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

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.

Keywords::

• Dengue fever
• dengue haemorrhagic fever
• dengue shock syndrome
• expanded dengue syndrome
• death rate
• Pakistan

Acknowledgement

We acknowledge the members of the expert committee Dr Arif Mehmood Siddique, Dr Ali Jawa, and Dr Muhammad Abbas Raza for their help in reviewing the reported dengue-related deaths. We are also grateful to Dr Muhammad Idrees of the Centre of Excellence in Molecular Biology for performing the RT-PCR. The ethics review committee of Allama Iqbal Medical College/Jinnah Hospital Lahore approved the study protocol.

Declaration of interest: The authors declare that they have no competing interests.