Duration of Fever in Patients with Dengue: A Systematic Review and Meta-Analysis

Nitin Gupta Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;

Search for other papers by Nitin Gupta in
Current site
Google Scholar
PubMed
Close
,
Carl Boodman Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;
University of Manitoba, Winnipeg, Manitoba, Canada;

Search for other papers by Carl Boodman in
Current site
Google Scholar
PubMed
Close
,
Christelle Genevieve Jouego Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;
Molecular Diagnostic and Research Group, University of Yaoundé, Yaoundé, Cameroon

Search for other papers by Christelle Genevieve Jouego in
Current site
Google Scholar
PubMed
Close
, and
Steven Van Den Broucke Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;

Search for other papers by Steven Van Den Broucke in
Current site
Google Scholar
PubMed
Close
Restricted access

Dengue is an acute febrile illness endemic to tropical countries and associated with high mortality rates. Despite being a viral infection, there is rampant misuse of antibiotics in patients with dengue because of perceived delay in defervescence and fear of secondary bacterial infections. Therefore, there is a need to establish the average fever duration with a confidence interval among patients with dengue. Studies up to October 21, 2022 from two databases (PubMed and Embase) were included using the search terms related to dengue and duration of fever. All retrieved articles were screened for eligibility by two independent reviewers. Studies where the average duration of fever was available were included for systematic review. Articles with at least more than 20 patients where a mean and standard deviation for the total duration of fever was available were included for meta-analysis. A total of 643 articles were included from the two databases after duplicate deletion. After two rounds of screening, 31 articles (n = 7,905) were finally included. The mean duration of fever in the 20 articles included for meta-analysis was 5.1 (95% CI: 4.7–5.5) days. Longer duration of fever was seen in those with a higher grade of fever, those with higher disease severity, and those with concurrent bacterial infections. In the absence of risk factors for concurrent bacteremia, antimicrobials may be unnecessary in those with dengue fever duration of less than 5.5 days.

    • Supplemental Materials (PDF 206.05 KB)

Author Notes

Authors’ addresses: Nitin Gupta, Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India, E-mail: nityanitingupta@gmail.com. Carl Boodman and Steven Van Den Broucke, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium, E-mails: carlboodman@gmail.com and svandenbroucke@itg.be. Christelle Genevieve Jouego, Molecular Diagnostic and Research Group, University of Yaoundé, Yaoundé, Cameroon, E-mail: chjouego@ext.itg.be.

Address correspondence to Steven Van Den Broucke, Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium. E-mail: svandenbroucke@itg.be
Save