Impact of delayed medical consultation on dengue severity and mortality during the 2023 outbreak in Burkina Faso

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Résumé

Objectives: Burkina Faso has experienced successive dengue outbreaks since 2013. Although most dengue cases are mild, prompt medical care for patients presenting with warning signs is essential to prevent progression to life-threatening complications. This study aimed to identify factors associated with delayed consultation among patients diagnosed with dengue during the 2023 outbreak in Burkina Faso.
Methods: A cross-sectional study was conducted at the University Hospital Centre of Bogodogo from January to December 2023. Patients aged ≥15 years hospitalized for dengue, including both severe and non-severe cases, with a positive NS1 antigen and/or anti-dengue immunoglobulin M/immunoglobulin G rapid diagnostic test, were included. Delayed consultation was defined as presentation more than 3 days after the onset of symptoms. Warning signs and severe dengue were classified according to the World Health Organization 2009 criteria.
Analyses were conducted using SPSS software, version 22.
Results: Among the 332 patients, the median age was 35 years (interquartile range, 25-49); 50.9% were male, and
95.5% resided in urban areas. Regarding the timing of presentation, 32.2% consulted within 3 days of symptom onset, whereas 67.8% presented after 3 days. Fever (98.2%), myalgia (91.3%), and headache (74.7%) were the most frequent symptoms. In the bivariate analysis, delayed consultation (>3 days) was significantly associated with several severe complications, including hypoxia, respiratory distress, hemorrhagic signs, severe acute kidney injury, elevated transaminase levels, and thrombocytopenia (all P < 0.05). Delayed consultation was also associated with a higher risk of death (odds ratio = 2.87; 95% confidence interval, 1.49-5.51; P = 0.003). In the multivariate analysis, delayed consultation remained independently associated with death (adjusted odds ratio = 2.99; 95% confidence interval, 1.54-5.80; P = 0.01)
Conclusion: Delayed consultation was associated with severe dengue and poor outcomes, emphasizing the importance of early care-seeking and public awareness

Mots-clés

Dengue Delayed consultation Outbreak Burkina Faso