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Khattak A, Khan S, Ali I, Gul A, Khabir MN, Javed B, Adnan M, Khan SN, Attaullah S. Burden and distribution of dengue infection in Pakistan (2000-19): a review. BRAZ J BIOL 2023; 84:e267982. [PMID: 37075435 DOI: 10.1590/1519-6984.267982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/22/2023] [Indexed: 04/21/2023] Open
Abstract
The goal of this study is to review the overall prevalence, burden, and distribution of the dengue disease in Pakistan from 2000 to 2019. Literature was searched using different search engines like Google scholar, PubMed, etc. providing the keywords "Dengue disease/infection, Dengue virus, DENV, DF/DHF/ DSS Pakistan". All the published research papers/reports on the dengue virus over the period 2000 to 2019 were studied and selected data were summarized using MS Excel for windows such as total cases, age wise, gender, DENV serotype distribution, total DHF, and DSS patients. The literature providing insufficient data was excluded. The total number of cases reported during 2000-19 were 201,269. The maximum number of cases during the mentioned literature survey period was reported in Khyber Pakhtunkhwa (KP) (23.3%) followed by Punjab (3.8%) and Sindh (1.9%). The majority of dengue-infected cases were reported as Dengue fever (74.4%) followed by DHF (24.1%) and DSS (1.5%). Overall the deaths during the mentioned literature survey were 1082, of which the maximum mortalities were reported from KP (N=248) followed by Punjab (N=220). DENV remains a major public health problem in Pakistan and seems to remain endemic for a long time. The total prevalence of dengue infection is increased accordingly with time from 2000 to 2019. Moreover, all the four serotypes exist in Pakistan with increased mortalities.
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Affiliation(s)
- A Khattak
- University of Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S Khan
- University of Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - I Ali
- Gulf University for Science and Technology, Center for Applied Mathematics and Bioinformatics, Mubarak Al-Abdullah, Kuwait
- COMSATS University, Department of Biosciences, Islamabad, Pakistan
| | - A Gul
- University of Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - M N Khabir
- University of Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - B Javed
- University of Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - M Adnan
- University of Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S N Khan
- Kohat University of Science and Technology, Department of Zoology, Kohat, Pakistan
| | - S Attaullah
- Islamia College Peshawar, Department of Zoology, Peshawar, Pakistan
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Padhi A, Gupta E, Singh G, Parveen S, Islam A, Tarai B. Circulation of DENV-3 Genotype 3 during 2017 to 2018 in Delhi: A Single-Center Hospital-Based Study. J Lab Physicians 2021; 14:21-26. [PMID: 36186256 PMCID: PMC9519262 DOI: 10.1055/s-0041-1734017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction
Delhi is hyperendemic for dengue virus (DENV) where all the four DENV have previously been reported. A constant vigilance of circulating DENV serotypes is important in surveillance, since the introduction of a new variant to areas affected by preexisting serotypes constitutes a risk factor for dengue hemorrhagic fever and dengue shock syndrome.
Objectives
This retrospective study was performed with an objective to determine the circulating serotype and genotype of DENV in acute phase blood samples of patients who have reported to a tertiary liver care hospital in New Delhi during the last 2 years (2017–2018).
Methods
The data of clinician-initiated testing for dengue nonstructural protein 1 (NS1) antigen (Ag) was searched in the institutional hospital information system. The serum sample of dengue NS1 Ag-positive cases confirmed by enzyme-linked immunosorbent assay (ELISA; PANBIO, Gyeonggi-do, ROK) and a fever duration of less than 5 days were retrieved from the laboratory archive. The DENV serotyping on these sample was performed by reverse transcriptase polymerase chain reaction (RT-PCR). Sequencing and phylogenetic analysis was done for the capsid premembrane (CprM) region to determine the genotype.
Results
A total of 440 acute-phase samples were received. Twenty one (4.77%) were positive for dengue NS1 Ag with a mean age of 35.1 years and male-to-female ratio of 1.1:1. Eight cases (38.09%) were positive by dengue RT-PCR and all belonged to DENV-3 serotypes. Phylogenetic tree analysis revealed DENV-3 clustered to genotype III with 100% homology with 2008 Indian subcontinent strain.
Conclusion
This study revealed circulation of DENV-3, genotype III in Delhi from 2017 to 2018, similar to the 2008 viral type. Virological surveillance is an important exercise to be done for viral infections with public threat and outbreak potential.
