Pulock Orindom Shing, Mannan Adnan, Chowdhury Abul Faisal Md Nuruddin, Tousif Golam, Majumder Koushik, Monsur Sabrina, Mehedi H M Hamidullah, Kaiser Emrul, Sultana Afreen, Sagar Md Abdul Hamid, Etu Silvia Naznin, Alam Nazmul, Mazid A H M Tharakul, Sattar M A
Disease Biology and Molecular Epidemiology Research Group, Chattogram, Bangladesh.
Department of Genetic Engineering & Biotechnology, University of Chittagong, Chattogram, Bangladesh.
BMC Infect Dis. 2025 Apr 7;25(1):469. doi: 10.1186/s12879-025-10792-y.
Since the first detection of dengue in 2000, Bangladesh has been facing an increasing number of dengue patients and related deaths every year. This situation warrants the importance of quickly identifying severe dengue patients to expedite necessary medical interventions which could potentially reduce the adverse consequences. The aim of this study was to identify clinical features and laboratory parameters of the severe dengue patients in the 2023 dengue outbreak in Bangladesh.
This hospital based cross-sectional study included the demographic, clinical and laboratory data of 1313 Dengue patients from several secondary and tertiary hospitals across Bangladesh from August 2023 to December 2023. According to the 2009 WHO classification, dengue cases were classified into severe dengue and non-severe dengue (with and without warning signs). Chi-square test, Fischer's exact test and multiple logistic regression analyses were conducted to identify potential risk factors associated with severe dengue cases.
Of the 1313 patients included in this study, nearly 20% had severe dengue, 36.71% of them were from the 16-25 year age bracket and nearly two-thirds were male. Fever (99.54%) was the most common clinical symptom followed by anorexia (69.54%) and severe headache (66.03%); whereas most common warning signs were severe lethargy (43.64%), persistent vomiting (27.57%), and severe abdominal pain and tenderness (20.03%) across all patients. Gastrointestinal symptoms such as nausea, vomiting, and diarrhea are significantly more common in severe dengue cases compared to non-severe ones. Among the laboratory parameters, decrease of platelet level and increased ALT level was more prominent in severe patients. Multiple logistic regression analysis found that severe abdominal pain, severe lethargy, respiratory distress, altered mental status, decreased urine output, pleural effusion and ascites were positively associated with the development of severe dengue.
This study presents warning signs, clinical symptoms and trends of laboratory parameters associated with severe cases of dengue in Bangladesh that can be used in improving patient management in the future.
自2000年首次检测到登革热以来，孟加拉国每年面临的登革热患者及相关死亡人数不断增加。这种情况凸显了快速识别重症登革热患者以加快必要医疗干预的重要性，而这可能会减少不良后果。本研究的目的是确定2023年孟加拉国登革热疫情中重症登革热患者的临床特征和实验室参数。
这项基于医院的横断面研究纳入了2023年8月至2023年12月期间来自孟加拉国几家二级和三级医院的1313例登革热患者的人口统计学、临床和实验室数据。根据2009年世界卫生组织的分类，登革热病例分为重症登革热和非重症登革热（有和没有警示体征）。进行卡方检验、费舍尔精确检验和多元逻辑回归分析以确定与重症登革热病例相关的潜在危险因素。
在本研究纳入的1313例患者中，近20%患有重症登革热，其中36.71%来自16至25岁年龄组，近三分之二为男性。发热（99.54%）是最常见的临床症状，其次是食欲不振（69.54%）和严重头痛（66.03%）；而所有患者中最常见的警示体征是严重嗜睡（43.64%）、持续呕吐（27.57%）以及严重腹痛和压痛（20.03%）。与非重症登革热病例相比，恶心、呕吐和腹泻等胃肠道症状在重症登革热病例中明显更为常见。在实验室参数方面，血小板水平降低和谷丙转氨酶水平升高在重症患者中更为突出。多元逻辑回归分析发现，严重腹痛、严重嗜睡、呼吸窘迫、精神状态改变、尿量减少、胸腔积液和腹水与重症登革热的发生呈正相关。
本研究呈现了孟加拉国重症登革热病例相关的警示体征、临床症状和实验室参数趋势，可用于未来改善患者管理。
