Dengue fever: The silent threat, risks and realities

Title : Dengue fever: The silent threat, risks and realities

Abstract:

Dengue fever is endemic in more than 100 countries, mainly in the tropical countries and is the most common communicable disease in Malaysia, with an incidence rate of 397.71 per 100,000 individuals. Globally, it is estimated that there are 100-400 million dengue infections annually, with 500,000 cases require hospitalisation each year [WHO, 2024]. The case fatality rate (CFR) of dengue varies significantly across countries, influenced by factors such as healthcare infrastructure and accessibility, timely diagnosis and case management, and vector control measures. Management of severe dengue remains a clinical challenge. A retrospective study will be highlighted which evaluated clinical features and laboratory biomarkers of patients associated with severe dengue at Hospital Sultanah Aminah Johor Bahru, Malaysia admitted from 1^st January 2022 to 31^st March 2023. Records of 99 patients, categorised into ICU (51) and non-ICU (48) groups, were identified and analysed using SPSS version 28.0. Sociodemographic details, clinical features and laboratory biomarkers were collected. Patients aged 50 and older, with obesity, and pre-existing comorbidities were significantly more likely to be admitted to ICU. The four commonest warning signs in both cohorts were lethargy/restlessness/confusion, abdominal pain, persistent vomiting and diarrhoea. Fever, or history of fever and thrombocytopenia were the two commonest severe dengue criteria present in both cohorts. ICU patients exhibited more signs of plasma leakage and abnormal laboratory findings, including normal white cell count, hypoalbuminemia, hyperbilirubinemia, and elevated creatine kinase. In contrast, leukopenia and normal albumin, bilirubin, and creatine kinase levels were more common in non-ICU patients. Hyponatremia and raised lactate dehydrogenase were seen in both groups. This study highlighted key differences and similarities in clinical features and laboratory biomarkers between ICU and non-ICU patients, emphasizing the need for further research to develop a comprehensive risk assessment tool for predicting severe dengue that resulted in ICU admission. Key principles of management on severe dengue will be emphasized.

Biography:

Dr Edmund L C Ong MBBS MSC FRCP FRCPI DTMH graduated from University of Newcastle Medical School, UK and trained in UK in Infectious Diseases, Tropical Medicine and General Internal Medicine. His research interests are in the field of opportunistic infections, evaluation of anti-infective agents, clinical epidemiology and innovations in healthcare quality improvement and clinical audit. He is a principal investigator and collaborates in numerous research projects including HIV, Tuberculosis, Dengue fever in Nigeria, South Africa and Myanmar. Dr Ong has contributed to numerous text books of infection and has co-authored more than 160 papers in peer reviewed journals. He is an examiner for both undergraduate and postgraduate examinations including MRCP, Dip in HIV Medicine and MMed qualifications. He is an International Global Advisor (Malaysia) for the Royal College of Physicians, London. He is a member and a former Chairperson of the British HIV Association Audit and Standard of Care Committee. He is a trustee of the Charity Health and Hope (UK).