Clinical Management and Outcomes of Dengue Fever and Enteric Fever.

BACKGROUND

Dengue fever and enteric fever, two prevalent infectious diseases in tropical and subtropical regions, pose significant public health challenges due to their overlapping clinical manifestations and distinct therapeutic approaches. This study aims to evaluate hospitalization and management protocols for both illnesses, assessing their adherence to clinical guidelines and examining patient outcomes across diverse healthcare settings.

METHODOLOGY

A retrospective cross-sectional study was conducted by reviewing hospital records over a five-year period (April 2019-April 2024). A total of 218 individuals diagnosed with enteric fever (n=98) and dengue fever (n=120) were included in the study. Data were retrospectively collected using standardized forms from hospital records, laboratory reports, and discharge summaries to capture demographics, clinical presentations, lab findings, treatments, complications, and outcomes for patients with dengue or enteric fever. Statistical analysis was conducted using SPSS, Version 26 (IBM Corp., Armonk, NY), applying descriptive statistics, chi-square test, t-test, logistic regression, and Cox modeling to evaluate associations between treatment protocols and patient outcomes, with significance set at p<0.05.

RESULTS

Dengue and enteric fever showed distinct clinical patterns: rash and headache were more common in dengue fever, while abdominal pain and diarrhea predominated in enteric fever. Although demographic differences in age, sex, and residence were observed, they were not statistically significant. Improved outcomes in dengue fever were significantly associated with fluid replacement (n=110, 91.67%, p=0.02), reflecting the collective effect of standard supportive care measures. In contrast, antibiotic therapy (n=98, 100.00%, p=0.01) was central to favorable outcomes in enteric fever. Dengue fever was primarily diagnosed through serological testing (n=115, 95.83%), while enteric fever relied on blood cultures (n=78, 79.59%) (χ²=126.98, p<0.0001, OR=0.02). Hospitalization durations were significantly longer in enteric fever, patients staying ≥5 days compared to dengue fever patients (χ²=8.76, p=0.0031, OR=0.39). Recovery without complications was slightly more frequent in dengue fever (n=112, 93.33%) than in enteric fever (n=88, 89.80%), though this difference was not statistically significant (χ²=0.49, p=0.483, OR=0.60). These findings apply to general dengue fever cases only; patients with dengue hemorrhagic fever were managed separately due to differing clinical protocols.

CONCLUSION

This study highlights the necessity of tailored treatment protocols for enteric and dengue fever, emphasizing the importance of strict adherence to established clinical guidelines to optimize patient outcomes, particularly in resource-limited healthcare settings. While appropriate management, such as antibiotic therapy for enteric fever and supportive care for dengue, is well defined, differentiating between these conditions based solely on clinical presentation remains a significant challenge due to overlapping symptoms with other febrile illnesses. This diagnostic ambiguity underscores the urgent need for more robust, accessible, and rapid diagnostic tools. Furthermore, ongoing education and capacity building for healthcare professionals are essential to enhance clinical judgment, ensure early recognition, and improve compliance with evolving evidence-based practices in the management of febrile illnesses.