A 15-year review of dengue hospitalizations in Singapore : reducing admissions without adverse consequences, 2003 to 2017
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 healthc...
| Main Authors: | , , , , , , |
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| Other Authors: | |
| Format: | Journal Article |
| Language: | English |
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2019
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| Online Access: | https://hdl.handle.net/10356/90056 http://hdl.handle.net/10220/49387 |
| _version_ | 1824455048337293312 |
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| author | Ang, Li Wei Thein, Tun-Linn Ng, Yixiang Boudville, Irving Charles Chia, Po Ying Lee, Vernon Jian Ming Leo, Yee-Sin |
| author2 | Althouse, Benjamin |
| author_facet | Althouse, Benjamin Ang, Li Wei Thein, Tun-Linn Ng, Yixiang Boudville, Irving Charles Chia, Po Ying Lee, Vernon Jian Ming Leo, Yee-Sin |
| author_sort | Ang, Li Wei |
| collection | NTU |
| description | 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. |
| first_indexed | 2025-02-19T03:32:01Z |
| format | Journal Article |
| id | ntu-10356/90056 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2025-02-19T03:32:01Z |
| publishDate | 2019 |
| record_format | dspace |
| spelling | ntu-10356/900562020-11-01T05:31:04Z A 15-year review of dengue hospitalizations in Singapore : reducing admissions without adverse consequences, 2003 to 2017 Ang, Li Wei Thein, Tun-Linn Ng, Yixiang Boudville, Irving Charles Chia, Po Ying Lee, Vernon Jian Ming Leo, Yee-Sin Althouse, Benjamin Lee Kong Chian School of Medicine (LKCMedicine) Hospitals Elderly Science::Medicine 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. Published version 2019-07-17T01:30:42Z 2019-12-06T17:39:43Z 2019-07-17T01:30:42Z 2019-12-06T17:39:43Z 2019 Journal Article 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 1935-2727 https://hdl.handle.net/10356/90056 http://hdl.handle.net/10220/49387 10.1371/journal.pntd.0007389 en PLoS Neglected Tropical Diseases © 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. 13 p. application/pdf |
| spellingShingle | Hospitals Elderly Science::Medicine Ang, Li Wei Thein, Tun-Linn Ng, Yixiang Boudville, Irving Charles Chia, Po Ying Lee, Vernon Jian Ming Leo, Yee-Sin A 15-year review of dengue hospitalizations in Singapore : reducing admissions without adverse consequences, 2003 to 2017 |
| title | A 15-year review of dengue hospitalizations in Singapore : reducing admissions without adverse consequences, 2003 to 2017 |
| title_full | A 15-year review of dengue hospitalizations in Singapore : reducing admissions without adverse consequences, 2003 to 2017 |
| title_fullStr | A 15-year review of dengue hospitalizations in Singapore : reducing admissions without adverse consequences, 2003 to 2017 |
| title_full_unstemmed | A 15-year review of dengue hospitalizations in Singapore : reducing admissions without adverse consequences, 2003 to 2017 |
| title_short | A 15-year review of dengue hospitalizations in Singapore : reducing admissions without adverse consequences, 2003 to 2017 |
| title_sort | 15 year review of dengue hospitalizations in singapore reducing admissions without adverse consequences 2003 to 2017 |
| topic | Hospitals Elderly Science::Medicine |
| url | https://hdl.handle.net/10356/90056 http://hdl.handle.net/10220/49387 |
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