The prevalence and correlates of post-infectious fatigue following dengue infection among adults admitted to two selected hospitals in Colombo District, Sri Lanka

Abstract

Introduction: Dengue illness, an acute viral infection, is endemic in Sri Lanka causing a substantial public health challenge today in all dimensions of health. Post-infectious fatigue (PIF) after dengue infection had been reported in several studies as well as in textbooks of medicine.Objectives: To describe the prevalence and correlates of PIF at one-month follow-up among adults confirmed with dengue infection admitted to selected healthcare institutions in Colombo District, Sri Lanka.Methods: A longitudinal study was conducted among 480 patients from July 2018 to January 2019. Participants were recruited on discharge from the hospital. We adopted systematic sampling method and followed them up one month after day 1 of the fever. Prevalence was assessed by the culturally adapted and validated Sinhala version of the Chalder Fatigue Questionnaire. Correlates were assessed by a pre-tested interviewer-administered questionnaire. A binomial multiple logistic regression analysis was carried out via the SPSS-21 version.Results: The response rate was 84.58 (406/480). The majority were between 18-35 years (69.2%) and male (60.15%). The prevalence of PIF at one month was 35% (95% CI: 30.3, 39.8). After controlling for confounders, age ≥35 years (adjusted OR (AOR)=4.05; 95% CI: 2.04, 8.04), not being married (AOR=2.7; 95% CI: 1.38, 5.28), having experience of stress full life events (AOR=1.98; 95%CI: 1.16, 3.36), not receiving an adequate quantity of sleep (AOR=2.51; 95% CI: 1.00, 6.31), poor quality of sleep (AOR=15.34; 95% CI: 3.25, 72.49), headache post-discharge (AOR=2.69; 95% CI: 1.6, 4.53), presence of myalgia post-discharge (AOR=3.63; 95% CI: 2.16, 6.11), haemoglobin <11 g/dl at acute stage (AOR=2.01; 95% CI: 1.02, 3.98) and having a platelet count ≤30,000/mm3 (AOR=2.38; 95% CI: 1.42, 3.99) showed significant associations with having PIF.Conclusions & Recommendations: Post-infectious fatigue was present among approximately one in three patients after one month following a dengue infection. The modifiable correlates suggest the indications for screening and prevention which is more applicable to clinicians.