E-Dengue System Insights: Exploring The Factors Influencing Dengue-Related Deaths in Urbanized State in Low-Middle Income Country (LMIC)

E-Dengue System Insights: Exploring The Factors Influencing Dengue-Related Deaths in Urbanized State in Low-Middle Income Country (LMIC) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article E-Dengue System Insights: Exploring The Factors Influencing Dengue-Related Deaths in Urbanized State in Low-Middle Income Country (LMIC) Farah Khalida, Sharifa Ezat Wan Puteh, Mohamad Azfar Zainuddin This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4855157/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 05 Nov, 2024 Read the published version in BMC Public Health → Version 1 posted 4 You are reading this latest preprint version Abstract Background Dengue has emerged as a rapidly escalating health issue in low- and middle-income countries, with its burden and geographic spread increasing over the years. Malaysia, in particular, has witnessed a significant rise in dengue cases, accompanied by a spike in mortality rates. Several studies have identified various factors, primarily focusing on the clinical aspects of severe dengue infection and the development of dengue-related fatalities. This research aims to go beyond clinical factors and explore different perspectives, including individual, healthcare and environmental factors related to dengue mortality, to enhance service quality and improve public health interventions and prevention strategies. Methods This is a 1:2 case-control study utilizing the E-dengue system database from 2015 to 2022. A total of 219 registered dengue cases were included, with 73 cases in the case group (all dengue fatalities) and 146 cases in the control group (randomly selected survivors). Multivariate regression models were conducted to identify predictors of dengue mortality. Results Multivariate analysis revealed several significant predictors of death: a platelet level less than 50,000/µL (OR 15.7; 95% CI: 5.65–43.53), having one comorbid condition (OR 3.1; 95% CI: 1.2-8.0), having more than two comorbid conditions (OR 11; 95% CI: 33), bronchial asthma (OR 12; 95% CI: 1.08-132.13), and outbreak locality status (OR 2.3; 95% CI: 1.11–4.79). Conclusion In conclusion, this prediction model can be used to identify, prioritize and improve clinical care of individuals at higher risk of death during dengue episodes as well as to implement particular surveillance and preventive measures. Beyond clinical factors, a new finding in this study is the significance of outbreak locality as a critical predictor of dengue mortality. Therefore, in addition to health screening and public awareness and medical preparedness, it is essential to implement targeted and enhanced monitoring and preventive measures in areas with frequent dengue outbreaks. Dengue Mortality Death Factors Outbreak Comorbidities Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 05 Nov, 2024 Read the published version in BMC Public Health → Version 1 posted Editorial decision: Revision requested 07 Aug, 2024 Editor assigned by journal 06 Aug, 2024 Submission checks completed at journal 06 Aug, 2024 First submitted to journal 03 Aug, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4855157","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":337007810,"identity":"ef5c7b15-0687-4fd1-a2b5-4da227d0bd9e","order_by":0,"name":"Farah Khalida","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCklEQVRIie3PMUvEMBTA8VcC6fKwa6CDXyFyEBBr+0FcUgK9SRAEpxtyyzm63pdwEME5ELip2rVQB7t0rrgIopg7bpP2zk0w//HxfjwegM/3Bws1AAFj4IAAh9evxM2CuRkjaLaEOhIsabEmek8CwAlSu5mOk/Cxfbsonw9pSO56xCq9vbbuyiw5GyQ4ncTLujtaEHrJGGvUQ5k7sirO9QDJoIAYexssCHLGeaOEcSTQdpBg1JEPRzJHJu9SPilRtTsIK2iMtc0dEcwYk4p61xXW0RMsrXK/XB3PtZKidlfkyC8YFaTBlT29iex986nTTFTT9qWfJYPkR/lmU+67vi77zbLP5/P9j74BGFJi0nu5YmoAAAAASUVORK5CYII=","orcid":"","institution":"National University of Malaysia","correspondingAuthor":true,"prefix":"","firstName":"Farah","middleName":"","lastName":"Khalida","suffix":""},{"id":337007811,"identity":"718dbd4a-45a0-4a19-9b8e-1fd72f40eae2","order_by":1,"name":"Sharifa Ezat Wan Puteh","email":"","orcid":"","institution":"National University of Malaysia","correspondingAuthor":false,"prefix":"","firstName":"Sharifa","middleName":"Ezat Wan","lastName":"Puteh","suffix":""},{"id":337007812,"identity":"f33efd82-a138-4abd-a95b-60f53cb30256","order_by":2,"name":"Mohamad Azfar Zainuddin","email":"","orcid":"","institution":"Penang State Health Department","correspondingAuthor":false,"prefix":"","firstName":"Mohamad","middleName":"Azfar","lastName":"Zainuddin","suffix":""}],"badges":[],"createdAt":"2024-08-04 03:08:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4855157/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4855157/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-024-20545-2","type":"published","date":"2024-11-05T15:57:53+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":68750867,"identity":"792512da-67bf-4ac8-b74c-f215fe879945","added_by":"auto","created_at":"2024-11-11 16:12:29","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":418294,"visible":true,"origin":"","legend":"","description":"","filename":"EDengueInsight.