Use of Haematological Changes as a Predictor of Dengue Infection among Suspected Cases at Kairuki Hospital in Dar Es Salaam, Tanzania: A Retrospective Cross Sectional Study

Abstract

Background: Dengue is a viral disease transmitted by female Aedes mosquitoes which are commonly found in tropical and subtropical areas. There is a dramatic increase in annual incidence rate of dengue attributed to urbanisation, poor environmental management as well as increased people mobility. Outbreak of dengue have been reported in Tanzania in recent years with Dar es salaam being the most affected region. Dengue is associated with haematological derangements and itindicates the severity of the disease. These changes have not been well elucidated in Tanzanian patients. The aim of this study was to determine these derangements among dengue patients admitted at Kairuki hospital in Dar es salaam, and compare these changes with non- dengue febrile patients.
Methods: A retrospective cross sectional study was conducted among patients who were suspected to have dengue; tested for dengue IgM and their Complete Blood Count were tested during the index illness. This information was obtained from Kairuki hospital laboratory database. Haematological parameters were compared between dengue and non-dengue patients using SPSS Version 20.0. Binary logistic regression analysis was used to determine haematological predictors of dengue positive results.
Results: A total of 255 patients were enrolled, whereby 188(73.7%) were dengue positive and 67 (26.3%) were negative. Dengue patients had relatively low mean total white blood cell counts compared to non-dengue patients (Student’s test= -2.7; p value=.007). Furthermore, Mean lymphocyte count was significantly low in dengue patients compared to non-dengue patients (Student’s (t) test=-5.1; p<.001). Other haematological parameters were not significantly different. Lymphopenia was a significant predictor for dengue positive results (Adjusted Odd Ration =5.26 (95% CI=2.28-12.2; P value <.001).
Conclusion: Patients with dengue had significantly low total white blood cell and lymphocyte count compared to non-dengue febrile patients. Lymphopenia is a significant haematological predictor for dengue positive results. Case defining signs and symptoms combined with these haematological changes may be used by clinicians as a guide to order confirmatory test for suspected dengue cases.