Socio-demographic patterns of dengue infections: Evidence from a tertiary care setting

Fahad Qaisar; Wajahat Hussain; Muhammad Hassan; Muhammad Naveed Iqbal; Muhammad Ehsan Sukhera; Muhammad Arif Shaheen

doi:10.61529/idjp.v34i1.378

Authors

Fahad Qaisar Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur Pakistan
Wajahat Hussain Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur Pakistan
Muhammad Hassan Bahawal Victoria Hospital/ Quaid-e-Azam Medical College, Bahawalpur Pakistan
Muhammad Naveed Iqbal Bahawal Victoria Hospital/ Quaid-e-Azam Medical College, Bahawalpur Pakistan
Muhammad Ehsan Sukhera Bahawal Victoria Hospital/ Quaid-e-Azam Medical College, Bahawalpur Pakistan
Muhammad Arif Shaheen Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur Pakistan

DOI:

https://doi.org/10.61529/idjp.v34i1.378

Abstract

Background: Dengue fever is a major public health concern with increasing incidence due to urbanization, climate change, and inadequate vector control. Variations in disease severity are influenced by socio-demographic factors. Understanding these patterns in a tertiary care setting is crucial for developing targeted public health interventions. To determine the association between socio-demographic factors and disease severity in laboratory-confirmed dengue cases admitted to a tertiary care hospital.

Materials and Methods: A cross-sectional analytical study was conducted at Bahawal Victoria Hospital, Bahawalpur, from January to December 2024. A total of 187 laboratory-confirmed dengue cases diagnosed via NS1 antigen and IgM/IgG serology were included. Cases with coinfections or chronic immunosuppressive conditions were excluded. Data were collected using a structured questionnaire documenting demographic details (age, gender, SES, education, residence) and clinical information (disease severity, comorbidities, hospital stay, ICU admission, outcomes). Statistical analysis was performed using SPSS (version 26), with chi-square tests employed to assess associations (p < 0.05 considered significant).

Results: The majority of patients 54.5% (102) were in the 20–40 years age group, and males accounted for 63.1% (118) of cases. Low SES and lack of formal education were significantly associated with severe dengue (p = 0.004, p = 0.031, respectively). ICU admission was required in 15.0% (28) of cases, and the overall mortality rate was 5.3% (10).

Conclusion: Dengue disproportionately affected young adults and males, with severe cases more common in older patients, individuals from lower SES backgrounds, and those with limited education.

Keywords: Dengue fever, Disease severity, Sociodemographic factors, Public health tertiary care

References

Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, et al. The global distribution and burden of dengue. Nature. 2013; 496(7446): 504–7. DOI: https://doi.org/10.1038/nature12060

World Health Organization. Dengue and severe dengue. Geneva: WHO; 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue

Gubler DJ. Dengue, urbanization and globalization: The unholy trinity of the 21st century. Trop Med Health. 2011; 39(4 Suppl): 3-11. DOI: https://doi.org/10.2149/tmh.2011-S05

Shepard DS, Undurraga EA, Halasa YA, Stanaway JD. The global economic burden of dengue: A systematic analysis. Lancet Infect Dis. 2016;16(8): 935–41.

DOI: https://doi.org/10.1016/s1473-3099(16)00146-8

Hotez PJ, Murray KO. Dengue, West Nile virus, chikungunya, Zika, and neglected tropical diseases in the Americas: Implications for population migration and travel medicine. PLoS Negl Trop Dis. 2017; 11(1): e0005327. DOI: https://doi.org/10.1371/journal.pntd.0005462

Castro MC, Wilson ME, Bloom DE. Disease and economic burdens of dengue. Lancet Infect Dis. 2017; 17(3): e70–8. DOI: https://doi.org/10.1016/S1473-3099(16)30545-X

Mondini A, Chiaravalloti Neto F. Socioeconomic variables and dengue transmission. Rev Panam Salud Publica. 2007; 22(3):178–83. DOI: https://doi.org/10.1590/s0034-89102007000600006

Halstead SB. Dengue in the Americas and Southeast Asia: Do they differ? Rev Panam Salud Publica. 2006; 20(6): 407–15. DOI: https://doi.org/10.1590/s1020-49892006001100007

Wilder-Smith A, Ooi EE, Horstick O, Wills B. Dengue. Lancet. 2019; 393(10169): 350–63. DOI: https://doi.org/10.1016/s0140-6736(18)32560-1

