A Retrospective Analysis of Dengue Cases in Suriname: Implications for Treatment and Prevention in a Lower Middle Income Country (LMIC)

Aims: To describe hospitalized dengue cases and characterize the hospitalization length and cost of dengue based on clinical and laboratory classification in a primary hospital in Paramaribo, Suriname.
Study Design: A retrospective study was conducted to identify patients at higher risk of dengue hemorrhagic fever (DHF) and to compare the length and cost of hospitalization by dengue classification and dengue severity.
Methodology: We analyzed 2800 dengue cases hospitalized between 2001 to 2012. All dengue cases were spatially visualized using a geographic information system (GIS).Dengue cases were stratified by demographic characteristics and classified as suspected, probable and confirmed. This classification was used to compare length and cost of hospitalization.
Results: The majority of hospitalized dengue cases, 50.1%, were ethnic Hindustani or Javansese (Southeast Asian descent). Dengue was laboratory confirmed in a 188 cases between 2001 and 2012. However, ethnicity is not associated with progression into DHF in hospitalized cases with a confirmed diagnosis of dengue. When comparing length of hospitalization, suspected dengue cases stayed on average longer hospitalized (7.81 days) than probable (6.65 days) and confirmed cases (6.29 days). In contrast, confirmed cases had the highest cost of hospitalization (3100 Surinamese dollars – SRD) compared to suspected (2766 SRD) and confirmed (2157 SRD) cases. Suspected and probable dengue fever cases had longer hospital stays compared to the more severe DHF. There is a difference in the length and cost of hospitalization among suspected, probable and confirmed dengue cases and dengue fever cases have longer hospitalization terms than DHF for suspected and probable cases.
Conclusion: This study contributed to the limited evidence of the demographic characteristics and the economic burden of dengue in Suriname. There is a need to standardize and increase diagnosis capabilities to improve surveillance and treatment of dengue while reducing hospitalization costs in Suriname.