Risk Factors Associated with a Dengue Fever Outbreak in Islamabad, Pakistan: Case-Control Study
BackgroundOn October 23, 2016, 79 dengue fever cases were reported from the Union Council Tarlai to Federal Disease Surveillance and Response Unit Islamabad. A team was established to investigate the suspected dengue outbreak. ObjectiveThe aim of this study was to...
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| Format: | Article |
| Language: | English |
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JMIR Publications
2021-12-01
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| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2021/12/e27266 |
| _version_ | 1797735488290816000 |
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| author | Amjad Mehmood Fawad Khalid Khan Ambreen Chaudhry Zakir Hussain Mumtaz Ali Laghari Ijaz Shah Zeeshan Iqbal Baig Mirza Amir Baig Yousef Khader Aamer Ikram |
| author_facet | Amjad Mehmood Fawad Khalid Khan Ambreen Chaudhry Zakir Hussain Mumtaz Ali Laghari Ijaz Shah Zeeshan Iqbal Baig Mirza Amir Baig Yousef Khader Aamer Ikram |
| author_sort | Amjad Mehmood |
| collection | DOAJ |
| description |
BackgroundOn October 23, 2016, 79 dengue fever cases were reported from the Union Council Tarlai to Federal Disease Surveillance and Response Unit Islamabad. A team was established to investigate the suspected dengue outbreak.
ObjectiveThe aim of this study was to determine the extent of the outbreak and identify the possible risk factors.
MethodsActive case finding was performed through a house-to-house survey. A case was defined as an acute onset of fever ≥38℃ in a resident of Tarlai from October 2 to November 11, 2016, with a positive dengue virus (nonstructural protein, NS-1) test and any of the two of following signs and symptoms: retroorbital/ocular pain, headache, rash, myalgia, arthralgia, and hemorrhagic manifestations. A structured questionnaire was used to collect data. Age- and sex-matched controls (1:1) were identified from residents in the same area as cases. Blood samples were taken and sent to the National Institute of Health for genotype identification.
ResultsDuring the active case search, 145 cases of dengue fever were identified by surveying 928 houses from October 23 to November 11, 2016. The attack rate (AR) was 17.0/10,000. The mean age was 34.4 (SD 14.4) years. More than half of the cases were male (80/145, 55.2%). Among all cases, 29% belonged to the 25-34 years age group and the highest AR was found in the 35-44 years age group (35.6/10,000), followed by the 55-64 years age group (35.5/10,000). All five blood samples tested positive for NS-1 (genotype DENV-2). The most frequent presenting signs/symptoms were fever and headache (both 100%). Stagnant water around houses (odds ratio [OR] 4.86, 95% CI 2.94-8.01; P<.001), presence of flower pots in the home (OR 2.73, 95% CI 1.67-4.45; P<.001), and open water containers (OR 2.24, 95% CI 1.36-3.60; P<.001) showed higher odds among cases. Conversely, use of bed nets (OR 0.44, 95% CI 0.25-0.77; P=.003), insecticidal spray (OR 0.33, 95% CI 0.22-0.55; P<.001), door screens (OR 0.27, 95% CI 0.15-0.46; P<.001), mosquito coil/mat (OR 0.26, 95% CI 0.16-0.44; P<.001), and cleanliness of the house (OR 0.12, 95% CI 0.05-0.26; P<.001) showed significant protective effects.