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Affiliation(s)
- Abhishek Padhi
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, Delhi, India
| | - Ekta Gupta
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, Delhi, India
| | - Gaurav Singh
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, Delhi, India
| | - Shama Parveen
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi, Delhi, India
| | - Arshi Islam
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi, Delhi, India
| | - Bansidhar Tarai
- Department of Microbiology and Infection Control, Max Superspeciality Hospital, New Delhi, Delhi, India
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Amir M, Hussain A, Asif M, Ahmed S, Alam H, Moga MA, Cocuz ME, Marceanu L, Blidaru A. Full-Length Genome and Partial Viral Genes Phylogenetic and Geographical Analysis of Dengue Serotype 3 Isolates. Microorganisms 2021; 9:microorganisms9020323. [PMID: 33557307 PMCID: PMC7915001 DOI: 10.3390/microorganisms9020323] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 11/16/2022] Open
Abstract
Dengue fever is among the most common vector-borne diseases. Dengue virus (DENV), responsible for dengue fever as well as dengue hemorrhagic fever, belongs to the genus flavivirus and family Flaviviridae. Flaviviruses infect various vertebrate species and arthropods and are also responsible for diseases in birds, wild animals, and primates. DENV consists of a single-stranded, positive-sense RNA genome ~11 kb in size. Complete genome and partial gene sequences of geographically distinct DENV-3 strains were retrieved from the GenBank database. The evolutionary divergence of the 33 whole-genome and individual gene sequences of the nucleotides and amino acids of DENV-3 strains were generated with the maximum likelihood (ML) and Bayesian phylogenetic study (BEAST) methods using the MEGA 7 software. The genome size varied from 10,484 to 10,724 nucleotides among the strains with distinct geographical backgrounds belonging to Central America, South-Central Asia, and Eastern Asia. A phylogenetic analysis of the nucleotide and amino acid sequences of these DENV-3 isolates revealed extensive differences in the topologies due to PrM/M, NS1, NS2B, and NS3 genes. These results suggest substantial variation in the evolutionary pathways of the studied genes and genomes.
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Affiliation(s)
- Muhammad Amir
- Department of Biotechnology, BUITEMS, Baluchistan University of Information & Technology, Engineering and Management Sciences (BUITEMS), Quetta 87300, Pakistan; (M.A.); (A.H.); (M.A.)
| | - Abrar Hussain
- Department of Biotechnology, BUITEMS, Baluchistan University of Information & Technology, Engineering and Management Sciences (BUITEMS), Quetta 87300, Pakistan; (M.A.); (A.H.); (M.A.)
| | - Muhammad Asif
- Department of Biotechnology, BUITEMS, Baluchistan University of Information & Technology, Engineering and Management Sciences (BUITEMS), Quetta 87300, Pakistan; (M.A.); (A.H.); (M.A.)
- Office of Research Innovation and Commercialization, Baluchistan University of Information & Technology, Engineering and Management Sciences (BUITEMS), Quetta 87300, Pakistan
| | - Sagheer Ahmed
- Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad 44000, Pakistan;
| | - Hina Alam
- Pakistan Institute of Medical Sciences, Islamabad 44000, Pakistan;
| | | | - Maria Elena Cocuz
- Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania;
- Correspondence: (M.E.C.); (L.M.)
| | - Luigi Marceanu
- Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania;
- Correspondence: (M.E.C.); (L.M.)
| | - Alexandru Blidaru
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila, 020021 Bucharest, Romania;
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Anwar F, Tayyab M, Salman M, Abdullah, Din M, Khan J, Haq I. Dengue outbreak 2018 in district Shangla KPK; clinical features and laboratory markers of dengue virus infection. Future Virol 2020. [DOI: 10.2217/fvl-2019-0130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Aim: To analyze and quantify the 2018 dengue outbreak which occurred in district Shangla, Pakistan. Materials & methods: 964 suspected dengue samples were collected and examined for clinical manifestation and laboratory markers. Results: In all, 375 suspected cases were confirmed with dengue virus infection using nonstructural protein 1 (NS1) antigen, immunoglobulin M (IgM) & Immunoglobulin G (IgG) antibodies and real-time PCR whereas PCR was 92.2% sensitive. The most prevalent serotype was dengue virus 3 (60.26%). The male/female ratio was 1.84 and the most highly affected tehsil was Alpuri. The most affected age group was 16–40 years (70.4%). A significant number of cases were reported in September (48.54%). Conclusion: Recurrence of the dengue outbreaks in the study area could alarmingly increase the mortality rate, therefore, proper measures are essential to control dengue epidemics in the future.
