical bleeding 10.5%). Most of the patients were suffering from primary dengue infection. The most common clinical presentation was fever followed by headache and myalgia. Vomiting and abdominal pain were the most prevalent warning signs. The common hematological findings on admission were leukopenia (63.3%), thrombocytopenia (30.4%) and increased hematocrit (26.6%). Raised serum ALT or AST was observed in 14.1% cases whereas raised serum creatinine was observed in 6.6% cases. Signs of plasma leakage (pleural effusion, respiratory distress, and ascites, rise of hematocrit >20% during hospital stay) and hepatic or renal involvement (serum ALT >42UI/L or serum creatinine >1.2 mg/dL) on admission were mostly associated with severe dengue. Conclusion: The study provides clinical evidence on presentation as well as hematological and biochemical profile of dengue patients in northern Bangladesh that should be implicated in effective patient management.

Clinical predictors of severe dengue: a systematic review and meta-analysis

“…Only one study defined abdominal pain as severe enough to warrant medical attention [17]. Persistent vomiting was defined in four ways: vomiting with signs of dehydration [18][19][20], ≥ 2 episodes of vomiting associated with fatigue or requiring intravenous fluid [17], at least six episodes of vomiting in 24 h [21] or vomiting during ≥ 2 consecutive days [22]. Similarly, liver enlargement was defined as > 2 cm in the midclavicular line in three studies [23][24][25].…”

Caracterización epidemiológica y clínica de pacientes adultos con dengue en la costa Atlántica de Honduras

“…coincide con la distribución nacional donde el sexo femenino representaba 52.6% y 47.4% al masculino. 11 En relación con la distribución según raza, las predominantes fueron mestiza con 84.0% (243) y el 6.8% (19) raza negra, a diferencia del estudio de da Silva y colaboradores en Brasil en el 2017, donde tanto el 91.9% de los pacientes hospitalizados como el 87.2% de los no hospitalizados fueron de raza blanca. 12 La procedencia más frecuente de los pacientes en este estudio fue el municipio de Tela con 65.2% (180) seguido por Arizona con 14.9% (41) y en tercer lugar La Másica con 12% (32), áreas urbanas.…”

“…Estos resultados difieren del estudio en Bangladesh en el 2020, donde el signo más común era vómito en 34.2% seguido por dolor abdominal en un 29.8%. 19 En cuanto los datos laboratoriales se encontró que apareció leucopenia en 92.0% a partir del segundo día. En el sexto y séptimo día se encontraron valores normales de leucocitos y luego se presentó leucopenia de nuevo el octavo y décimo día.…”

“…El 92% (254) presentó leucopenia desde el segundo día y trombocitopenia 92.8% (267) desde el primer día de enfermedad. Solamente 6.9% (19) contó con resultados de pruebas de laboratorio y de éstas fueron positivas 0.7% (2) RT-PCR, serología IgM 1.8% (5) e IgG 1.4% (4). Discusión: La presentación clínicaepidemiológica más común fue en mujeres jóvenes sin antecedentes personales patológicos, clasificada como dengue con signos de alarma.…”

AuNP Coupled Rapid Flow-Through Dot-Blot Immuno-Assay for Enhanced Detection of SARS-CoV-2 Specific Nucleocapsid and Receptor Binding Domain IgG

“…69 Moreover, the assay was designed to take into account the dengue-endemic situation of Bangladesh. 70 Since both diseases have common characteristics in the early phase and there has been a report of antigenic cross-reactivity between SARS-CoV-2 and dengue virus (DENV), there is a chance of misdiagnosis. 71 To avoid the risk, 24 prepandemic dengue-positive sera were incorporated into the evaluation panel.…”