Seroepidemiology of dengue fever in Khyber Pakhtunkhawa, Pakistan

Ali, Amjad; Rehman, Habib ur; Nisar, Muhammad; Rafique, Shazia; Ali, Sádia; Hussain, Abrar; Nausheen,; Idrees, Muhammad; Sabri, Sabeen; Zada, Hakeem; Hussain, Sayed

doi:10.1016/j.ijid.2013.01.007

Cited by 49 publications

(45 citation statements)

References 24 publications

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“…The study population consisted of more males than females and is consistent with the studies done elsewhere and in Sri Lanka [Gupta et al, ; Messer et al, ; Ali et al, ]. In Sri Lanka, hospitalized patients reference to DENV infections, show males seeking hospital treatment whereas females seek care from traditional practitioners and are less likely to present to hospitals due to factors such as family commitments [Guha‐Sapir and Schimmer, ].…”

Section: Discussionsupporting

confidence: 77%

Characterization of dengue virus infections in a sample of patients suggests unique clinical, immunological, and virological profiles that impact on the diagnosis of dengue and dengue hemorrhagic fever

Senaratne

Wimalaratne

Alahakoon

et al. 2016

Journal of Medical Virology

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Dengue virus (DENV) infections are increasing with respect to incidence and severity in the Central Province of Sri Lanka. The objective of this study was to define the clinical, immunological, and virological profiles of patients admitted to the General Hospital, Kandy with clinically apparent dengue. Demographic, clinical, hematological parameters, liver enzymes (ALT and AST), and blood samples were collected from 292 patients with fever <5 days post onset and fulfilling the WHO criteria for the diagnosis of dengue fever/dengue hemorrhagic fever (DF/DHF). Samples were analyzed for, anti-DENV IgM, IgG, and DENV nucleic acid. Myalgia was the commonest complaint by 65% of the patients. Packed cell volume was >45% in 27% of the patients while 42.12% had reduced platelets and 62.67% had reduced white blood cell counts. In contrast to other studies, positive tourniquet test (PTT) and petechiae were not major indicators of DENV infection or severity of the disease. Clinical profiles were significantly different between DF and DHF/DSS and showed many similarities to that reported elsewhere. Altogether, 43 patients (14.73%) were viremic as detected by RT-PCR; 181 patients (62%) were positive for anti-DENV IgM, and 245 (84%) patients were positive for anti-DENV IgG. In combination, anti-DENV IgM and RT-PCR assays detected 224 (77.5%) of DENV infected cases, thus improving the DENV diagnosis rate. Hence, the diagnostic utility of PTT, anti-DENV IgM/IgG serology, or RT-PCR used alone in the early phase of illness is low in Sri Lanka but the diagnostic value can be improved by a combination of serology and RT-PCR. J. Med. Virol. 88:1703-1710, 2016. © 2016 Wiley Periodicals, Inc.

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Section: Discussionsupporting

confidence: 77%

Characterization of dengue virus infections in a sample of patients suggests unique clinical, immunological, and virological profiles that impact on the diagnosis of dengue and dengue hemorrhagic fever

Senaratne

Wimalaratne

Alahakoon

et al. 2016

Journal of Medical Virology

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“…Demographic data analysis showed that the infection rate in males was double the rate in females, with a male to female ratio of 2:1, an observation that corresponds with previous results from studies of the KPK province [1213]. …”

supporting

confidence: 87%

“…During 2013 to 2015, individuals aged 16-30 yr of age were the main victims of DENV infection, followed by individuals between 31-45 yr of age [112]. Demographic data analysis showed that the infection rate in males was double the rate in females, with a male to female ratio of 2:1, an observation that corresponds with previous results from studies of the KPK province [1213].…”

supporting

confidence: 74%

Dengue Virus Serotypes Circulating in Khyber Pakhtunkhwa Province, Pakistan, 2013-2015

et al. 2017

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From 2013 to 2015, the National Institute of Health, Pakistan, received 1,270 blood samples of suspected dengue cases reported from inpatient and outpatient departments of various hospitals in Khyber Pakhtunkhwa (KPK) province. In this study, we determined the circulating dengue virus (DENV) serotypes using real-time reverse transcriptase (RT)-PCR to understand the serotype-based epidemiology of DENV. All four serotypes (DENV-1 [6%], DENV-2 [33%], DENV-3 [47%], and DENV-4 [0.1%]) were found circulating during the study period. Our findings suggest the need for an active surveillance system coupled with the laboratory diagnosis, especially in the chronic endemic areas of the country. Public awareness programs are needed for effective control and prevention of outbreaks in the future.

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“…Additionally seroprevalence surveys sometimes use serum samples collected for a different purpose and therefore may not be representative of the population. Six out of the 37 studies used such samples: from blood banks [44], ante-natal clinics [64], hospitals [55,79,80], or residual samples from a different study [66]. Use of convenience samples can increase the volume of serological data produced, but the potential biases such sampling introduces must be taken into account when analysing such data.…”

Section: Discussionmentioning

confidence: 99%

Estimating Dengue Transmission Intensity from Sero-Prevalence Surveys in Multiple Countries

et al. 2015

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BackgroundEstimates of dengue transmission intensity remain ambiguous. Since the majority of infections are asymptomatic, surveillance systems substantially underestimate true rates of infection. With advances in the development of novel control measures, obtaining robust estimates of average dengue transmission intensity is key for assessing both the burden of disease from dengue and the likely impact of interventions.Methodology/Principal FindingsThe force of infection (λ) and corresponding basic reproduction numbers (R0) for dengue were estimated from non-serotype (IgG) and serotype-specific (PRNT) age-stratified seroprevalence surveys identified from the literature. The majority of R0 estimates ranged from 1–4. Assuming that two heterologous infections result in complete immunity produced up to two-fold higher estimates of R0 than when tertiary and quaternary infections were included. λ estimated from IgG data were comparable to the sum of serotype-specific forces of infection derived from PRNT data, particularly when inter-serotype interactions were allowed for.Conclusions/SignificanceOur analysis highlights the highly heterogeneous nature of dengue transmission. How underlying assumptions about serotype interactions and immunity affect the relationship between the force of infection and R0 will have implications for control planning. While PRNT data provides the maximum information, our study shows that even the much cheaper ELISA-based assays would provide comparable baseline estimates of overall transmission intensity which will be an important consideration in resource-constrained settings.

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Seroepidemiology of dengue fever in Khyber Pakhtunkhawa, Pakistan

Cited by 49 publications

References 24 publications

Characterization of dengue virus infections in a sample of patients suggests unique clinical, immunological, and virological profiles that impact on the diagnosis of dengue and dengue hemorrhagic fever

Characterization of dengue virus infections in a sample of patients suggests unique clinical, immunological, and virological profiles that impact on the diagnosis of dengue and dengue hemorrhagic fever

Dengue Virus Serotypes Circulating in Khyber Pakhtunkhwa Province, Pakistan, 2013-2015

Estimating Dengue Transmission Intensity from Sero-Prevalence Surveys in Multiple Countries

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