More than 635,000 people were admitted to government hospitals in Bangladesh with fever, pneumonia and respiratory tract infections between the start of the year and September 24, amid continuing measles and dengue outbreaks, government data showed. Men outnumbered women among pneumonia and respiratory infection patients, while women accounted for a higher share of fever admissions.
Excluding measles, measles symptoms and dengue, 635,000-plus patients were admitted with the three illnesses during the period. The total included 327,000 men and 308,000 women.
Data from the Directorate General of Health Services showed that unspecified or common fever was the most prevalent type among fever cases reported nationwide.
Of around 395,000 fever patients, about 250,000 had unspecified fever. More than 130,000 people were admitted with fever of unknown origin, while 9,000 were hospitalised with specified fever and 842 with fever caused by drug side effects.
Women accounted for 52% of fever patients, or 206,464 cases, compared with 188,784 men, or 48%.
Doctors said female hormones, including oestrogen, can activate immune responses against viruses more rapidly, leading to stronger inflammation and fever symptoms. The pattern varies by age group.
The highest number of fever cases was reported among one-year-old children, with about 28,500 cases.
A total of 175,175 people were admitted to hospitals with pneumonia this year. The figure included 102,000 male patients and 73,000 female patients.
Men also outnumbered women in admissions for pneumonia caused by respiratory viruses, adenoviruses, parainfluenza viruses, and Streptococcus and Haemophilus bacteria.
Hospitals admitted 64,775 patients with respiratory tract infections this year, including 35,797 men, or about 55%, and 28,958 women.
Men were more numerous among patients with acute lower respiratory tract infections, acute bronchitis and acute nasal inflammation. Women, however, were more affected by acute inflammation of the tonsils.
Public health experts said the gender differences in fever, pneumonia and respiratory tract infections were consistent with international public health research and Bangladesh’s context.
Case-control studies by the United States Department of Health and Human Services’ Library of Medicine, the American Society for Microbiology and the Global Burden of Disease project have found that men are more likely to suffer from pneumonia and acute respiratory infections.
Experts cited biological and social factors. Men may be more susceptible to bacterial and viral infections because of average lung structure and biological characteristics of their immune systems. In Bangladesh, men are also more likely to be exposed to dust, public transport and air pollution caused by unplanned urbanisation while working outside. Higher smoking rates among men can directly reduce lung function and substantially increase pneumonia risk.
Public health experts also said higher male hospital admissions may reflect social patterns, as families often seek treatment more quickly when men fall ill, whereas women may receive medical care only after their condition becomes severe.
A 2024 study published in the German-British scientific journal Springer Nature found gender differences in healthcare-seeking behaviour in South Asia, including Bangladesh. Biological and social gender influences affect access to and use of healthcare, as well as healthcare quality and financing.
Senior public health specialist Dr Abu Jamil Faisal told Ajker Patrika: “There is no single reason why the number of male patients is higher in fever, pneumonia and respiratory tract infections. Greater exposure among men to air pollution, dust, workplace risks and smoking may be involved, while some biological differences in the immune system may also play a role. However, hospital admission data cannot determine the actual prevalence of diseases. Treatment-seeking behaviour and access to healthcare also affect such statistics.”
The Institute of Epidemiology, Disease Control and Research, or IEDCR, has also been monitoring the gender disparity. The government agency, which monitors and controls epidemic, communicable and non-communicable diseases and conducts related research, collected patient samples from 10 specialised government hospitals and analysed infection trends by age, gender and disease type.
IEDCR observations this year indicate the detection of respiratory syncytial virus, or RSV, among respiratory infection cases. RSV is a contagious respiratory virus that can infect the nose, throat and lungs and is particularly significant among children. The institute has also observed differences in infection patterns between men and women.
IEDCR Director Dr Kazi Ahmed Jaki told Ajker Patrika: “Whether it is influenza or RSV, we review it by age and gender. The first reason is that an infected person has come into contact with another infected person in some way. In cases of avian influenza or bird flu, there may have been contact with infected or dead birds, including domestic ducks, chickens or wild birds. The issue cannot be explained simply by saying that men are more affected by pneumonia or RTIs because they work outside.”
Hospitals have faced additional pressure this year due to dengue and an unprecedented measles outbreak.
More than 88,360 people had been admitted with dengue nationwide from the beginning of the year until Monday, while 271 people had died, according to Directorate General of Health Services statistics.
A review of dengue data from this year and previous years showed that men accounted for more hospital admissions, but women accounted for more deaths. In 2023, men made up 60.1% of dengue admissions, while women accounted for 57% of deaths.
The nationwide measles outbreak, which began in March, has also placed heavy pressure on hospitals. More than 219,000 people were identified with measles or measles symptoms between March 15 and October 5, and more than 175,000 of them were admitted to hospitals. Most of the more than 1,128 deaths were children.
Dr Ariful Basar, senior consultant in medicine at Dhaka Infectious Disease Hospital, said: “Multiple types of infections are now being found among patients arriving at hospitals with fever. As a result, treatment plans cannot be based on only one specific disease. Patients with different infections must be managed at the same time, particularly with pressure from paediatric patients. In this situation, it is important to monitor patients according to their physical condition and symptoms, conduct necessary tests and begin treatment quickly.”