Dengue hospitalizations and in-hospital mortality changes in trend in Ecuador: a nationwide study from 2015 to 2022

Abstract

During recent years, dengue infection has spread rapidly within countries and between regions. Rapid rise in the global burden has been related to sociodemographic changes.

Objective

This study aimed to analyze dengue hospitalizations and in-hospital mortality trends in Ecuador, along with sociodemographic factors influencing adverse outcomes.

Methods

This study included 31,616 dengue hospitalizations in Ecuador during 2015–2022, of which 115 (0.36%) died. Data were extracted from national hospital registries. Age adjusted rates were calculated, and for the analysis of changes in trend, a Joinpoint regression was performed. Multivariate binary and multinomial logistic regressions were performed for assessing sociodemographic factors influencing dengue adverse outcomes.

Results

During 2015–2022, the mean age adjusted dengue hospitalization rate was 22.3 per 100,000 inhabitants with 49.41% annual decrease during 2015–2017 and 31.73% annual increase during 2017–2022 with higher rates in 2020 with 31.61, 2021 with 34.42, and 2022 with 25.81. The mean dengue in-hospital mortality rate was 0.08, mortality rates did not show significant changes during 2015–2022. Higher probability of death was observed in ages ≥50 years and ethnic minorities. People living in rural areas exhibited a 64% higher risk for complicated dengue hospitalization.

Conclusions

It was observed as an important accomplishment in Ecuador’s ongoing efforts to improve healthcare regarding dengue. 0.36% of dengue hospitalizations ended in death which is below the recommended 1%. The increase in dengue hospitalizations in Ecuador during recent years remains a concern. The COVID-19 pandemic might have influenced dengue prevention and vector control to be neglected leading to an increase in cases.

Keywords:

• Dengue
• hospital mortality
• socioeconomic disparities in health
• COVID-19
• Ecuador

Author contributions

GJLT contributed to the study conception, methodology, data curation, formal analysis, writing, review of the article and approved the final version.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data analyzed during the current study are publicly available on The Ecuadorian National Institute of Statistics and Censuses official website: https://www.ecuadorencifras.gob.ec/camas-y-egresos-hospitalarios/. Curated data could be shared upon reasonable request.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.