Leukopenia and thrombocytopenia in dengue patients: a cross-sectional study from a tertiary hospitals in Koshi Province, Nepal
Abstract
Dengue fever remains a public health challenge in Nepal, with hematological abnormalities like leukopenia and thrombocytopenia often observed. However, their prevalence and clinical significance outside the Kathmandu Valley remain poorly characterized. This study examines these markers in Koshi Province, a region prone to recurrent outbreaks but with limited data, to enhance regional understanding and early severity detection. A cross-sectional study was conducted across four tertiary hospitals in Sunsari district, Koshi province of Nepal during the 2022 dengue outbreak. A convenience sample of 325 laboratory-confirmed dengue patients (NS1 antigen/IgM/IgG positivity) was enrolled. Data on demographics, clinical features, leukocytes count, and platelet counts were collected using Case Report Form (CRF). Hematological parameters (leukocyte count < 4,000 cells/mm³; and platelet count < 150,000 cells/mm³) were analyzed alongside clinical severity (WHO 2009 classification: DWWS, DWS, SD). Chi-square tests, adjusted residuals and logistic regression (adjusted for age and diabetes) were used to assess associations between these hematological markers and dengue severity. Additional analyses were performed to examine associations of leukopenia and thrombocytopenia with demographic characteristics (e.g., age, sex) and clinical symptoms (e.g., joint pain, rash, retro-orbital pain, nausea). Leukopenia was observed in 21.5% of patients, while thrombocytopenia occurred in 62.1%.…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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