COVID-19 onslaught is masking the 2021 dengue outbreak in Dhaka, Bangladesh

Hossain, Mohammad Sorowar; Amin, Robed; Mosabbir, Abdullah Al

doi:10.1371/journal.pntd.0010130

Cited by 22 publications

(26 citation statements)

References 14 publications

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“…Coupled with the potential misdiagnosis of dengue due to it exhibiting similar initial clinical manifestations to COVID-19, the number of notified DF cases is likely to significantly lower ( Roy and Bhattacharjee, 2021 ). In 2021 in particular, when many countries experienced a COVID-19 onslaught, DF outbreaks may have been severely masked by the terrible burden on the healthcare system ( Hossain et al, 2022 ). Furthermore, with the widespread administration of COVID-19 vaccines, it is worth exploring whether herd immunity to dengue virus has been affected, given that many studies have confirmed serological cross-reactivity between dengue and COVID-19 ( Masyeni et al., 2021 ; Pandey et al., 2021 ; Santoso et al., 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Effects of COVID-19 Non-Pharmacological Interventions on Dengue Infection: A Systematic Review and Meta-Analysis

Dong

et al. 2022

Front. Cell. Infect. Microbiol.

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Non-pharmacological interventions (NPIs) implemented during the coronavirus disease 2019 (COVID-19) pandemic have demonstrated significant positive effects on other communicable diseases. Nevertheless, the response for dengue fever has been mixed. To illustrate the real implications of NPIs on dengue transmission and to determine the effective measures for preventing and controlling dengue, we performed a systematic review and meta-analysis of the available global data to summarize the effects comprehensively. We searched Embase, PubMed, and Web of Science in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines from December 31, 2019, to March 30, 2022, for studies of NPI efficacy on dengue infection. We obtained the annual reported dengue cases from highly dengue-endemic countries in 2015–2021 from the European Centre for Disease Prevention and Control to determine the actual change in dengue cases in 2020 and 2021, respectively. A random-effects estimate of the pooled odds was generated with the Mantel-Haenszel method. Between-study heterogeneity was assessed using the inconsistency index (I2) and subgroup analysis according to country (dengue-endemic or non-endemic) was conducted. This review was registered with PROSPERO (CRD42021291487). A total of 17 articles covering 32 countries or regions were included in the review. Meta-analysis estimated a pooled relative risk of 0.39 (95% CI: 0.28–0.55), and subgroup revealed 0.06 (95% CI: 0.02-0.25) and 0.55 (95% CI: 0.44-0.68) in dengue non-endemic areas and dengue-endemic countries, respectively, in 2020. The majority of highly dengue-endemic countries in Asia and Americas reported 0–100% reductions in dengue cases in 2020 compared to previous years, while some countries (4/20) reported a dramatic increase, resulting in an overall increase of 11%. In contrast, there was an obvious reduction in dengue cases in 2021 in almost all countries (18/20) studied, with an overall 40% reduction rate. The overall effectiveness of NPIs on dengue varied with region and time due to multiple factors, but most countries reported significant reductions. Travel-related interventions demonstrated great effectiveness for reducing imported cases of dengue fever. Internal movement restrictions of constantly varying intensity and range are more likely to mitigate the entire level of dengue transmission by reducing the spread of dengue fever between regions within a country, which is useful for developing a more comprehensive and sustainable strategy for preventing and controlling dengue fever in the future.

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Section: Discussionmentioning

confidence: 99%

Effects of COVID-19 Non-Pharmacological Interventions on Dengue Infection: A Systematic Review and Meta-Analysis

Dong

et al. 2022

Front. Cell. Infect. Microbiol.

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“…1). With the majority (67.80%) of cases being secondary infections, explains an increased severity of DENV infections, as evident by a reported 57 dengue deaths among 15,000 cases since January, 2021 with another study reporting 98 deaths among 26,000 cases till November, 2021 [10,11]. Dengue being hyperendemic in Bangladesh explains the predominance of secondary dengue infections among the study population, as a significant percentage of the Bangladeshi population had prior exposures to dengue, particularly DENV2 which had been in circulation for the last few decades and DENV3 which has been prevalent since its reemergence in late 2017 [4].…”

Section: Letter To the Editormentioning

confidence: 99%

Prevalence of Dengue Virus Serotypes of 2021 Dengue Outbreak in Dhaka, Bangladesh

Rahmat

Shahera

Naser

et al. 2022

IJTDH

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“…During overlapping “twin-demics” of dengue and COVID-19, all cases of undifferentiated febrile illness may need to be managed as COVID-19 until proved otherwise via diagnostic testing, with significant implications on healthcare resources. Misdiagnosis or delay in diagnosis of dengue is also conceivable because of the similarities in clinical manifestations of these two diseases [ 4 , 5 ]. Reliance on diagnostic testing to distinguish these two diseases further strains laboratory capacity, especially in resource-limited settings where molecular testing for SARS-CoV-2 and dengue may be unavailable [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Dengue and COVID-19: Managing Undifferentiated Febrile Illness during a “Twindemic”

Wee

Sim

et al. 2022

TropicalMed

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Background: During the COVID-19 pandemic, distinguishing dengue from COVID-19 in endemic areas can be difficult, as both may present as undifferentiated febrile illness. COVID-19 cases may also present with false-positive dengue serology. Hospitalisation protocols for managing undifferentiated febrile illness are essential in mitigating the risk from both COVID-19 and dengue. Methods: At a tertiary hospital contending with COVID-19 during a dengue epidemic, a triage strategy of routine COVID-19 testing for febrile patients with viral prodromes was used. All febrile patients with viral prodromes and no epidemiologic risk for COVID-19 were first admitted to a designated ward for COVID-19 testing, from January 2020 to December 2021. Results: A total of 6103 cases of COVID-19 and 1251 cases of dengue were managed at our institution, comprising a total of 3.9% (6103/155,452) and 0.8% (1251/155,452) of admissions, respectively. A surge in dengue hospitalisations in mid-2020 corresponded closely with the imposition of a community-wide lockdown. A total of 23 cases of PCR-proven COVID-19 infection with positive dengue serology were identified, of whom only two were true co-infections; both had been appropriately isolated upon admission. Average length-of-stay for dengue cases initially admitted to isolation during the pandemic was 8.35 days (S.D. = 6.53), compared with 6.91 days (S.D. = 8.61) for cases admitted outside isolation (1.44 days, 95%CI = 0.58–2.30, p = 0.001). Pre-pandemic, only 1.6% (9/580) of dengue cases were admitted initially to isolation-areas; in contrast, during the pandemic period, 66.6% (833/1251) of dengue cases were initially admitted to isolation-areas while awaiting the results of SARS-CoV-2 testing. Conclusions: During successive COVID-19 pandemic waves in a dengue-endemic country, coinfection with dengue and COVID-19 was uncommon. Routine COVID-19 testing for febrile patients with viral prodromes mitigated the potential infection-prevention risk from COVID-19 cases, albeit with an increased length-of-stay for dengue hospitalizations admitted initially to isolation.

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COVID-19 onslaught is masking the 2021 dengue outbreak in Dhaka, Bangladesh

Cited by 22 publications

References 14 publications

Effects of COVID-19 Non-Pharmacological Interventions on Dengue Infection: A Systematic Review and Meta-Analysis

Effects of COVID-19 Non-Pharmacological Interventions on Dengue Infection: A Systematic Review and Meta-Analysis

Prevalence of Dengue Virus Serotypes of 2021 Dengue Outbreak in Dhaka, Bangladesh

Dengue and COVID-19: Managing Undifferentiated Febrile Illness during a “Twindemic”

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