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4855157/v1_covered_3bc31eac-8816-46df-bc7e-be7fbd6494f9.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"E-Dengue System Insights: Exploring The Factors Influencing Dengue-Related Deaths in Urbanized State in Low-Middle Income Country (LMIC)","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Dengue, Mortality, Death, Factors, Outbreak, Comorbidities","lastPublishedDoi":"10.21203/rs.3.rs-4855157/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4855157/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDengue has emerged as a rapidly escalating health issue in low- and middle-income countries, with its burden and geographic spread increasing over the years. Malaysia, in particular, has witnessed a significant rise in dengue cases, accompanied by a spike in mortality rates. Several studies have identified various factors, primarily focusing on the clinical aspects of severe dengue infection and the development of dengue-related fatalities. This research aims to go beyond clinical factors and explore different perspectives, including individual, healthcare and environmental factors related to dengue mortality, to enhance service quality and improve public health interventions and prevention strategies.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis is a 1:2 case-control study utilizing the E-dengue system database from 2015 to 2022. A total of 219 registered dengue cases were included, with 73 cases in the case group (all dengue fatalities) and 146 cases in the control group (randomly selected survivors). Multivariate regression models were conducted to identify predictors of dengue mortality.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eMultivariate analysis revealed several significant predictors of death: a platelet level less than 50,000/\u0026micro;L (OR 15.7; 95% CI: 5.65\u0026ndash;43.53), having one comorbid condition (OR 3.1; 95% CI: 1.2-8.0), having more than two comorbid conditions (OR 11; 95% CI: 33), bronchial asthma (OR 12; 95% CI: 1.08-132.13), and outbreak locality status (OR 2.3; 95% CI: 1.11\u0026ndash;4.79).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eIn conclusion, this prediction model can be used to identify, prioritize and improve clinical care of individuals at higher risk of death during dengue episodes as well as to implement particular surveillance and preventive measures. Beyond clinical factors, a new finding in this study is the significance of outbreak locality as a critical predictor of dengue mortality. Therefore, in addition to health screening and public awareness and medical preparedness, it is essential to implement targeted and enhanced monitoring and preventive measures in areas with frequent dengue outbreaks.\u003c/p\u003e","manuscriptTitle":"E-Dengue System Insights: Exploring The Factors Influencing Dengue-Related Deaths in Urbanized State in Low-Middle Income Country (LMIC)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-02 14:23:54","doi":"10.21203/rs.3.rs-4855157/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-08-07T06:01:34+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-08-06T23:17:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-08-06T23:15:54+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2024-08-04T03:00:12+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d09ebe96-072f-4ef4-9049-2abda448e365","owner":[],"postedDate":"September 2nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-11-11T16:08:17+00:00","versionOfRecord":{"articleIdentity":"rs-4855157","link":"https://doi.org/10.1186/s12889-024-20545-2","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2024-11-05 15:57:53","publishedOnDateReadable":"November 5th, 2024"},"versionCreatedAt":"2024-09-02 14:23:54","video":"","vorDoi":"10.1186/s12889-024-20545-2","vorDoiUrl":"https://doi.org/10.1186/s12889-024-20545-2","workflowStages":[]},"version":"v1","identity":"rs-4855157","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4855157","identity":"rs-4855157","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}