Background. Dengue fever is an emerging public health problem in Pakistan. The aim of this study was to determine the relationship between comorbid conditions in individuals suffering from dengue fever and the development of dengue hemorrhagic fever or dengue shock syndrome. Methods. In this age- and sex-matched case control study, total of 132 cases of dengue hemorrhagic fever/dengue shock syndrome and 249 randomly selected controls were recruited from two major teaching hospitals of Lahore, Pakistan. A semistructured questionnaire was used to collect data through interview and by reviewing clinical records. SPSS version 18 was utilized for statistical analysis including conditional logistic regression. Results. Odds of developing dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) among diabetics are higher than in controls, but this association was not found statistically significant (OR. 1.26; 95% CI. 0.78–2.03; ). Similarly, no association was observed in individuals suffering from hypertension (OR. 0.93; 95% CI. 0.57–1.49; ). Odds of developing DHF and DSS were higher for bronchial asthma (adjusted OR. 1.34) and pulmonary tuberculosis (adjusted OR. 1.41); however P values were insignificant. Conclusion. Presence of diabetes mellitus, hypertension, ischemic heart disease and bronchial asthma among patients contracted dengue fever will not increase the risk of dengue hemorrhagic fever and dengue shock syndrome. 1. Background Dengue fever is an emerging public health problem prevalent mostly in tropical and subtropical regions of the world. It is an arbovirus infection transmitted through Aedes aegypti and Aedes albopictus mosquito species. Four dengue virus serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) have yet been identified and are responsible for most of the clinical manifestations, ranging from asymptomatic disease to symptomatic dengue fever (DF) and dengue hemorrhagic fever (DHF). In majority of patients, infection is self-limiting, but in small proportions, the resultant dengue shock syndrome (DSS) may increase morbidity and mortality. Infection with one serotype does not give protection against other dengue viruses, yet sequential infections increase the risk of developing dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) [1, 2]. Dengue is endemic in many Southeast Asian countries and Western pacific region [2]. About 2.5 billion people (40% of world’s population) are at risk of dengue transmission. The World Health Organization (WHO) estimates that 50 to 100 million infections occur yearly, including 500,000 DHF
References
[1]
World Health Organization, Dengue and Dengue Haemmorrhagic Fever, World Health Organization, Geneva, Switzerland, 2012.
[2]
Centers for Disease Control (CDC), “Epidemiology of Dengue fever,” 2012, http://www.cdc.gov/dengue/epidemiology/index.html.
[3]
M. Malik, “Dengue prevention, control and management,” in International Conference in Lahore Pakistan on Dengue Prevention and Management, 2012.
[4]
J. A. Potts and A. L. Rothman, “Clinical and laboratory features that distinguish dengue from other febrile illnesses in endemic populations,” Tropical Medicine and International Health, vol. 13, no. 11, pp. 1328–1340, 2008.
[5]
D. J. Gubler, “Epidemic dengue/dengue hemorrhagic fever as a public health, social and economic problem in the 21st century,” Trends in Microbiology, vol. 10, no. 2, pp. 100–103, 2002.
[6]
L. Thomas, Y. Brouste, F. Najioullah et al., “Predictors of severe manifestations in a cohort of adult dengue patients,” Journal of Clinical Virology, vol. 48, no. 2, pp. 96–99, 2010.
[7]
G. N. Malavige, P. K. Ranatunga, V. G. N. S. Velathanthiri et al., “Patterns of disease in Sri Lankan dengue patients,” Archives of Disease in Childhood, vol. 91, no. 5, pp. 396–400, 2006.
[8]
J. G. Rigau-Pérez and M. K. Laufer, “Dengue-related deaths in Puerto Rico, 1992–1996: diagnosis and clinical alarm signals,” Clinical Infectious Diseases, vol. 42, no. 9, pp. 1241–1246, 2006.
[9]
O. Parkash, A. Almas, S. W. Jafri, S. Hamid, J. Akhtar, and H. Alishah, “Severity of acute hepatitis and its outcome in patients with dengue fever in a tertiary care hospital Karachi, Pakistan (South Asia),” BMC Gastroenterology, vol. 10, no. 2, article 43, 2010.
[10]
M. M. Riaz, K. Mumtaz, M. S. Khan et al., “Outbreak of dengue fever in Karachi 2006: a clinical perspective,” Journal of the Pakistan Medical Association, vol. 59, no. 6, pp. 339–344, 2009.
[11]
M. A. A. Figueiredo, L. C. Rodrigues, M. L. Barreto et al., “Allergies and diabetes as risk factors for dengue hemorrhagic fever: results of a case control study,” PLoS Neglected Tropical Diseases, vol. 4, no. 6, article e699, 2010.
[12]
J. G. Rigau-Pérez and M. K. Laufer, “Dengue-related deaths in Puerto Rico, 1992–1996: diagnosis and clinical alarm signals,” Clinical Infectious Diseases, vol. 42, no. 9, pp. 1241–1246, 2006.
[13]
World Health Organization, “Impact of dengue,” 2008, http://www.who.int/csr/disease/dengue/impact/en/index.html.
[14]
World Health Organization, “Comprehensive guidelines for prevention and control of Dengue and Dengue haemorrhagic fever- Revised and expanded edition, 2011,” SEARO technical publication series No. 60, http://www.searo.who.int/entity/vector_borne_tropical_diseases/documents/SEAROTPS60/en/index.html.
