Severity of dengue in relation to dengue serotype: A retrospective observational study in children admitted to Parami General Hospital

Saw Win¹, Win Lai May¹, Htin Lin², Hnin Thuzar Aung¹, Wai Mar Tin¹, Aung Khin Thein¹,

Mya Myat Ngwe Tun³, Aung Myo Min¹, Hnin Yadanar Naing¹, Ngu War Htun¹, Ei Shwe Sin Win¹

Published in Volume 67, No. 2, 2025 April – June

https://doi.org/10.64455/xmma0002

Keywords:       Severity of dengue, dengue serotype, Parami General Hospital

Abstract

Myanmar is one of the most highly dengue endemic countries in which all four dengue serotypes have been observed. This study aimed to evaluate the distribution of dengue serotypes and to determine the clinical presentations and severity associated with different dengue serotypes in children admitted to a private general hospital. A retrospective study was carried out on hospitalized children less than 18 years who had confirmed dengue infection, and dengue serotypes was determined by Polymerase Chain Reaction, during the peak dengue season of 2022 and 2023. All four dengue serotypes were identified among 216 children (mean age ± SD of 7.2 ± 3.1 years): DENV-1 (88; 40.7%), DENV-2 (65; 30.1%), DENV-3 (16; 7.4%), DENV- 4 (12; 5.6%) and mixed infection (35; 16.2%). Certain clinical parameters were significantly associated with particular serotypes: higher clinical & fluid accumulation and lower platelet count in DENV-2, lower hospital stay and NS-1 positivity in DENV-3, higher aches and pain in DENV-4 and higher mucosal bleeding in mixed infections. DENV-2 was associated with severe dengue in this study. Early identifying of dengue serotypes in children could be beneficial, to predict the disease severity.

1. Parami General Hospital, Yangon, Myanmar
2. Virology Research Division, Department of Medical Research, Yangon, Myanmar
3. Virology Department, Institute of Tropical Medicine, Nagasaki University, Japan