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Affiliation(s)
- Faheem Anwar
- Department of Genetics, Hazara University, Mansehra Pakistan
| | - Muhammad Tayyab
- Institute of Biotechnology & Genetic Engineering (IBGE), The University of Agriculture, Peshawar, Pakistan
- Author for correspondence:
| | - Muhammad Salman
- Department of Microbiology & Biotechnology, Abasyn University, Peshawar, Pakistan
| | - Abdullah
- Department of Microbiology & Biotechnology, Abasyn University, Peshawar, Pakistan
| | - Misbahud Din
- Department of Biotechnology, Quaid-I-Azam University, Islamabad, Pakistan
| | - Jawad Khan
- Department of Genetics, Hazara University, Mansehra Pakistan
| | - Ihteshamul Haq
- Graduate School of Biotechnology & Oriental Medicine Kyunghee University, Suwon, South Korea
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Abdullah, Ali S, Salman M, Din M, Khan K, Ahmad M, Khan FH, Arif M. Dengue Outbreaks in Khyber Pakhtunkhwa (KPK), Pakistan in 2017: An Integrated Disease Surveillance and Response System (IDSRS)-Based Report. Pol J Microbiol 2019; 68:115-119. [PMID: 31050259 PMCID: PMC7256837 DOI: 10.21307/pjm-2019-013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2018] [Indexed: 12/26/2022] Open
Abstract
The current study is a retrospective epidemic report regarding dengue fever (DF) virus infection cases (2017) from fifteen districts of KPK, Pakistan. Medical records of 120 948 patients were reviewed retrospectively for demographic, clinical and laboratory data. The presence of dengue infection was confirmed by NS1-ELISA and RT-PCR, respectively. The total positive cases (of suspected DF samples) were 24 938 (20.6%), whereas seventy cases (0.28%) had a fatal outcome. Mean age ± SD of the dengue patients was 26 ± 19.8 years, while; the most affected age group was from 16 to 30 years (Chi-square: 12 820.125, p: 0.00). The infected males were 65.3%, and that of the female was 34.7%. All the dengue-infected patients were observed with symptoms of severe fever (100%), body aches (95%), gums and nose bleeding (5%), skin rashes (30%), vomiting (70%). The highest infection rate was found in district Peshawar and that of the lowest was in Bannu, Hungu and Luki Marwat. A high rate of dengue infection was found in post-monsoon months i.e. October (41%) and September (32%) of the year. The results proved that if the dengue outbreaks reveal further in KPK, it could alarmingly increase the mortality rate. Therefore, the Department of Public Health in KPK, Pakistan may take proper measures to avoid and control dengue epidemics in the future.
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Affiliation(s)
- Abdullah
- Department of Biotechnology, Abdul Wali University , Mardan , Pakistan
| | - Sher Ali
- Universidade Federal do Paraná Brazil, Department of Chemistry , Parana , Brazil
| | - Muhammad Salman
- Department of Microbiology and Biotechnology, Abasyn University Peshawar , Pakistan
| | - Misbahud Din
- Department of Biotechnology, Abdul Wali University , Mardan , Pakistan
| | - Kachkol Khan
- Tehsil Head Quarter Hospital Dargai , Malakand , Pakistan
| | - Munib Ahmad
- Department of Biotechnology, Abdul Wali University , Mardan , Pakistan
| | - Faisal Hayat Khan
- Department of Biotechnology, Abdul Wali University , Mardan , Pakistan
| | - Muhammad Arif
- Department of Biotechnology, Abdul Wali University , Mardan , Pakistan
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Parveen N, Islam A, Tazeen A, Hisamuddin M, Abdullah M, Naqvi IH, Faizan MI, Gulyani D, Ahmed A, Parveen S. Circulation of single serotype of Dengue Virus (DENV-3) in New Delhi, India during 2016: A change in the epidemiological trend. J Infect Public Health 2019; 12:49-56. [DOI: 10.1016/j.jiph.2018.08.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 07/20/2018] [Accepted: 08/27/2018] [Indexed: 11/29/2022] Open
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Antivirus effectiveness of ivermectin on dengue virus type 2 in Aedes albopictus. PLoS Negl Trop Dis 2018; 12:e0006934. [PMID: 30452439 PMCID: PMC6277121 DOI: 10.1371/journal.pntd.0006934] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 12/03/2018] [Accepted: 10/18/2018] [Indexed: 12/27/2022] Open
Abstract
Background Dengue fever is the most rapidly spreading mosquito-borne viral disease over the past 50 years, with a 30-fold increase in global incidence. Dengue vector control is a key component for the dengue control strategy, since no absolutely effective vaccine or drug is available yet. However, the rapid rise and spread of mosquito insecticide resistance have become major threats to the efficiency of insecticide-based vector control activities. Thus, innovative vector control tools are badly needed. This study aims to confirm the antivirus effectiveness of ivermectin on dengue virus type 2 (DENV-2) in Aedes albopictus (Skuse, 1894), then to explore its potential use in the combating to the dengue epidemics. Methods Aedes albopictus were first infected with DENV-2 in human whole blood, and at the fourth day after infectious blood feeding, they were divided into eight groups. Seven of them were held for six days with access to 0, 2, 4, 8, 16, 32 and 64 ng/ml