Deaths due to dengue fever at a tertiary care hospital in Lahore, Pakistan

• Published in: Scandinavian journal of infectious diseases Vol. 46; no. 4; pp. 303 - 309
• Main Authors: Assir, Muhammad Zaman Khan, Ahmad, Hafiz Ijaz, Masood, Muhammad Adnan, Kamran, Umair, Yusuf, Noshin Wasim
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01-04-2014; Taylor & Francis
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; death rate; Dengue - mortality; Dengue - physiopathology; Dengue fever; dengue haemorrhagic fever; dengue shock syndrome; expanded dengue syndrome; Female; Hospital Mortality; Humans; Infant; Male; Middle Aged; Pakistan; Pakistan - epidemiology; Severe Dengue - mortality; Severe Dengue - physiopathology; Tertiary Care Centers - statistics & numerical data; Young Adult; Pakistan
• ISSN: 0036-5548; 1651-1980
• DOI: 10.3109/00365548.2013.877155

Abstract
Objective: We conducted this study to review deaths due to dengue fever (DF) during a large outbreak of DF in Lahore, Pakistan. Methods: We reviewed deaths due to DF at Jinnah Hospital Lahore between August and November 2011. Clinical and laboratory data were abstracted. The 2011 World Health Organization Regional Office for South-East Asia (WHO SEARO) guidelines were used to classify the disease. Results: Out of 128,634 probable DF patients who visited the outpatient department, 2313 patients were hospitalized; 1699 (73.3%) were male. RT-PCR was positive in 92 of 114 hospitalized patients (DENV-2 in 91 patients and DENV-3 in 1 patient). Sixty dengue-related deaths were reported; 41 (68.3%) were male. The mean age (± standard deviation) was 44 (± 20.5) y. The diagnosis at the time of presentation was DF in 5 (8.3%), dengue haemorrhagic fever without shock in 16 (26.6%), dengue shock syndrome in 20 (33%), and expanded dengue syndrome in 19 (31.7%) patients. Expanded dengue syndrome included encephalopathy in 12 (20%) patients, intracerebral bleed in 3 (5%), multiorgan failure in 3 (5%), and Guillain-Barré syndrome in 1 (1.6%). Twenty-nine (48.3%) patients had at least 1 comorbidity. Conclusion: Dengue shock syndrome and expanded dengue syndrome were the most common causes of death.