Understanding dengue mortality factors and nursing roles: insights from two Malaysian Government Hospitals

Introduction: Dengue, a mosquito-borne viral infection, imposes significant socio-economic and disease burdens on tropical and subtropical regions worldwide. Data provided by Malaysia’s Health Ministry indicate that the number of dengue cases in 2024 is exhibiting a steeper increase compared to the corresponding period last year. This study aims to identify factors contributing to dengue mortality in Malaysian government hospitals and assess nursing involvement in mortality prevention. Method: A retrospective study was conducted using a proforma. Electronic data and documented nursing care in the nursing report before the patient’s death were extracted and analysed for all dengue mortality cases. Results: Thirty-seven dengue mortality cases were identified, 28 from Hospital 1 and 9 from Hospital 2, respectively. Most patients were admitted during the critical phase (day 4 or 5), with rates of 67.8% and 88.9% in Hospitals 1 and 2, respectively. Mean hospital stays were 3.39 days (SD±1.62) in Hospital 1 and 4.56 days (SD±1.88) in Hospital 2. Among cases with comorbidities (53.6%), diabetes mellitus was most common in Hospital 1. Common clinical signs included myalgia, arthralgia, severe vomiting, and fever (78.6%). Dehydration and headache were documented in approximately 75.0% of cases in Hospital 1 and 66.7% and 77.8%, respectively, in Hospital 2. Nursing interventions primarily focused on hyperthermia reduction, with dehydration management being less common. Conclusion: Major factors contributing to dengue-related deaths in both hospitals include illness stage at admission, dengue severity/classification, and delayed hospital admission. Future efforts should prioritise assessing patients’ hydration status upon admission and continuous nursing assessment for early signs of dehydration.

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