TY - JOUR
T1 - Clinical characteristics and serotype association of dengue and dengue like illness in Pakistan
AU - Iqbal, Najeeha Talat
AU - Ahmed, Kumail
AU - Khalid, Aqsa
AU - Imtiaz, Kehkashan
AU - Ali, Qamreen Mumtaz
AU - Munir, Tania
AU - Mahmood, Syed Faisal
AU - Khan, Unab
AU - Afzal, Badar
AU - Qamar, Farah Naz
AU - Waggoner, Jesse J.
AU - Fenelon, Hannah
AU - McOwen, Helene
AU - Khan, Erum
AU - Rabinowitz, Peter
AU - Van Voorhis, Wesley C.
N1 - Publisher Copyright:
© 2025 Iqbal et al.
PY - 2025
Y1 - 2025
N2 - Background Pakistan has been an endemic country for dengue virus since 1994, with a significant increase in cases reported in 2022 largely due to heavy rainfall and flooding. All four serotypes of the dengue virus (DENV) are present in Pakistan, with DENV 1 and DENV 2 being the most prevalent. The current study aims to explore the clinical presentations and features of dengue fever in a tertiary care hospital. Methodology We enrolled and studied 349 cases of suspected and confirmed dengue present-ing for care at the Aga Khan University Hospital in Karachi between June 2021 and November 2023. Collected data on cases included clinical symptoms and laboratory results including qRT-PCR and serotype characterization. Findings The majority of subjects enrolled (75%) had mild disease without warning signs, while 11% exhibited warning signs, 1.4% had severe dengue, and 12.6% had no dengue diagnosis. Patients with severe dengue (SD) had significantly higher levels of liver enzymes (AST and ALT) compared to those with non-severe dengue (NSD) (AST; p = 0.024 and ALT; p = 0.047). Additionally, a higher grade of thrombocytopenia was significantly associated with hospitalization (p = 0.0008), and prolonged illness (p = 0.03). Both Platelet (p < 0.0001) and WBC counts (p = 0.001) were significantly lower in dengue PCR-positive patients in comparison to Dengue PCR-negative. Among those tested for dengue serotypes, DENV 1 (34%) and DENV 2 (45%) emerged as the predominant serotypes, with mixed infections accounting for 17%. The sensitivity of q-RT PCR was found to be 87.25% and the specificity of 68.35%. qRT-PCR detected 43.5% of cases with viral fever initially screened negative by IgM or NS1. Conclusion The epidemiology of dengue fever during a widespread outbreak in 2022 showed a predominance of DENV 1 and DENV 2 serotypes with milder phenotype of viral illness. Screening with rapid tests requires further confirmation by molecular assay in cases with dengue and dengue-like illness. The sensitivity of q-RT PCR using gold standard.
AB - Background Pakistan has been an endemic country for dengue virus since 1994, with a significant increase in cases reported in 2022 largely due to heavy rainfall and flooding. All four serotypes of the dengue virus (DENV) are present in Pakistan, with DENV 1 and DENV 2 being the most prevalent. The current study aims to explore the clinical presentations and features of dengue fever in a tertiary care hospital. Methodology We enrolled and studied 349 cases of suspected and confirmed dengue present-ing for care at the Aga Khan University Hospital in Karachi between June 2021 and November 2023. Collected data on cases included clinical symptoms and laboratory results including qRT-PCR and serotype characterization. Findings The majority of subjects enrolled (75%) had mild disease without warning signs, while 11% exhibited warning signs, 1.4% had severe dengue, and 12.6% had no dengue diagnosis. Patients with severe dengue (SD) had significantly higher levels of liver enzymes (AST and ALT) compared to those with non-severe dengue (NSD) (AST; p = 0.024 and ALT; p = 0.047). Additionally, a higher grade of thrombocytopenia was significantly associated with hospitalization (p = 0.0008), and prolonged illness (p = 0.03). Both Platelet (p < 0.0001) and WBC counts (p = 0.001) were significantly lower in dengue PCR-positive patients in comparison to Dengue PCR-negative. Among those tested for dengue serotypes, DENV 1 (34%) and DENV 2 (45%) emerged as the predominant serotypes, with mixed infections accounting for 17%. The sensitivity of q-RT PCR was found to be 87.25% and the specificity of 68.35%. qRT-PCR detected 43.5% of cases with viral fever initially screened negative by IgM or NS1. Conclusion The epidemiology of dengue fever during a widespread outbreak in 2022 showed a predominance of DENV 1 and DENV 2 serotypes with milder phenotype of viral illness. Screening with rapid tests requires further confirmation by molecular assay in cases with dengue and dengue-like illness. The sensitivity of q-RT PCR using gold standard.
UR - https://www.scopus.com/pages/publications/105005377576
U2 - 10.1371/journal.pntd.0012978
DO - 10.1371/journal.pntd.0012978
M3 - Article
C2 - 40354421
AN - SCOPUS:105005377576
SN - 1935-2727
VL - 19
JO - PLoS Neglected Tropical Diseases
JF - PLoS Neglected Tropical Diseases
IS - 5
M1 - e0012978
ER -
