Time analysis of dengue-related deaths that occurred in two regions of Peru during the climatic-atmospheric phenomena El Niño Costero and Cyclone Yaku

Background: This study analyzed the time of dengue-related deaths in two regions of Peru during the atmospheric phenomena of El Niño Costero and Cyclone Yaku, which caused the largest dengue epidemic ever registered in Peru at that time. Methods: We included 40 dengue-related deaths between January 1 and June 3, 2023. A death was considered to be dengue-related if it occurred as a consequence of the clinical signs or the clinical evolution of dengue during the medical care process, or in which dengue significantly contributed to the clinical worsening of another disease. We reviewed the research database of the deaths as well as the clinical epidemiology records, death certificates, and laboratory test results. A time analysis was performed from the date of onset of symptoms, the date of the first visit to a health establishment, the date the dengue diagnosis was first registered, and the date of death. Results: The median age of death was 51 years, 51.2% had at least one comorbidity, and 14% had self-medicated. The median times from symptom onset to first consultation, diagnosis and from diagnosis to death were 3, 0, and 1 day, respectively. Adults presented a time from symptom onset to first consultation that was significantly greater than that of the other age groups (p = 0.048). The diagnosis time was significantly less than that seen at regional government (GORE) public establishments compared to private establishments (p = 0.014) and greater in pediatrics (p = 0.018). The time from diagnosis until death was significantly less in those who self-medicated (p = 0.041). Conclusion: Several factors significantly influenced time from symptom onset to first consultation, diagnosis time, and diagnosis-to-death time in dengue-related deaths during the FENC epidemic and Cyclone Yaku in 2023. These factors should be analyzed to reduce mortality in Peru during future climate-related epidemics.