The impact of dengue on women
By Meera Murugesan
FOR Hawiah Azit, her battle with severe dengue when she was in her 20s was one of the most traumatic experiences of her life.
"It started with just a fever, then a severe headache for a few days. My parents took me to a clinic near my house and I was only prescribed paracetamol, without any further tests," recalls Hawiah, who's now 45.
She was then just 22 years old and knew little about dengue, so she just took the paracetamol given, drank lots of water and hoped it would pass.
Despite feeling very sick, she travelled to her hometown for a wedding, where her condition worsened and she was eventually diagnosed with dengue at a nearby hospital.
"By then, I was bleeding from my nose and gums, and I collapsed in the bathroom. When they transferred me to the hospital, I couldn't even climb onto the bed by myself. My blood platelet levels kept dropping. I had a terrible headache and was shivering so badly I thought I was going to die."
The days that followed were agonising. She kept bleeding. When she drank water, she could see blood in the water bottle and taste it in her saliva. "After two weeks, I was exhausted — physically and emotionally."
Even after discharge, it was a long time before she regained her strength and appetite.
She used to play volleyball and work out on weekends but having severe dengue changed all that. She could barely eat and felt drained for weeks.
"Now, as a mother and wife, I am constantly worried for my family. I have a 15-year-old daughter, and my husband is a high-risk individual with comorbid conditions, and he has already suffered dengue twice," says Hawiah.
Her experience, she adds, has made her realise the importance of dengue prevention, including dengue vaccination and having adequate knowledge of this infection which plagues Malaysians.
Dengue fever remains a major public health concern in Malaysia, with thousands of cases reported annually. In 2024 alone, there were 122,423 cases and 117 deaths, continuing the upward trend in fatalities since 2021, according to Health Ministry data.
The country's tropical climate and rapid urbanisation create ideal breeding conditions for mosquitoes, contributing to dengue's persistence and placing individuals at constant risk of infection.
While dengue affects both men and women, emerging insights reveal that women may bear a disproportionate burden of the disease — not just physically, but also socially and economically.
Women are more likely to develop severe dengue and dengue haemorrhagic fever due to physiological factors, says consultant paediatrician Dr Hon Mun Cheng.
"Their immune system tends to mount a stronger response to the virus, leading to higher viral loads and increased inflammation," she adds.
"Women also have lower blood volume, which makes them more susceptible to hypovolemic shock, a dangerous complication of severe dengue."
Dr Hon also highlights the role of capillary leakage in dengue severity among women.
As women's blood vessels naturally allow more fluid to pass through their walls, they are more prone to bruising and internal bleeding. This is especially concerning for women who contract severe dengue while menstruating, as they are at risk of excessive bleeding, alongside other symptoms such as abdominal pain, persistent vomiting, mucosal bleeding such as gum and nose bleeds, and plasma leakage.
These factors significantly increase the risk of severe complications, requiring close medical monitoring, especially in women with low platelet counts or anaemia — conditions that are more common in women than in men.
Dr Hon says pregnant women face an even greater risk from dengue which can have serious consequences for both mother and child.
Dengue during pregnancy can lead to low birth weight, premature birth, stillbirth and an increased risk of maternal death.
The virus can also be transmitted to the baby in the womb, potentially causing severe dengue with haemorrhagic symptoms in the baby.
Aside from the physiological risks, women often carry a heavier social and emotional burden when it comes to dengue.
As primary caregivers in many households, women are responsible for looking after children, elderly parents and sick family members.
However, when they themselves fall ill, they may have limited support or feel compelled to downplay their symptoms to continue their caregiving responsibilities.
"Delaying care can come at a high personal cost as dengue progresses rapidly, and without timely intervention, complications can become life-threatening," says Dr Hon.
The situation can become even more challenging if access to healthcare services is limited by financial constraints, lack of childcare options and other socio-economic factors.
Women from low income groups may lack the means to seek treatment while those in informal employment may face financial difficulties if they are unable to work. This may cause women to delay medical attention, choosing instead to prioritise their families over their own health.
These interconnected factors create a cycle where women are more vulnerable to severe dengue outcomes simply because they struggle to prioritise their health.
Source : health-impact-dengue-women
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