Dengue has evolved into a major public health crisis in Bangladesh, transitioning from sporadic outbreaks to endemic transmission with increasing frequency and severity. The unprecedented 2023 epidemic recorded more deaths than the cumulative total of the previous two decades, highlighting the urgent need for a comprehensive synthesis of epidemiological trends and control challenges.
This narrative review synthesizes published literature, surveillance reports, and national health data from 2000 to 2024 to examine the evolving epidemiology, clinical characteristics, transmission dynamics, and public health responses related to dengue in Bangladesh.
Epidemiological analysis reveals a dramatic rise in incidence and mortality, with widespread geographic expansion beyond Dhaka into southern and rural districts and a shift toward earlier seasonal peaks. Serotype transitions, particularly the dominance of DENV-3 followed by DENV-2—likely intensified disease severity through secondary infections. High case fatality rates were observed among females and older adults, with a substantial proportion of deaths occurring within 24 h of hospitalization, suggesting critical gaps in care-seeking and clinical management. Transmission dynamics are shaped by interactions between Aedes vector ecology, climate change, rapid urbanization, human mobility, and extensive insecticide resistance to pyrethroids. Public health responses remain constrained by passive surveillance, limited vector control efficacy, healthcare system strain, and insufficient community engagement.
The dengue burden of Bangladesh underscores the need for integrated and adaptive control strategies. Strengthening multi-domain surveillance (epidemiological, entomological, genomic), implementing resistance-aware Integrated Vector Management incorporating novel approaches such as Wolbachia, enhancing healthcare readiness, promoting community-driven behavioral interventions, integrating climate adaptation measures, and advancing vaccine and therapeutic research within a One Health framework are critical for sustainable dengue prevention and control.