ivermectin, respectively, and the last one was set as a historical control group, which was stored at -80°C until being detected at the same time with the other groups. Each mosquito was detected using real-time fluorescent RT-PCR kit. DENV-2 RNA concentration (copies/ml) and infection rate in each group were compared. Results Both of quantitatively and qualitatively inhibiting effects of ivermectin have been detected in this study. Generally, DENV-2 replicated well in Aedes albopictus without ivermectin intervention, whose virus loads exhibited significantly higher when the mosquitoes were holding from 4 days to 10 days after infectious blood feeding. In contrast, with the treatment of ivermectin, the infection rate was reduced by as much as 49.63%. The regression equation between infection rates (Y2) and ivermectin concentration log2 values (X2) was obtained as Y2 = 91.41–7.21*X2 with R2 = 0.89. Conclusion Ivermectin can directly or indirectly inhibit DENV-2 multiplication in Aedes albopictus. Moreover, the actual concentration for application in zooprophylaxis needs to be confirmed in the further field trials. Dengue fever is one of neglected vector-borne tropical diseases with a 30-fold increase in global incidence recently. In 2012, World Health Organization set a goal to reduce dengue mortality by at least 50% by 2020. Being faced with more challenges in the dengue control programs, such as the increase of dengue outbreaks, lacking absolutely effective vaccine, rise of vector insecticide resistance and so on; innovative vector control tools are urgently needed for current control programs on dengue fever. To find a new avenue in vector control, we for the first time assessed the inhibiting effectiveness of ivermectin on dengue virus type 2 (DENV-2) inside Aedes mosquitoes. We found that about 80% Aedes albopictus mosquitoes were effectively infected with DENV-2 without treatment of ivermectin. But in the groups of ivermectin treatment, the infection rate of DENV-2 and the median of virus loads were significantly reduced by up to 49.63% and 99.99%, respectively. Both quantitatively and qualitatively inhibiting effects of ivermectin were detected. We found out that ivermectin was able to effectively inhibit the DENV-2 multiplication in Aedes albopictus, which may gave us a hint that using ivermectin in some control programs as a zooprophylaxis to block dengue epidemic through inhibiting DENV-2 in field Aedes mosquitoes.
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Khan J, Khan I, Ghaffar A, Khalid B. Epidemiological trends and risk factors associated with dengue disease in Pakistan (1980-2014): a systematic literature search and analysis. BMC Public Health 2018; 18:745. [PMID: 29907109 PMCID: PMC6003098 DOI: 10.1186/s12889-018-5676-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/05/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Dengue is becoming more common in Pakistan with its alarming spreading rate. A historical review needs to be carried out to find the root causes of dengue dynamics, the factors responsible for its spread and lastly to formulate future strategies for its control. METHODS We searched (January, 2015) all the published literature between 1980 and 2014 to determine spread/burden of dengue disease in Pakistan. RESULTS A total of 81 reports were identified, showing high numbers of dengue cases in 2010, 2011, and 2013. The tendency of dengue to occur in younger than in older age groups was evident throughout the survey period and all four serotypes were recorded, with DENV1 the least common. Most dengue hemorrhagic fever (DHF) cases fell in the 20-45 years age range. High frequencies tended to be observed first in the Southern coastal region characterized by mild winters and humid warm summers and then the disease progressed towards the lowland areas of the Indus plain with cool winters, hot summers and monsoon rainfall. Based on this survey, new risk maps and infection estimates were identified reflecting public health burden imposed by dengue at the national level. CONCLUSIONS Our study showed that dengue is common in the three provinces of Pakistan, i.e., Khyber Pakhtunkhwa (KP), Punjab and Sindh. Based on the literature review as well as on our study analysis the current expansion of dengue seems multifactorial and may include climate change, virus evolution, and societal factors such as rapid urbanization, population growth and development, socioeconomic factors, as well as global travel and trade. Due to inadequate remedial strategies, effective vector control measures are essential to target the dengue vector mosquito where high levels of human-vector contact occur. The known social, economic, and disease burden of dengue is alarming globally and it is evident that the wider impact of this disease is grossly underestimated. An international multi-sectoral response, outlined in the WHO Global Strategy for Dengue Prevention and Control, 2012-2020, is now essential to reduce the significant influence of this disease in Dengue endemic areas. Overall gaps were identified in knowledge around seroprevalence, dengue incidence, vector control, genotype evolution and age-stratified serotype circulation.
