Hernández-Galdamez Diego Rolando, González-Block Miguel Ángel, Romo-Dueñas Daniela Karola, Osorio-López Erick Antonio, Cerón-Meza Rosalba, Méndez-Hernández Pablo
Escuela de Salud Pública de México, Cuernavaca, Morelos, México.
Universidad Anáhuac, Ciudad de México, México.
PLoS Negl Trop Dis. 2025 Jul 28;19(7):e0012933. doi: 10.1371/journal.pntd.0012933. eCollection 2025 Jul.
In Mexico, some of the most prevalent noncommunicable diseases (NCDs) among adults are diabetes, hypertension, and chronic kidney disease (CKD). Mexico is currently facing a syndemic characterized by the convergence of dengue and NCDs. This study aims to describe and analyze the association between the prevalence of NCDs and hospitalization, the presence of hemorrhagic disorders, and death in all officially confirmed cases of dengue in Mexico during 2024.
METHODOLOGY/PRINCIPAL FINDINGS: This cross-sectional study was carried out through a secondary analysis of the confirmed cases of dengue reported in 2024. We assessed the associations between NCDs and the probability of hospitalization, bleeding disorders, and death, using one logistic regression model for each clinical outcome. We adjusted the three models for age, sex, social security affiliation, ethnicity and for each of the NCDs (diabetes, hypertension, chronic kidney disease, immunosuppression, cirrhosis, and peptic ulcer disease). The most common noncommunicable diseases were diabetes, hypertension, CKD, and immunosuppression. For hospitalization, CKD had the strongest association (OR 5.74), followed by immunosuppression (OR 2.84), peptic ulcer disease (OR 2.33), and diabetes (OR 2.10). We found significant associations between bleeding disorders and several NCDs (diabetes, peptic ulcer disease, immunosuppression, cirrhosis, and hypertension) compared to people without these conditions. People with CKD, peptic ulcer disease and diabetes, had more odds for death compared to those without these comorbidities.
CONCLUSIONS/SIGNIFICANCE: We found a significant association between several comorbidities and worse clinical outcomes in patients with dengue, such as hospitalization, bleeding disorders, or death. The syndemic of NCDs and dengue in Mexico has been rapidly increasing, and this problem needs to be addressed. This work confirms and extends the findings of previous studies and suggests that patients with these comorbidities have worse clinical outcomes.
在墨西哥,成年人中一些最常见的非传染性疾病包括糖尿病、高血压和慢性肾脏病(CKD)。墨西哥目前正面临一种以登革热和非传染性疾病并存为特征的综合征。本研究旨在描述和分析2024年墨西哥所有官方确诊的登革热病例中,非传染性疾病的患病率与住院、出血性疾病的存在以及死亡之间的关联。
方法/主要发现:本横断面研究通过对2024年报告的登革热确诊病例进行二次分析开展。我们针对每种临床结局使用一个逻辑回归模型,评估了非传染性疾病与住院概率、出血性疾病和死亡之间的关联。我们对这三个模型进行了年龄、性别、社会保障归属、种族以及每种非传染性疾病(糖尿病、高血压、慢性肾脏病、免疫抑制、肝硬化和消化性溃疡疾病)的调整。最常见的非传染性疾病是糖尿病、高血压、慢性肾脏病和免疫抑制。对于住院情况,慢性肾脏病的关联最强(比值比5.74),其次是免疫抑制(比值比2.84)、消化性溃疡疾病(比值比2.33)和糖尿病(比值比2.10)。与没有这些疾病的人相比,我们发现出血性疾病与几种非传染性疾病(糖尿病、消化性溃疡疾病、免疫抑制、肝硬化和高血压)之间存在显著关联。与没有这些合并症的人相比,患有慢性肾脏病、消化性溃疡疾病和糖尿病的人死亡几率更高。
结论/意义:我们发现登革热患者的几种合并症与更差的临床结局之间存在显著关联,如住院、出血性疾病或死亡。墨西哥非传染性疾病和登革热的综合征一直在迅速增加,这个问题需要得到解决。这项工作证实并扩展了先前研究的结果,并表明患有这些合并症的患者临床结局更差。