Clinical characteristics and outcomes among patients admitted with Viral Hemorrhagic Fever at Mbarara Regional Referral Hospital, Uganda

Background Viral hemorrhagic fevers (VHFs) such as Rift Valley Fever (RVF) and Crimean-Congo Hemorrhagic Fever (CCHF) pose serious public health concerns in endemic regions like Uganda, where outbreaks occur sporadically. Despite this, there is limited data on the clinical characteristics and outcomes of affected patients in rural settings. Methods This is a retrospective descriptive study of 36 patients with laboratory-confirmed VHF who were treated at the isolation unit of Mbarara Regional Referral Hospital in Southwestern Uganda during the outbreaks that occurred between 2018 and 2024. We extracted data on demographics, clinical presentation including laboratory parameters, complications and outcomes from patients’ files and analyzed using descriptive statistics. We used Welch’s t test- to describe the difference in length of hospital stay between the survivors and patients who succumbed to VHF. Results Of the 36 patients included, 88.9% (n=32) were male, with a median age of 35 (IQR: 28 – 42.5) years. 69.4% (n=25) of the patients interacted directly with animals or animal products in their occupations. The most common presenting symptoms included bleeding tendencies (28 [77.8%]), fever (23 [63.9%]) and vomiting (19 [52.8%]). The median duration of symptoms was 5 days (IQR: 4 – 7). Laboratory results revealed severe kidney impairment with a median creatinine of 10.3 mg/dl (IQR: 7.46 – 13), elevated AST of 1014 (IQR 173-2570) IU/L and ALT of 795.9 (IQR 233-1634) IU/L, prolonged INR (median 1.65 [IQR: 1.5 – 1.7]), hyperbilirubinemia (mean serum bilirubin 5.7 [SD 1.2]) and thrombocytopenia (median platelet count 43000 (IQR 16000 – 65000)). The overall case fatality rate was 41.7% (n=15) with mean time from admission to death of 2.40 [SD 2.75] days. There was a statistically significant difference in the mean length of hospital stay between the survivors and those who died in hospital (mean difference 15.07 days, 95% CI 11.57–18.57; p < 0.001). Conclusion In Southwestern Uganda, patients with VHFs present with severe illness, characterized by hemorrhagic, hepatic, and renal complications. The high case fatality rate indicates the need for early detection and comprehensive supportive care interventions, such as hemodialysis.