Are the rise in childhood obesity rates leading an increase in hospitalizations due to dengue?

BackgroundObesity and diabetes are known risk factors for severe dengue. The prevalence of obesity has markedly increased in many dengue endemic countries and the association of obesity with increased risk of hospitalization has not been previously been studied. Methods and findingsChildren aged 10 to 20 years (n=5207), were recruited from nine districts in Sri Lanka using a stratified multi-stage cluster sampling method. Details of previous admissions to hospital due to dengue and anthropometric measurements were recorded and seropositivity rates for dengue were assessed. The body mass index centile (BMI) in children aged 10 to 18, was derived by plotting the values on the WHO BMI-for-age growth charts, to acquire the percentile ranking. For participants aged >18 years of age, BMI was calculated and interpretated as for adults and a BMI of > 23.9 kg/m2 were considered as obese. Although the dengue seropositivity rates were similar in children of the different BMI centiles, 12/66 (18.2%) seropositive children with BMI centile >97th, had been hospitalized for dengue, compared to 103/1086 (9.48%) of children with a BMI centile of <97th. Therefore, those with a BMI centile of >97th, were twice as likely (odds ratio 2.1, 95% CI, 1.1 to 3.9, p=0.03) to have been hospitalized for dengue compared to children with a lower BMI. In those >18 years of age, obese individuals were again significantly more likely to have been hospitalized compared to leaner individuals (odds ratio 2.6, 95% CI, 1.0 to 6.1, p=0.04). ConclusionsObesity appears to increase the risk of hospitalization in those with dengue, highlighting the importance of creating awareness regarding obesity and risk of severe disease and hospitalization in dengue endemic countries.