A Retrospective Analysis of the Significance of Haemoglobin SS and SC in Disease Outcome in Patients With Sickle Cell Disease and Dengue Fever

doi:10.1016/j.ebiom.2015.07.002

EBioMedicine

Volume 2, Issue 8, August 2015, Pages 937-941

https://doi.org/10.1016/j.ebiom.2015.07.002 Get rights and content

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Highlights

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Dengue Fever case fatality ratio was 12.5%( p < 0.0001) in persons with Sickle Cell Disease.
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The odds of dying from dengue and SC disease was 4.4 (95% CI 0.6 to 31.7).

Abstract

Background

Little is known about the significance of haemoglobin genotype in dengue fever severity. This study was undertaken to determine the case fatality ratio and the impact of genotype in patients with sickle cell disease and confirmed dengue fever.

Methods

This retrospective analysis included 40 patients with confirmed dengue and sickle cell disease, during the study period (2010–2012).

Findings

There was a significantly higher case fatality ratio, 12.5% among patients with either haemoglobin SC disease or homozygous SS disease when compared to that of the general population 0.41% (p < 0.0001). The unadjusted odds of dying among those with haemoglobin SC disease compared with the group with homozygous SS disease was OR = 4.4 (95% CI 0.6 to 31.7). The predictors of mortality independent of sickle cell disease genotype were haemoglobin concentration at presentation OR = 0.57 (95% CI, 0.35 to 0.94) and the change in haemoglobin concentration from steady state OR = 0.59 (95% CI, 0.37 to 0.94). Adjusting for haemoglobin concentration at presentation increased the risk of death for the SC genotype relative to SS genotype OR = 13.4 (95% CI 1.1 to 160.3).

Interpretation

The risk of fatal dengue may be higher among patients with a relatively mild genotype (haemoglobin SC).

Keywords

Dengue

Sickle

Cited by (0)

^☆: Research in context: Jamaica, like many other countries with a high burden of Sickle Cell Disease (SCD) also suffers from epidemics of dengue fever. The two most common types of SCD are homozygous haemoglobin SS (HbSS) and haemoglobin C (HbSC) disease. SCD has been observed to be a risk factor for fatal dengue. This study adds to literature as we observed that the less severe disease, HbSC, may be associated with a higher risk of death from dengue fever. There are currently no vaccines for dengue fever. Hence determining risk factors will inform public health campaigns aimed at risk reduction.

^☆☆: Funding: No funding organizations involved.