ConclusionsStagnant water acting as breeding grounds for vectors was identified as the probable cause of spread of the dengue outbreak. Establishment of surveillance and an early reporting system along with use of protective measures against the vector are strongly recommended. |
| first_indexed | 2024-03-12T12:59:45Z |
| format | Article |
| id | doaj.art-ac146ad56d0440d089dc4dddb86745d6 |
| institution | Directory Open Access Journal |
| issn | 2369-2960 |
| language | English |
| last_indexed | 2024-03-12T12:59:45Z |
| publishDate | 2021-12-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Public Health and Surveillance |
| spelling | doaj.art-ac146ad56d0440d089dc4dddb86745d62023-08-28T20:05:26ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602021-12-01712e2726610.2196/27266Risk Factors Associated with a Dengue Fever Outbreak in Islamabad, Pakistan: Case-Control StudyAmjad Mehmoodhttps://orcid.org/0000-0002-2711-6754Fawad Khalid Khanhttps://orcid.org/0000-0002-3908-5932Ambreen Chaudhryhttps://orcid.org/0000-0002-1549-2445Zakir Hussainhttps://orcid.org/0000-0002-2741-1980Mumtaz Ali Lagharihttps://orcid.org/0000-0003-4462-3771Ijaz Shahhttps://orcid.org/0000-0001-6108-9270Zeeshan Iqbal Baighttps://orcid.org/0000-0002-1486-7823Mirza Amir Baighttps://orcid.org/0000-0002-4814-4914Yousef Khaderhttps://orcid.org/0000-0002-7830-6857Aamer Ikramhttps://orcid.org/0000-0002-6440-750X BackgroundOn October 23, 2016, 79 dengue fever cases were reported from the Union Council Tarlai to Federal Disease Surveillance and Response Unit Islamabad. A team was established to investigate the suspected dengue outbreak. ObjectiveThe aim of this study was to determine the extent of the outbreak and identify the possible risk factors. MethodsActive case finding was performed through a house-to-house survey. A case was defined as an acute onset of fever ≥38℃ in a resident of Tarlai from October 2 to November 11, 2016, with a positive dengue virus (nonstructural protein, NS-1) test and any of the two of following signs and symptoms: retroorbital/ocular pain, headache, rash, myalgia, arthralgia, and hemorrhagic manifestations. A structured questionnaire was used to collect data. Age- and sex-matched controls (1:1) were identified from residents in the same area as cases. Blood samples were taken and sent to the National Institute of Health for genotype identification. ResultsDuring the active case search, 145 cases of dengue fever were identified by surveying 928 houses from October 23 to November 11, 2016. The attack rate (AR) was 17.0/10,000. The mean age was 34.4 (SD 14.4) years. More than half of the cases were male (80/145, 55.2%). Among all cases, 29% belonged to the 25-34 years age group and the highest AR was found in the 35-44 years age group (35.6/10,000), followed by the 55-64 years age group (35.5/10,000). All five blood samples tested positive for NS-1 (genotype DENV-2). The most frequent presenting signs/symptoms were fever and headache (both 100%). Stagnant water around houses (odds ratio [OR] 4.86, 95% CI 2.94-8.01; P<.001), presence of flower pots in the home (OR 2.73, 95% CI 1.67-4.45; P<.001), and open water containers (OR 2.24, 95% CI 1.36-3.60; P<.001) showed higher odds among cases. Conversely, use of bed nets (OR 0.44, 95% CI 0.25-0.77; P=.003), insecticidal spray (OR 0.33, 95% CI 0.22-0.55; P<.001), door screens (OR 0.27, 95% CI 0.15-0.46; P<.001), mosquito coil/mat (OR 0.26, 95% CI 0.16-0.44; P<.001), and cleanliness of the house (OR 0.12, 95% CI 0.05-0.26; P<.001) showed significant protective effects. ConclusionsStagnant water acting as breeding grounds for vectors was identified as the probable cause of spread of the dengue outbreak. Establishment of surveillance and an early reporting system along with use of protective measures against the vector are strongly recommended.https://publichealth.jmir.org/2021/12/e27266 |
| spellingShingle | Amjad Mehmood Fawad Khalid Khan Ambreen Chaudhry Zakir Hussain Mumtaz Ali Laghari Ijaz Shah Zeeshan Iqbal Baig Mirza Amir Baig Yousef Khader Aamer Ikram Risk Factors Associated with a Dengue Fever Outbreak in Islamabad, Pakistan: Case-Control Study JMIR Public Health and Surveillance |
| title | Risk Factors Associated with a Dengue Fever Outbreak in Islamabad, Pakistan: Case-Control Study |
| title_full | Risk Factors Associated with a Dengue Fever Outbreak in Islamabad, Pakistan: Case-Control Study |
| title_fullStr | Risk Factors Associated with a Dengue Fever Outbreak in Islamabad, Pakistan: Case-Control Study |
| title_full_unstemmed | Risk Factors Associated with a Dengue Fever Outbreak in Islamabad, Pakistan: Case-Control Study |
| title_short | Risk Factors Associated with a Dengue Fever Outbreak in Islamabad, Pakistan: Case-Control Study |
| title_sort | risk factors associated with a dengue fever outbreak in islamabad pakistan case control study |
| url | https://publichealth.jmir.org/2021/12/e27266 |
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