Guzman MG, Halstead SB, Artsob H, Buchy P, Farrar J, Gubler DJ, et al. Dengue: A continuing global threat. Nat Rev Microbiol. 2010; 8(12 Suppl): S7–16. DOI: https://doi.org/10.1038/nrmicro2460

Yacoub S, Wills B. Predicting outcome from dengue. BMC Med. 2014; 12(1): 147. DOI: https://doi.org/10.1186/s12916-014-0147-9

Tissera H, Ooi EE, Gubler DJ, Horstick O, Wilder-Smith A. Surveillance and outbreak response for dengue. Lancet Infect Dis. 2021; 21(4): e161–8. DOI: https://doi.org/10.1155/2013/756832

Bhatt S, Messina JP, Farlow AW, Moyes CL, Drake JM, Brownstein JS, et al. Impact of climate, urbanization, and globalization on future dengue risk. Nat Microbiol. 2019; 4(9): 1725–31. DOI: https://doi.org/10.2149/tmh.2011-S05

Barreto ML, Teixeira MG, Bastos FI, Ximenes RAA, Barata RB, Rodrigues LC. Successes and failures in the control of infectious diseases in Brazil: Social and environmental context, policies, interventions, and research needs. Lancet. 2011; 377(9780): 1877–89. DOI: https://doi.org/10.1016/s0140-6736(11)60202-x

Rodríguez-Barraquer I, Solomon SS, Kuganantham P, Babu GR, Cohen T, Iqbal SH, et al. The hidden burden of dengue and chikungunya in Chennai, India. PLoS Negl Trop Dis. 2015; 9(3): e0003906. DOI: https://doi.org/10.1371/journal.pntd.0003906

Gupta N, Srivastava S, Jain A, Chaturvedi UC. Dengue in India. Indian J Med Res. 2021; 153(5): 533-6. Available from:https://pmc.ncbi.nlm.nih.gov/articles/PMC3510884/pdf/IJMR-136-373.pdf

Garg A, Garg J, Rao YK, Upadhyay GC, Sakhuja S. Prevalence of dengue among clinically suspected febrile episodes at a teaching hospital in North India. J Infect Dis Immun. 2011; 3(5): 85-9. DOI: https://doi.org/10.5897/JIDI.9000033

Chakravarti A, Kumaria R. Eco-epidemiological analysis of dengue infection during an outbreak of dengue fever, India. Virol J. 2021;18(1):1-9. DOI: https://doi.org/10.1186/1743-422x-2-32

Bowman LR, Donegan S, McCall PJ. Is dengue vector control deficient in effectiveness or evidence? Systematic review and meta-analysis. PLoS Negl Trop Dis. 2016; 10(3): 216-19.

DOI: https://doi.org/10.1371/journal.pntd.0004551

Tantawichien T. Dengue fever and dengue hemorrhagic fever in adolescents and adults. Paediatr Int Child Health. 2012; 32(S1): 22-7. DOI: https://doi.org/10.1179/2046904712z.00000000049

Nguyen NM, Thi Hue Kien D, Tuan TV, Quyen NTH, Tran CNB, Vo Thi L, et al. Host and viral features of human dengue cases shape the population of infected and infectious Aedes aegypti mosquitoes. Proc Natl Acad Sci USA. 2020; 117(16): 9423-30. DOI: https://doi.org/10.1073/pnas.1303395110

Lee IK, Liu JW, Yang KD. Fatal dengue hemorrhagic fever in adults: emphasizing the evolutionary pre-fatal clinical and laboratory manifestations. PLoS Negl Trop Dis. 2012; 6(2): e1532.

DOI: https://doi.org/10.1371/journal.pntd.0001532

Sam SS, Omar SF, Teoh BT, Abd-Jamil J, AbuBakar S. Review of dengue hemorrhagic fever fatal cases seen among adults. PLoS Negl Trop Dis. 2013; 13(1): 105. DOI: https://doi.org/10.1371/journal.pntd.0002194

Halstead SB. Dengue virus-mosquito interactions. Annu Rev Entomol. 2008; 53: 273-91.

DOI:https://doi.org/10.1146/annurev.ento.53.103106.093326

Morin CW, Comrie AC, Ernst K. Climate and dengue transmission: Evidence and implications. Environ Health Perspect. 2013; 121(11-12): 1264-72.

DOI: https://doi.org/10.1289/ehp.1306556