Hypertension, Diabetes and Severe Dengue in a Tertiary-Care Cohort: Interaction With Urban Exposure Indicators
Keywords:
dengue, hypertension, diabetes, severe dengue, comorbidity, urban exposureAbstract
Background: Cardiometabolic comorbidities are increasingly common in dengue-endemic settings and may influence progression to severe disease.
Objective: To quantify associations of hypertension and diabetes with severe dengue while exploring whether residential urban-exposure indicators modify risk.
Methods: Records of 1,286 adults hospitalised with laboratory-confirmed dengue over two transmission seasons were reviewed. Severe dengue was defined using prespecified clinical criteria. Hypertension, diabetes and other comorbidities were abstracted from medical records. Residential zones were linked to area-level particulate pollution and population-density indicators. Multivariable logistic regression adjusted for age, sex, day of illness at admission and baseline platelet count.
Results: Severe dengue occurred in 13.7% of admissions. Diabetes was present in 17.1% and hypertension in 21.4%. After adjustment, diabetes was associated with severe dengue (adjusted odds ratio [aOR] 1.72; 95% CI 1.18–2.51), while hypertension showed a smaller association (aOR 1.34; 95% CI 0.96–1.88). Patients with both conditions had the highest risk (aOR 2.06; 95% CI 1.26–3.36). High residential pollution exposure was independently associated with respiratory complications but did not materially modify the diabetes–severity relationship. Sensitivity analysis excluding patients transferred from other hospitals produced similar estimates.
Conclusion: Diabetes was associated with greater odds of severe dengue in this cohort, and combined cardiometabolic disease identified a particularly vulnerable subgroup. Urban exposure indicators contributed additional information about respiratory complications but did not explain the comorbidity effect.
Publication format: research abstract. No full-text manuscript accompanies this record.
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