Use of Haematological Changes as a Predictor of Dengue Infection among Suspected Cases at Kairuki Hospital in Dar Es Salaam, Tanzania: A Retrospective Cross Sectional Study

Abstract

Background: Dengue is a viral disease transmitted by female Aedes mosquitoes which are commonly found in tropical and subtropical areas. There is a dramatic increase in annual incidence rate of dengue attributed to urbanisation, poor environmental management as well as increased people mobility. Outbreak of dengue have been reported in Tanzania in recent years with Dar es salaam being the most affected region. Dengue is associated with haematological derangements and itindicates the severity of the disease. These changes have not been well elucidated in Tanzanian patients. The aim of this study was to determine these derangements among dengue patients admitted at Kairuki hospital in Dar es salaam, and compare these changes with non- dengue febrile patients. Methods: A retrospective cross sectional study was conducted among patients who were suspected to have dengue; tested for dengue IgM and their Complete Blood Count were tested during the index illness. This information was obtained from Kairuki hospital laboratory database. Haematological parameters were compared between dengue and non-dengue patients using SPSS Version 20.0. Binary logistic regression analysis was used to determine haematological predictors of dengue positive results. Results: A total of 255 patients were enrolled, whereby 188(73.7%) were dengue positive and 67 (26.3%) were negative. Dengue patients had relatively low mean total white blood cell counts compared to non-dengue patients (Student’s test= -2.7; p value=.007). Furthermore, Mean lymphocyte count was significantly low in dengue patients compared to non-dengue patients (Student’s (t) test=-5.1; p<.001). Other haematological parameters were not significantly different. Lymphopenia was a significant predictor for dengue positive results (Adjusted Odd Ration =5.26 (95% CI=2.28-12.2; P value <.001). Conclusion: Patients with dengue had significantly low total white blood cell and lymphocyte count compared to non-dengue febrile patients. Lymphopenia is a significant haematological predictor for dengue positive results. Case defining signs and symptoms combined with these haematological changes may be used by clinicians as a guide to order confirmatory test for suspected dengue cases.

Association of Hematological and Biochemical Parameters with Serological Markers of Acute Dengue Infection during the 2022 Dengue Outbreak in Nepal

“…In addition to decreased platelets, increased AST levels, and high glucose levels as independent predictors of dengue virus infection, leukopenia with monocytosis (in NS1 only) and leukopenia with lymphopenia (in both NS1 + IgM) were also observed in certain serological durations of illness. Leukopenia with monocytosis and leukopenia with lymphopenia have also been observed in other studies [ 17 , 32 , 33 ]. Virus-induced destruction of WBC and inhibition of myeloid progenitor cells causes leukopenia, while monocytes phagocytose and present the antigen to T- helper cells, causing monocytosis; this explains leukopenia with monocytosis [ 34 , 35 ].…”

“…Few studies report similar findings of insignificance; this may be because our study included only dengue fever patients with mild primary active infections. Thus, there is less chance of plasma leakage, which does not indicate abnormal hematocrit results [ 16 , 17 ]. Thrombocytopenia, which is well correlated with dengue severity as shown by various studies, also remained significant in our study [ 18 – 21 ].…”

Analysis of essential hematological parameters and nutrient levels of dengue patients aiming for quick recovery and sustainable immunity

“…Such features indicate an augmented immune response due to secondary viral antigen exposure, leading to a more severe form of the disease. 6 Apart from thrombocytopenia, DF is characterized by peripheral blood parameters such as leucopenia (WBC < 5000 cells/mm3) and rising hematocrit (10-20%), which change the status of the illness over time. The average total leucocyte count (TLC) is 4 thousand to 11 thousand, and the hematocrit level should be 41% to 50% for males, while females should have 36% to 46%.…”

Big data analytics framework for childhood infectious disease surveillance system using modified mapreduce algorithm: a case study of Tanzania

“…The re-occurrence of chikungunya and dengue fever outbreak in 2010, 2012, 2014, 2018, and 2019 have been affected different regions including Dar es Salaam, Kilimanjaro, Arusha, Morogoro, Tanga, Zanzibar, and other regions (Vairo et al, 2014;Chipwaza et al, 2021;Kajeguka et al, 2016). For instance, in 2019 the last dengue fever was reported in Dar es Salaam, Tanga, Pwani, Morogoro, Singida, and Kilimanjaro in which 3500 cases were reported and 13 deaths (Salvatory Kalabamu & Maliki, 2021). These diseases by far are the main causes of high mortality rates for women and children of 0-5 years of age (Mangu et al, 2016).…”

“…This situation encourages patients' readmission, unnecessary treatments, lack of patients' medical history, lack of past laboratory test results, limited analysis, and unnecessary costs. 2010, 2012, 2014, 2018, and 2019), chikungunya, and among others, demonstrate how infectious diseases surveillance system needs not only an emergency management system but also a system that analyze data leading to timely infectious disease detection with dynamic, sophisticated data collection, analysis, visualization, and reporting (Salvatory Kalabamu & Maliki, 2021).…”