Time analysis of dengue deaths that occurred in two regions of Peru during the climatic-atmospheric phenomena El Niño Costero and Cyclone Yaku

Abstract

ABSTRACT OBJECTIVE To perform a dengue-related death time analysis that occurred in Piura and Ica (Peru) during the atmospheric phenomena of El Niño Costero and Cyclone Yaku in 2023. MATERIAL AND METHODS A case-series study was performed. We included the deaths between January 1 and June 3, 2023. We reviewed the research data base of the deaths as well as the clinical epidemiology records, death certificates and laboratory test results. A time analysis was performed from the date of onset of symptoms, date of first visit at a health establishment, date that dengue diagnosis was first registered and date of death. RESULTS We included 40 deaths by dengue in the study. 70% were females, the median age of death was 51 years of age, and 70% came from Piura. 51.2% presented some comorbidity and 14% had self-medicated with metamizole, other NSAIDS or corticoids before the initial medical consultation. 37.5% presented an unconventional clinical pattern at admission and dengue was not suspected in 40% during the initial assessment. The median time until the initial assessment, the diagnosis time, and the time from diagnosis until death were 3 days, 0 days, and 1 day, respectively. Adults presented a time until the initial assessment significantly greater than the other age groups (p=0.048), the diagnosis time was significantly less than those seen at the Health Department establishments and regional government establishments (MINSA/GORE) than in private establishments (p=0.014) and greater in pediatrics (p=0.018). The time from diagnosis until death was significantly less in those that self-medicated before the initial assessment (p=0.041). CONCLUSION The adults presented a significantly greater time until the initial assessment; the diagnosis time was less than those seen in MINSA/GORE establishments and greater in pediatrics, furthermore, the time from diagnosis until death was significantly less in those who self-medicated before the initial assessment. An important fraction of deaths presented comorbidities and an unconventional clinical pattern at admission, with dengue frequently not suspected during the initial assessment.