Please use this identifier to cite or link to this item: https://hdl.handle.net/10356/90056
Title: A 15-year review of dengue hospitalizations in Singapore : reducing admissions without adverse consequences, 2003 to 2017
Authors: Ang, Li Wei
Thein, Tun-Linn
Ng, Yixiang
Boudville, Irving Charles
Chia, Po Ying
Lee, Vernon Jian Ming
Leo, Yee-Sin
Keywords: Hospitals
Elderly
Science::Medicine
Issue Date: 2019
Source: Ang, L. W., Thein, T.-L., Ng, Y., Boudville, I. C., Chia, P. Y., Lee, V. J. M., & Leo, Y.-S. (2019). A 15-year review of dengue hospitalizations in Singapore : reducing admissions without adverse consequences, 2003 to 2017. PLoS Neglected Tropical Diseases, 13(5), e0007389-. doi:10.1371/journal.pntd.0007389
Series/Report no.: PLoS Neglected Tropical Diseases
Abstract: Objectives: Since the 1990s, Singapore has experienced periodic dengue epidemics of increasing frequency and magnitude. In the aftermath of the 2004–2005 dengue epidemic, hospitals refined their admission criteria for dengue cases to right-site dengue case management and reduce the burden of healthcare utilization and negative outcomes. In this study, we describe the national trends of hospital admissions for dengue and disease severity in terms of length of stay (LOS), admission to the intensive care unit (ICU) and death in hospital, and case fatality rate (CFR) in Singapore. Methods: We conducted a retrospective study of notified cases and laboratory confirmed dengue patients admitted to all public and private hospitals between 2003 and 2017. Case notifications for dengue and hospitalization records were extracted from national databases. Results: The proportion of dengue cases hospitalized was lower in recent years; 28.9% in the 2013–2014 epidemic, compared to 93.2% in the 2004–2005 epidemic, and 58.1% in the 2007 epidemic. Median LOS remained stable over the years; overall LOS was 3 to 4 days and ICU stay was 2 to 3 days. Less than 2% of hospitalized patients were admitted to the ICU. Overall CFR was low and remained below 0.5%. The proportions of dengue cases hospitalized and patients admitted to the ICU were highest in the elderly aged 65 years and older. Conclusions: While the proportion of dengue cases hospitalized saw a drastic decline due to more selective admission criteria, there was no concomitant increase in adverse outcomes, suggesting that admission criteria were appropriate to focus on severe dengue cases. Further studies are needed to optimize dengue management in older adults who are more likely to be hospitalized with greater disease severity, given the higher proportions of hospitalizations and severe disease among older adults.
URI: https://hdl.handle.net/10356/90056
http://hdl.handle.net/10220/49387
ISSN: 1935-2727
DOI: http://dx.doi.org/10.1371/journal.pntd.0007389
Rights: © 2019 Ang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

Files in This Item:
File Description SizeFormat 
A 15-year review of dengue hospitalizations in Singapore.pdf1.37 MBAdobe PDFThumbnail
View/Open

Google ScholarTM

Check

Altmetric

Items in DR-NTU are protected by copyright, with all rights reserved, unless otherwise indicated.