Clinico-epidemiological determinants of severe dengue in an endemic district of coastal Karnataka

Abstract

Background: Dengue fever (DF) a significant public health challenge globally, with clinical manifestations ranging from mild symptoms to severe dengue. Objectives: To identify the clinico-epidemiological characteristics, management, and outcomes of severe dengue fever among inpatients of a tertiary care hospital. Settings and design: Prospective observational study was conducted in a tertiary care hospital, Karnataka. Materials and methods: Study included all laboratory-confirmed adult dengue patients admitted to Departments of General Medicine and Infectious Diseases during the study period. Socio-demographic, clinical, and laboratory data were collected and analysed. Statistical analysis used: Descriptive and analytical tests, including multiple logistic regression analyses, were performed. Results: Among 443 patients, 70% were males. Fever (91.9%) and aches/pains (81.7%) were most frequently reported symptoms with thrombocytopenia (81.9%), elevated AST (81.2%), and ALT (73.3%) were commonly observed. Severe dengue was observed in 12.1% of patients, frequently accompanied by acute kidney injury (32.9%), hepatitis (29.4%), and multiple organ dysfunction (22.4%). Severe cases were associated with age over 60 (COR = 4.6; 95% CI:2.1–9.9), low education status (COR = 3.6; 95% CI:1.3–10.4), unskilled occupations (COR = 4.2; 95% CI:1.1–15.8), presence of co-morbidities (COR = 2.5; 95% CI:1.4–4.4) and co-infections (COR = 5.2;95% CI:2.7–9.8), and supportive treatment (COR = 3.9; 95% CI:2.1–7). Independent predictor for severity was coinfection (AOR = 15.6; 95% CI:3.9–61.7). Supportive care was received by 36.3% patients, with 97.5% showing improvement, while 1.6% succumbed to death. Conclusion: The study highlights the significant burden of severe dengue, stressing the importance of early detection, supportive care, and treatment of co-infections.