The 2023 Dengue Outbreak in Bangladesh: Exploring the Epidemiology in Hospitalized Patients

Urby Saraf Anika Public Health and Research, Tropical Disease and Health Research Center, Dhaka, Bangladesh;

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Muna Islam Department of Medicine, Chittagong Medical College Hospital, Chattogram, Bangladesh;

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Fatema E Nur Mou Department of Radiology and Imaging, Mugda Medical College Hospital, Dhaka, Bangladesh;

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Mrinal Saha Department of Critical Care Medicine, Chittagong Medical College Hospital, Chattogram, Bangladesh;

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Aparna Deb Department of Medicine, Chittagong Medical College Hospital, Chattogram, Bangladesh;

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Rubaiya Rahman Tui Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh;

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Joarder Rakeen Manzoor Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh;

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Afroza Jesmin Department of Dermatology and Venerology, Mugda Medical College Hospital, Dhaka, Bangladesh

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Ayesha Martuja Department of Medicine, Chittagong Medical College Hospital, Chattogram, Bangladesh;

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Jannatul Fardous Public Health and Research, Tropical Disease and Health Research Center, Dhaka, Bangladesh;

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Mohiuddin Sharif Public Health and Research, Tropical Disease and Health Research Center, Dhaka, Bangladesh;

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Md. Abdur Rafi Public Health and Research, Tropical Disease and Health Research Center, Dhaka, Bangladesh;

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Mohammad Jahid Hasan Public Health and Research, Tropical Disease and Health Research Center, Dhaka, Bangladesh;

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For the past two decades, Bangladesh has faced recurrent dengue outbreaks, with the most recent occurring in 2023. We investigated the socioeconomic, clinical, and laboratory aspects of patients diagnosed with dengue during this outbreak. This observational study was conducted from July to September 2023 at Dhaka Medical College Hospital and Chittagong Medical College Hospital, and included 450 confirmed cases of dengue. Sociodemographic information was collected via face-to-face interviews, clinical examinations, and laboratory testing, which was done within 24 hours of admission. Dengue severity was classified according to the 2009 WHO dengue guidelines. Notably, 17% of patients experienced severe dengue, and 89% of those with nonsevere cases exhibited at least one warning sign. Most patients were young adults (mean age, 33 years), with a nearly equal male-to-female ratio. Common clinical presentations included fever (95%), myalgia (62%), and headache (58%), whereas warning signs such as vomiting (54%) and abdominal pain (39%) were prevalent. Plasma leakage indicators, including ascites, pleural effusion, and edema, were found predominantly in severe cases. Laboratory findings revealed leukopenia, thrombocytopenia, and elevated hepatic enzymes (alanine aminotransferase and aspartate aminotransferase) in nearly half the patients. An elevated hematocrit level was associated with severe dengue. We report that a substantial number of patients developed severe dengue during the epidemic in 2023, and provide detailed clinical–epidemiological profiles of the patients, offering valuable insight into management of dengue cases.

Author Notes

Disclosures: The study protocol was reviewed and approved by the ethical review committee of Dhaka Medical College (ERC-DMC/ECC/2022/423). Informed written consent was obtained from each of the participating patients after informing them of the objectives of the study and their right to remain or opt out of the study if they felt uncomfortable. No human subjects were harmed and the procedures followed were in accordance with the ethical standards and regulations established by the Declaration of Helsinki of the World Medical Association. We used ChatGPT 3.5 for language editing and improved clarity of the manuscript.

Authors’ contributions: M. A. Rafi and M. J. Hasan conceptualized the study. F. E. N. Mou, M. Saha, A. Deb, R. R. Tui, and J. R. Manzoor provided resources. U. S. Anika, M. Islam, F. E. N. Mou, M. Saha, A. Deb, R. R. Tui, J. R. Manzoor, A. Jesmin, A. Martuja, J. Fardous, M. Sharif, M. A. Rafi, and M. J. Hasan conducted the investigation. U. S. Anika, M. Islam, M. A. Rafi, and M. J. Hasa conducted formal analyses. U. S. Anika, M. Islam, F. E. N. Mou, M. Saha, A. Deb, R. R. Tui, J. R. Manzoor, A. Jesmin, A. Martuja, J. Fardous, M. Sharif, M. A. Rafi, and M. J. Hasan created the methodology. A. Jesmin, A. Martuja, J. Fardous, M. Sharif, M. A. Rafi, and M. J. Hasan supervised. F. E. N. Mou, M. Saha, A. Deb, R. R. Tui, J. R. Manzoor, A. Jesmin, A. Martuja, J. Fardous, and M. Sharif wrote the first draft of the manuscript. U. S. Anika, M. Islam, F. E. N. Mou, M. Saha, A. Deb, R. R. Tui, J. R. Manzoor, A. Jesmin, A. Martuja, J. Fardous, M. Sharif, M. A. Rafi, and M. J. Hasan reviewed and edited the final manuscript.

Data availability: Data and other necessary details are available and will be provided upon reasonable request to the corresponding authors.

Authors’ addresses: Urby Saraf Anika, Jannatul Fardous, Mohiuddin Sharif, Md. Abdur Rafi, and Mohammad Jahid Hasan, Public Health and Research, Tropical Disease and Health Research Center, Dhaka, Bangladesh, E-mails: urby.anika@gmail.com, jannatulfardous888@gmail.com, mohiuddinsharif.fmc@gmail.com, abdurrafi007@gmail.com, and jahid.hasan@tdhrc.org. Muna Islam, Aparna Deb, and Ayesha Martuja, Department of Medicine, Chittagong Medical College Hospital, Chattogram, Bangladesh, E-mails: drmunaislam@gmail.com, deb.aparna84@gmail.com, and ayeshamartujassmc@gmail.com. Fatema E Nur Mou, Department of Radiology and Imaging, Mugda Medical College Hospital, Dhaka, Bangladesh, E-mail: mou07smu@gmail.com. Mrinal Saha, Department of Critical Care Medicine, Chittagong Medical College Hospital, Chattogram, Bangladesh, E-mail: drmrinalsaha82@gmail.com. Rubaiya Rahman Tui and Joarder Rakeen Manzoor, Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh, E-mails: rubaiya9326@gmail.com and rakeen.1632@gmail.com. Afroza Jesmin, Department of Dermatology and Venerology, Mugda Medical College Hospital, Dhaka, Bangladesh, E-mail: dr.afrozajesmin@gmail.com.

Address correspondence to Mohammad Jahid Hasan or Urby Saraf Anika, Public Health and Research, Tropical Disease and Health Research Center, Dhaka-1205, Bangladesh. E-mail: jahid.hasan@tdhrc.org or urby.anika@gmail.com
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