Clinical spectrum and risk factors of severe dengue infection: findings from the 2023 dengue outbreak in Bangladesh

Abstract Background 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 co...

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Main Authors: Orindom Shing Pulock, Adnan Mannan, Abul Faisal Md. Nuruddin Chowdhury, Golam Tousif, Koushik Majumder, Sabrina Monsur, H. M. Hamidullah Mehedi, Emrul Kaiser, Afreen Sultana, Md Abdul Hamid Sagar, Silvia Naznin Etu, Nazmul Alam, A. H. M. Tharakul Mazid, M. A. Sattar
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-10792-y
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author Orindom Shing Pulock
Adnan Mannan
Abul Faisal Md. Nuruddin Chowdhury
Golam Tousif
Koushik Majumder
Sabrina Monsur
H. M. Hamidullah Mehedi
Emrul Kaiser
Afreen Sultana
Md Abdul Hamid Sagar
Silvia Naznin Etu
Nazmul Alam
A. H. M. Tharakul Mazid
M. A. Sattar
author_facet Orindom Shing Pulock
Adnan Mannan
Abul Faisal Md. Nuruddin Chowdhury
Golam Tousif
Koushik Majumder
Sabrina Monsur
H. M. Hamidullah Mehedi
Emrul Kaiser
Afreen Sultana
Md Abdul Hamid Sagar
Silvia Naznin Etu
Nazmul Alam
A. H. M. Tharakul Mazid
M. A. Sattar
author_sort Orindom Shing Pulock
collection DOAJ
description Abstract Background 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. Methods 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. Results 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. Conclusion 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.
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spelling doaj-art-81612244e69b40aaa2dddb38fdde04f92025-08-20T03:06:54ZengBMCBMC Infectious Diseases1471-23342025-04-0125111210.1186/s12879-025-10792-yClinical spectrum and risk factors of severe dengue infection: findings from the 2023 dengue outbreak in BangladeshOrindom Shing Pulock0Adnan Mannan1Abul Faisal Md. Nuruddin Chowdhury2Golam Tousif3Koushik Majumder4Sabrina Monsur5H. M. Hamidullah Mehedi6Emrul Kaiser7Afreen Sultana8Md Abdul Hamid Sagar9Silvia Naznin Etu10Nazmul Alam11A. H. M. Tharakul Mazid12M. A. Sattar13Disease Biology and Molecular Epidemiology Research GroupDisease Biology and Molecular Epidemiology Research GroupDepartment of Medicine, Chittagong Medical CollegeDepartment of Medicine, Shaheed Syed Nazrul Islam Medical CollegeDisease Biology and Molecular Epidemiology Research GroupDepartment of Medicine, Dhaka Medical CollegeDepartment of Medicine, 250 Bedded General HospitalDepartment of Medicine, Fatikchari Health ComplexDepartment of Microbiology, Chittagong Medical CollegeDepartment of Medicine, Chittagong Medical CollegeDisease Biology and Molecular Epidemiology Research GroupDepartment of Public Health, Asian University for WomenDepartment of Medicine, 250 Bedded General HospitalDepartment of Medicine, Chittagong Medical CollegeAbstract Background 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. Methods 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. Results 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. Conclusion 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.https://doi.org/10.1186/s12879-025-10792-yDengueOutbreakBangladeshDengue fever
spellingShingle Orindom Shing Pulock
Adnan Mannan
Abul Faisal Md. Nuruddin Chowdhury
Golam Tousif
Koushik Majumder
Sabrina Monsur
H. M. Hamidullah Mehedi
Emrul Kaiser
Afreen Sultana
Md Abdul Hamid Sagar
Silvia Naznin Etu
Nazmul Alam
A. H. M. Tharakul Mazid
M. A. Sattar
Clinical spectrum and risk factors of severe dengue infection: findings from the 2023 dengue outbreak in Bangladesh
BMC Infectious Diseases
Dengue
Outbreak
Bangladesh
Dengue fever
title Clinical spectrum and risk factors of severe dengue infection: findings from the 2023 dengue outbreak in Bangladesh
title_full Clinical spectrum and risk factors of severe dengue infection: findings from the 2023 dengue outbreak in Bangladesh
title_fullStr Clinical spectrum and risk factors of severe dengue infection: findings from the 2023 dengue outbreak in Bangladesh
title_full_unstemmed Clinical spectrum and risk factors of severe dengue infection: findings from the 2023 dengue outbreak in Bangladesh
title_short Clinical spectrum and risk factors of severe dengue infection: findings from the 2023 dengue outbreak in Bangladesh
title_sort clinical spectrum and risk factors of severe dengue infection findings from the 2023 dengue outbreak in bangladesh
topic Dengue
Outbreak
Bangladesh
Dengue fever
url https://doi.org/10.1186/s12879-025-10792-y
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