ArticleTropical medicine and health2026
Epidemiological, virological, and clinical characteristics of dengue in the Lao People's Democratic Republic, 2022-2023: a cross-sectional study.
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Abstract
backgroundDengue has remained a public health challenge in the Lao People's Democratic Republic (Lao PDR) for several decades, with all four dengue serotypes circulating. This study aimed to investigate the epidemiology, clinical characteristics, and role of co-circulation with factors associated with severe dengue in this setting.
methodsWe conducted a cross-sectional study to retrieve all serum samples from patients suspected of having dengue collected through the National Dengue Surveillance System between 2022 and 2023 in Lao PDR, as well as their demographic and clinical information. All samples were tested for DENV detection and serotyping by reverse-transcription PCR. In-house DENV IgM/IgG ELISAs confirmed the infections and classified them as primary or secondary infections. Multinomial logistic regression was used to analyze the factors associated with disease severity.
resultsOf the 1098 serum samples from suspected dengue patients, 615 (56%) tested DENV-positive. The median age of the DENV-positive patients was 22 years (IQR 15-33), and 339 (55.1%) were female. Overall, 178 (29%) infections were classified as primary and 437 (71%) as secondary infections. DENV-positive patients were common in the northern region (37.4%) compared to other regions, with significant geographic differences in serotype distribution (p < 0.0001): DENV-2 was identified in the south (62.5%), while DENV-1 was detected in the north (45.9%) (p < 0.0001). In the southern region, secondary infections due to DENV-2 (66.7%) were more common, whereas primary infections due to DENV-1 were more frequent in the northern region (p = 0.0002). Greater disease severity was observed in DENV-2 infection (83.3%) (p = 0.002). Severe dengue was more likely in secondary infection (OR = 2.38, 95% CI: 0.84-6.74) compared to primary infection and was significantly higher in the southern (OR = 11.16, 95% CI: 3.05-40.77) (p < 0.001) and central regions (OR = 10.34, 95% CI: 2.81-38.09) (p < 0.001).
conclusionCollectively, our findings identified the key factors that contributed to the dengue epidemic in 2022-2023. DENV-2, secondary infection, and geographic variation were associated with severe outcomes. Enhanced genomic and epidemiological surveillance is critical for addressing the dengue burden in the Lao PDR.
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