PLoS Neglected Tropical Diseases (Apr 2023)

Associated risk factors of severe dengue in Reunion Island: A prospective cohort study.

  • Mathys Carras,
  • Olivier Maillard,
  • Julien Cousty,
  • Patrick Gérardin,
  • Malik Boukerrou,
  • Loïc Raffray,
  • Patrick Mavingui,
  • Patrice Poubeau,
  • André Cabie,
  • Antoine Bertolotti

DOI
https://doi.org/10.1371/journal.pntd.0011260
Journal volume & issue
Vol. 17, no. 4
p. e0011260

Abstract

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BackgroundSince 2018, a dengue epidemic has been raging annually in Reunion Island, which poses the major problem of its morbidity and mortality. However, there is no consensus in the literature on factors associated with severity of illness. The objective of this study was to identify the factors associated with the occurrence of severe dengue (SD) according to the criteria adopted in 2009 by the World Health Organization (WHO), during the 2019 epidemic.Methodology/principal findingsA total of 163 patients with RT-PCR-confirmed dengue were included in a multicenter prospective cohort study in Reunion Island between January and June 2019. Of these, 37 (23%) were classified as SD, which involves presentation dominated by at least one organ failure, and 126 (77%) classified as non-SD (of which 90 (71%) had warning signs). Confusion, dehydration, and relative hypovolemia were significantly associated with SD in bivariate analysis (p Conclusions/significanceThis study confirms that SD is a frequent cause of hospitalization during dengue epidemics in Reunion Island. It suggests that cardiovascular disease, Western European origin, and delay in diagnosis and management are risk factors associated with SD fever, and that restoration of blood volume and correction of dehydration must be performed early to be effective.Trial registrationNCT01099852; clinicaltrials.gov.