ArticlePLoS neglected tropical diseases2021
Outcomes among children and adults at risk of severe dengue in Sri Lanka: Opportunity for outpatient case management in countries with high disease burden.
Article in PLoS neglected tropical diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 14 citations in OpenAlex.
- Improving early prediction for adverse dengue outcomes using data from the IDAMS prospective multicentre study.Nature communications · 2026Observational
- Factors Associated With Severe Dengue During the 2019 Outbreak in Southern Colombia: Implications for Hyperendemic Regions.Journal of tropical medicine · 2026Article
- Academic global health collaboration: the Ruhuna-Duke partnership.Global health action · 2025Article
- Leveraging machine learning on the role of hospitalizations in the dynamics of dengue spread in Brazil: an ecological study of health systems resilience.Lancet regional health. Americas · 2025Article
- Estimating per-infection cost and burden for dengue and Zika as a function of antibody-dependent enhancement.PLoS neglected tropical diseases · 2025Article
- Global prevalence and risk factors of fatigue and post-infectious fatigue among patients with dengue: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Clinical and Laboratory Features and Treatment Outcomes of Dengue Fever in Pediatric Cases.Cureus · 2024Article
- Severe Organ Impairment Was Common in Elderly Individuals with Dengue in Guangdong, China.The American journal of tropical medicine and hygiene · 2024Article
- Trends in emerging vector-borne viral infections and their outcome in children over two decades.Pediatric research · 2024Review
- DENV-2 NS1 promotes AMPK-LKB1 interaction to activate AMPK/ERK/mTOR signaling pathway to induce autophagy.Virology journal · 2023Article
- Correction: Outcomes among children and adults at risk of severe dengue in Sri Lanka: Opportunity for outpatient case management in countries with high disease burden.PLoS neglected tropical diseases · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
15 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundHealthcare systems in dengue-endemic countries are often overburdened due to the high number of patients hospitalized according to dengue management guidelines. We systematically evaluated clinical outcomes in a large cohort of patients hospitalized with acute dengue to support triaging of patients to ambulatory versus inpatient management in the future. METHODS/PRINCIPAL
findingsFrom June 2017- December 2018, we conducted surveillance among children and adults with fever within the prior 7 days who were hospitalized at the largest tertiary-care (1,800 bed) hospital in the Southern Province, Sri Lanka. Patients who developed platelet count ≤100,000/μL (threshold for hospital admission in Sri Lanka) and who met at least two clinical criteria consistent with dengue were eligible for enrollment. We confirmed acute dengue by testing sera collected at enrollment for dengue NS1 antigen or IgM antibodies. We defined primary outcomes as per the 1997 and 2009 World Health Organization (WHO) classification criteria: dengue hemorrhagic fever (DHF; WHO 1997), dengue shock syndrome (DSS; WHO 1997), and severe dengue (WHO 2009). Overall, 1064 patients were confirmed as having acute dengue: 318 (17.4%) by NS1 rapid antigen testing and 746 (40.7%) by IgM antibody testing. Of these 1064 patients, 994 (93.4%) were adults ≥18 years and 704 (66.2%) were male. The majority (56, 80%) of children and more than half of adults (544, 54.7%) developed DHF during hospitalization, while 6 (8.6%) children and 22 (2.2%) adults developed DSS. Overall, 10 (14.3%) children and 113 (11.4%) adults developed severe dengue. A total of 2 (0.2%) patients died during hospitalization.
conclusionsOne-half of patients hospitalized with acute dengue progressed to develop DHF and a very small number developed DSS or severe dengue. Developing an algorithm for triaging patients to ambulatory versus inpatient management should be the future goal to optimize utilization of healthcare resources in dengue-endemic countries.
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