Research shows obese children at higher risk of hospitalization from dengue

Very overweight children infected with dengue appear to be at a higher risk of hospitalisation, according to researchers who call for more public awareness about the risks of obesity and severe disease.

Spread by the Aedes mosquito, dengue cases reached a historic high of over 6.5 million in 2023, with more than 7,300 dengue-related deaths, the World Health Organization reported. Approximately 90 per cent of those hospitalised were children under five years old.

With 10 million cases already reported by the end of June, 2024 is set to break the record again.

Neelika Malavige, professor of Immunology and Molecular Medicine at the University of Sri Jayewardenepura, Sri Lanka, says the disease is a significant problem in many South American and Asian countries, including Sri Lanka.

“Some individuals develop [the severe form] dengue haemorrhagic fever, requiring hospitalisation,” said Malavige, co-author of the study published in PLOS Neglected Tropical Diseases. “Others develop plasma leakage, which leads to shock, and if untreated, death. Therefore, early detection of complications is crucial.”

Obesity and diabetes, both on the rise in many countries, are known risk factors for dengue. However, there is little data on whether these conditions lead to more dengue-related hospitalisations, researchers say.

To investigate, researchers analysed nearly 5,000 Sri Lankan children aged 10 to 18 years, examining hospitalisations due to dengue and their body mass index (BMI).

Children with higher BMI for their age group (50th to 85th centiles) showed higher hospitalisation rates compared to those with a lower BMI. Children in the top centiles (98th and above), indicating clinical obesity, were twice as likely to be hospitalised.

“With the increase in obesity in many countries, it is important to create awareness and educate the public about the potential risks regarding obesity and the risk of severe disease and hospitalisation from dengue,” Malavige said.

“It is important to study if obesity, diabetes, and metabolic diseases lead to more symptomatic illness and an increase in hospitalisations,” she added.

Dengue, often referred to as break bone fever due to the severe joint, bone, and muscle pain it causes, is typically transmitted during the rainy season when conditions are favourable for mosquito population growth.

According to the WHO, dengue is now endemic in more than 100 countries, with the Americas, South-East Asia, and Western Pacific regions most seriously affected.

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Marianne Comparet, director at the UK-based International Society for Neglected Tropical Diseases, emphasized the importance of studies like this for supporting the clinical management of at-risk groups amid the “alarming” global progression of dengue.

“With a vast majority of cases in resource-scarce countries, the already vulnerable health systems are easily overwhelmed during dengue outbreaks with children significantly at risk of potentially fatal complications,” Comparet told SciDev.Net - a website dedicated to science and development in developing countries. 

With no current treatments available, further research to better understand and quantify the risks of progression to severe dengue in children “is both urgent and crucial,” she added.