Systematic review on factors of mortality among dengue patients in Malaysia

Introduction: Malaysia has a high concentration of dengue cases. Even though the case fatality rate is low among dengue patients, identification of the risk factors of dengue mortality helps in the management of these patients. Findings from previous studies were inconclusive, thus, we systematically review studies to identify the factors of mortality among dengue patients in Malaysia. Methods: Three main search engines such as PubMed, ScienceDirect and EBSCO were used to screen the articles. This systematic review follows PRISMA guidelines. Results: The initial search yielded a total of 523 articles to be reviewed. However, after screening,  four articles were left with all of them being quantitative studies. From the four studies accepted, thirty-six factors were identified. The factors include age, gender, nausea, vomiting, bleeding, lethargy, body ache, abdominal pain, retro-orbital pain, dysuria, shock, pleural effusion, ascites, prolonged Prothrombin Time (PT), Haematocrit (HCT)>20%, Serum pH <7.35, Serum ferritin >10,000 ni/mL, serum creatinine, serum lactate >2, white blood cell (WBC) count, insulin dependant diabetes, ischemic cardiovascular disease and progressive renal disease. Conclusions: To conclude, age and bleeding were found as the most important health risk for Dengue patients and poses a great liability towards mortality among patients infected with dengue in Malaysia