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Affiliation(s)
- Jehangir Khan
- Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 Guangdong China
- Sun Yat-sen University-Michigan State University Joint Center of Vector Control for Tropical Diseases, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080 Guangdong China
- Department of Zoology, Abdul Wali Khan University Mardan (AWKUM), Mardan, Khyber Pakhtunkhwa Pakistan
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, 510080 China
| | - Inamullah Khan
- Nuclear Institute for Food and Agriculture (NIFA), Peshawar, Khyber Pakhtunkhwa Pakistan
| | - Abdul Ghaffar
- Department of Meteorology, COMSATS University (CUI), Islamabad, Pakistan
| | - Bushra Khalid
- Evolution and Ecology Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
- Earth System Physics, The Abdus Salam, International Centre for Theoretical Physics, Trieste, Italy
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Khan J, Ghaffar A, Khan SA. The changing epidemiological pattern of Dengue in Swat, Khyber Pakhtunkhwa. PLoS One 2018; 13:e0195706. [PMID: 29689060 PMCID: PMC5916521 DOI: 10.1371/journal.pone.0195706] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 03/28/2018] [Indexed: 11/18/2022] Open
Abstract
Background Pakistan is suffering from dengue fever since 1994. In the country, major dengue outbreaks have been documented in 2010, 2011 and 2013 in Punjab (Lahore) and Sindh (Karachi) Provinces. District Swat was hit for the first time by dengue virus in 2013, claiming 57 deaths and 8000 morbidities. The molecular and entomological aspects along with the ecological and social context of the dengue outbreaks were investigated in this study. Method In addition to entomological survey, the data collected from patients' files (Saidu Sharif Teaching Hospital, Swat) and by directly questioning the patients (field data) was analyzed for epidemiological trends, molecular identification (RT-PCR based serotyping of DENV), clinical profile, socioeconomic status (SES) and demographic features. Results The peak prevalence of dengue was documented in September (56% in 2013, 38% in 2014) and October (33% in 2013, 24% in 2014), whereas in 2015, in October (54.5%) and November (30.5%). The serotype 3 (≤60%) and serotype 2 (≤40%) were found dominant in the area. Among the reported patients (5513), 69% were males and 31% females. Majority of them were found in the age of 14–30 years (52.5%) as compared to 31–60 years (34.5%) (Chi-square: 3219.463, p-value: 0.00). About 63% cases reported in low SES. Among the different categories of government employees affected with dengue, majority (4%) were belonging to health department (Chi-square: 4541.011, p-value: 0.00). Similarly, dengue targeted the dwellers living in multiple-storey houses (65%) as compared to those in the single-storeyed houses (35%) (Chi-square: 495.630, p-value: 0.00). The overall death toll observed was of 57 persons. Dengue prevailed more (38.4%) among low qualified individuals as compared to high qualified (11.5%) (Chi-square: 884.315, p-value: 0.00). Conclusion Our analysis indicated a decrease in the epidemiological trend of dengue (now) in the area, though initially it was observed affecting all types of communities on a larger scale. However, the DENV-2 and DENV-3 were dominantly circulating in the area and the prevalence (with usual peaks in post-monsoon) found high in males, illiterate (less educated) individuals and in those with low SES. Urbanization, infected human travelling, climate change, socioeconomic, sociodemographic as well as the wide range adaptation of vector mosquitoes, altogether, are the important factors playing role in the expansion of dengue. Further studies are needed to determine the association of these variables with the dengue spread in the area.
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Affiliation(s)
- Jehangir Khan
- Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
- Sun Yat-sen University-Michigan State University Joint Center of Vector Control for Tropical Diseases, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
- Department of Zoology, Abdul Wali Khan University Mardan (AWKUM), Khyber Pakhtunkhwa, Pakistan
- * E-mail:
| | - Abdul Ghaffar
- Department of Meteorology, COMSATS Institute of Information Technology Islamabad, Islamabad, Pakistan
| | - Shujaat Ali Khan
- Department of Biotechnology & Bioinformatics, Islamic International University Islamabad, Pakistan
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