Factors associated with deaths from dengue in a city in a metropolitan region in Southeastern Brazil: a case-control study

ABSTRACT Background: Dengue is a public health problem in Brazil. Therefore, this study aimed to analyze factors associated with deaths from dengue in residents of the municipality of Contagem, Metropolitan Region of Belo Horizonte, state of Minas Gerais, Brazil, during the 2016 epidemic. Methods: To determine the factors associated with deaths due to dengue, we used a logistic regression model (univariate and multivariable) in which the response variable (outcome) was death due to dengue. Independent variables analyzed included demographic variables and those related to symptoms, treatment, hospitalization, testing, comorbidities, and case history. Results: The factors associated with dengue deaths in the final multivariable model [p < 0.05; 95% confidence interval (CI)] were age (OR = 1.07; 95%CI 1.03-1.11) and presence of bleeding (OR = 8.55; 95%CI 1.21-59.92). Conclusions: The results showed that age and the presence of bleeding factors increased the risk of dengue death. These findings indicate that warning signs of dengue should be routinely monitored, and patients should be instructed to seek medical attention when they occur. It is also emphasized that the parameters and epidemiological conditions of dengue patients need to be continuously investigated to avoid a fatal outcome.

摘要 研究背景：登革热是巴西面临的公共卫生问题。本研究旨在分析巴西米纳斯吉拉斯州贝洛奥里藏特都会区孔塔根市居民在2016年登革热流行期间，与登革热死亡相关的各类影响因素。研究方法：为明确登革热死亡的相关影响因素，本研究采用logistic回归模型开展单因素及多因素分析，以登革热死亡作为因变量（结局指标）。本次分析所纳入的自变量包括人口统计学变量，以及与症状、治疗、住院、检测、合并症及病例病史相关的各类变量。研究结果：最终多因素分析模型中（P<0.05，95%置信区间（Confidence Interval, CI）），与登革热死亡显著相关的因素为年龄（比值比（Odds Ratio, OR）=1.07；95%CI 1.03~1.11）与出血症状（OR=8.55；95%CI 1.21~59.92）。研究结论：结果显示，年龄增长与出血症状的存在均会提升登革热患者的死亡风险。本研究结果提示，临床工作中应常规监测登革热的预警征象，并指导患者在出现相关征象时及时就医。同时需强调，需持续探究登革热患者的相关参数与流行病学特征，以避免出现致死性结局。