Dengue infection during pregnancy in Burkina Faso: a cross-sectional study

Abstract

BackgroundDengue fever is prevalent in the world; in recent years, several outbreaks occurred in West Africa. It affects pregnant women. We aimed to assess the consequences of dengue fever on pregnant women and their fetuses during dengue epidemic in Burkina Faso.MethodsWe conducted a cross-sectional study from November 1, 2015 to January 31, 2017 in 15 public and private health facilities in Ouagadougou, using secondary data. Immunochromatographic rapid test Duo detecting specific antibodies, immunoglobin M/G and /or dengue non structural antigen1 virus was used to diagnose dengue cases.ResultsOut of 399 (48%) women registered during the study period, 25 (6%) were pregnant. The average age of pregnant women was 30 years, with 18 and 45 years as extremes. The main symptoms were fever (92%) and headache (92%). Nine patients (36%) had severe dengue characterized by bleeding (16%), neurological symptoms (16%) and acute respiratory distress (8%). Eight (32%) of the 25 women had early miscarriage and 8 (32%) women gave birth to viable fetuses. Among those with viable babies, 5 (20%) presented post-partum hemorrhage and 3 (12%) presented early delivery. The main fetal complications included 3 cases of acute fetal distress (12%). One case of maternal death (4%) and 4 cases of neonatal mortality (44.5%) were notified.ConclusionDengue fever occurring during pregnancy increases maternal and neonatal mortality. Its severe complications require specific monitoring of pregnant women until delivery.

Maternal and fetal outcomes of dengue fever in pregnancy: a large prospective and descriptive observational study

“…We screened only those women for inclusion in our study who presented with fever, thereby reducing the number of false positive cases due to serologic positivity solely, which could have confounded the results of our study. Symptoms of dengue observed in our study were similar to symptoms observed in other studies on pregnant and non-pregnant women with dengue [ 14 – 16 ] with myalgia and arthralgias present in more than 90% of women.…”

“…Previous studies have demonstrated rates of thrombocytopenia in pregnant women with dengue between 48–100%. [ 8 , 10 , 14 , 17 ]…”

“…We found high incidences of post-partum hemorrhage, post-partum sepsis, shock, AKI, ARDS and acute liver failure in our study. Post-partum hemorrhage, due to dengue associated thrombocytopenia is a significant concern in pregnant women with reported rates of 2.2–30% [ 7 , 8 , 14 , 23 ]. We found a post-partum hemorrhage rate of 25%.…”

“…We found 11.4% rate of still births. Rates of still births in previous studies have been reported from 3.8 to 13.1% [ 7 , 8 , 14 , 23 ]. However, further research is needed to establish whether these increased rates of fetal loss are secondary to the effects of hyperthermia or to dengue virus and its effects.…”

Dengue Virus Infection and Associated Risk Factors in Africa: A Systematic Review and Meta-Analysis

“…These observations support evidence previously documented [ 5 , 7 ]. After 2010, severe dengue cases have been increasingly reported in different countries, including Burkina Faso [ 79 ], Côte d’Ivoire [ 80 ], Djibouti [ 30 ], the Republic of Sudan [ 81 ], Senegal [ 22 ], and Tanzania [ 31 ]. The previous report shows that these countries have experienced continuous active DENV transmission in the past decade [ 5 ].…”