Kandel Shashi, Dahal Gokarna, Das Chuman Lal, Thapa Susmita, Karna Ajit Kumar, Parajuli Ashna, Aryal Riju, Naing Khin PaPa, Lama Nancy, Pandey Bandana, Ghimire Prabesh, Marasini Rudra Prasad
Department of Health Services, Epidemiology and Disease Control Division, Ministry of Health and Population, Kathmandu, Nepal.
Ministry of Health and Population, Kathmandu, Nepal.
PLOS Glob Public Health. 2025 Jun 2;5(6):e0004694. doi: 10.1371/journal.pgph.0004694. eCollection 2025.
Dengue is a mosquito-borne acute febrile illness, also known as break bone fever, and is a major public health problem in the tropics and subtropics worldwide. Understanding the factors that contribute to dengue-related mortalities is crucial for decision-making and implementing effective strategies for prompt patient care. This retrospective analysis aimed to understand the clinical characteristics as well as associated infections and co-morbidities related to dengue fatalities in Nepal. Additionally, this insight aids in developing targeted public health interventions to save lives, enhancing disease surveillance systems, and fostering community awareness about dengue prevention. We conducted a retrospective study of the dengue-related deaths in Nepal reported to the Epidemiology and Disease Control Division between 01 January and 30 November 2022 through early warning and reporting system. Medical records of 88 patients who died from dengue were collected and reviewed from 23 hospitals of Nepal. Among 88 deaths that were reviewed, 47 (53.4%) were males and 41 (46.6%) were females. Of all the death cases reviewed, 26% experienced septic shock, 23% had multiple organ dysfunction syndromes, 20% had a cardiopulmonary arrest, 15% had acute respiratory distress syndrome, and 5% had severe gastro-intestinal bleeding, before the death. Fatality from severe dengue were in 46 cases (52%), from dengue associated with other diseases were in 23 cases (26%), and from dengue associated with co-morbidity complications were in 19 cases 22%. Dengue-related mortality in Nepal disproportionately affected older adults with underlying health conditions and co-infections. Late presentation and rapid clinical deterioration were common. Strengthening early diagnosis, timely referral, and clinical management, particularly for high-risk groups is essential. Public awareness of dengue warning signs and prompt healthcare-seeking behavior should be a key component of dengue control strategies.
登革热是一种由蚊子传播的急性发热性疾病，也被称为“断骨热”，是全球热带和亚热带地区的一个主要公共卫生问题。了解导致登革热相关死亡的因素对于决策和实施有效的及时患者护理策略至关重要。这项回顾性分析旨在了解尼泊尔登革热死亡病例的临床特征以及相关感染和合并症。此外，这一见解有助于制定有针对性的公共卫生干预措施以挽救生命、加强疾病监测系统并提高社区对登革热预防的认识。我们通过预警和报告系统对2022年1月1日至11月30日期间向尼泊尔流行病学与疾病控制司报告的尼泊尔登革热相关死亡病例进行了回顾性研究。从尼泊尔的23家医院收集并审查了88例死于登革热患者的病历。在审查的88例死亡病例中，47例（53.4%）为男性，41例（46.6%）为女性。在所有审查的死亡病例中，26%经历了感染性休克，23%患有多器官功能障碍综合征，20%发生了心肺骤停，15%患有急性呼吸窘迫综合征，5%在死亡前出现了严重的胃肠道出血。严重登革热导致的死亡有46例（52%），登革热合并其他疾病导致的死亡有23例（26%），登革热合并合并症并发症导致的死亡有19例（22%）。尼泊尔登革热相关死亡率对有潜在健康状况和合并感染的老年人影响尤为严重。就诊延迟和临床快速恶化很常见。加强早期诊断、及时转诊和临床管理，特别是对高危人群而言至关重要。公众对登革热警示信号的认识以及及时就医行为应成为登革热控制策略的关键组成部分。
