Risk Factors of Dengue Fever in Urban Areas of Rawalpindi District in Pakistan During 2017: A Case Control Study
BackgroundDuring August 2017, increased numbers of suspected dengue fever cases were reported in the hospitals of Rawalpindi district. A case control study was conducted to determine the risk factors among urban areas, dengue serotype, and recommend preventive measures....
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| Format: | Article |
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JMIR Publications
2022-01-01
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| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2022/1/e27270 |
| _version_ | 1797735426142765056 |
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| author | Najma Javed Awan Ambreen Chaudhry Zakir Hussain Zeeshan Iqbal Baig Mirza Amir Baig Rana Jawad Asghar Yousef Khader Aamer Ikram |
| author_facet | Najma Javed Awan Ambreen Chaudhry Zakir Hussain Zeeshan Iqbal Baig Mirza Amir Baig Rana Jawad Asghar Yousef Khader Aamer Ikram |
| author_sort | Najma Javed Awan |
| collection | DOAJ |
| description |
BackgroundDuring August 2017, increased numbers of suspected dengue fever cases were reported in the hospitals of Rawalpindi district. A case control study was conducted to determine the risk factors among urban areas, dengue serotype, and recommend preventive measures.
ObjectiveThe objective of the investigation was to determine the risk factors among urban areas, dengue serotype, and recommend preventive measures.
MethodsA case was defined as having acute febrile illness with one or more of the following symptoms: retro-orbital pain, headache, rash, myalgia, arthralgia, and hemorrhage. The cases were residents of Rawalpindi and were confirmed for dengue fever from August 30, 2017, to October 30, 2017. All NS1 confirmed cases from urban areas of Rawalpindi were recruited from tertiary care hospitals. Age- and sex-matched controls were selected from the same community with a 1:1 ratio. Frequency, univariate, and multivariate analyses were performed at 95% CI with P<.05 considered statistically significant.
ResultsTotally 373 cases were recruited. The mean age was 36 (SD 2.9) years (range 10-69 years), and 280 cases (75%) were male. The most affected age group was 21-30 years (n=151, attack rate [AR] 40%), followed by 31-40 years (n=66, AR 23%). Further, 2 deaths were reported (case fatality rate of 0.53%). The most frequent signs or symptoms were fever (n=373, 100%), myalgia and headache (n=320, 86%), and retro-orbital pain (n=272, 73%). Serotype identification was carried out in 322 cases, and DEN-2 was the dominant serotype (n=126, 34%). Contact with a confirmed dengue case (odds ratio [OR] 4.27; 95% CI 3.14-5.81; P<.001), stored water in open containers at home (OR 2.04; 95% CI 1.53-2.73; P<.001), and travel to a dengue outbreak area (OR 2.88; 95% CI 2.12-3.92; P<.001) were the main reasons for the outbreak, whereas use of mosquito repellents (OR 0.12; 95% CI 0.09-0.18; P<.001) and regular water supply at home (OR 0.03; 95% CI 0.02-0.04; P<.001) showed protective effects. The geographical distribution of cases was limited to densely populated areas and all the 5 randomly collected water samples tested positive for dengue larvae.
ConclusionsStored water in containers inside houses and subsequent mosquito breeding were the most probable causes of this outbreak. Based on the study findings, undertaking activities to improve the use of mosquito repellents and removing sources of breeding (uncovered water stored indoors) are some recommendations for preventing dengue outbreaks. |
| first_indexed | 2024-03-12T12:58:54Z |
| format | Article |
| id | doaj.art-d9ec0402b53849a998778ded5646258b |
| institution | Directory Open Access Journal |
| issn | 2369-2960 |
| language | English |
| last_indexed | 2024-03-12T12:58:54Z |
| publishDate | 2022-01-01 |
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| series | JMIR Public Health and Surveillance |
| spelling | doaj.art-d9ec0402b53849a998778ded5646258b2023-08-28T20:23:34ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602022-01-0181e2727010.2196/27270Risk Factors of Dengue Fever in Urban Areas of Rawalpindi District in Pakistan During 2017: A Case Control StudyNajma Javed Awanhttps://orcid.org/0000-0002-8904-5357Ambreen Chaudhryhttps://orcid.org/0000-0002-1549-2445Zakir Hussainhttps://orcid.org/0000-0002-2741-1980Zeeshan Iqbal Baighttps://orcid.org/0000-0002-1486-7823Mirza Amir Baighttps://orcid.org/0000-0002-4814-4914Rana Jawad Asgharhttps://orcid.org/0000-0001-5413-5742Yousef Khaderhttps://orcid.org/0000-0002-7830-6857Aamer Ikramhttps://orcid.org/0000-0002-6440-750X BackgroundDuring August 2017, increased numbers of suspected dengue fever cases were reported in the hospitals of Rawalpindi district. A case control study was conducted to determine the risk factors among urban areas, dengue serotype, and recommend preventive measures. ObjectiveThe objective of the investigation was to determine the risk factors among urban areas, dengue serotype, and recommend preventive measures. MethodsA case was defined as having acute febrile illness with one or more of the following symptoms: retro-orbital pain, headache, rash, myalgia, arthralgia, and hemorrhage. The cases were residents of Rawalpindi and were confirmed for dengue fever from August 30, 2017, to October 30, 2017. All NS1 confirmed cases from urban areas of Rawalpindi were recruited from tertiary care hospitals. Age- and sex-matched controls were selected from the same community with a 1:1 ratio. Frequency, univariate, and multivariate analyses were performed at 95% CI with P<.05 considered statistically significant. ResultsTotally 373 cases were recruited. The mean age was 36 (SD 2.9) years (range 10-69 years), and 280 cases (75%) were male. The most affected age group was 21-30 years (n=151, attack rate [AR] 40%), followed by 31-40 years (n=66, AR 23%). Further, 2 deaths were reported (case fatality rate of 0.53%). The most frequent signs or symptoms were fever (n=373, 100%), myalgia and headache (n=320, 86%), and retro-orbital pain (n=272, 73%). Serotype identification was carried out in 322 cases, and DEN-2 was the dominant serotype (n=126, 34%). Contact with a confirmed dengue case (odds ratio [OR] 4.27; 95% CI 3.14-5.81; P<.001), stored water in open containers at home (OR 2.04; 95% CI 1.53-2.73; P<.001), and travel to a dengue outbreak area (OR 2.88; 95% CI 2.12-3.92; P<.001) were the main reasons for the outbreak, whereas use of mosquito repellents (OR 0.12; 95% CI 0.09-0.18; P<.001) and regular water supply at home (OR 0.03; 95% CI 0.02-0.04; P<.001) showed protective effects. The geographical distribution of cases was limited to densely populated areas and all the 5 randomly collected water samples tested positive for dengue larvae. ConclusionsStored water in containers inside houses and subsequent mosquito breeding were the most probable causes of this outbreak. Based on the study findings, undertaking activities to improve the use of mosquito repellents and removing sources of breeding (uncovered water stored indoors) are some recommendations for preventing dengue outbreaks.https://publichealth.jmir.org/2022/1/e27270 |
| spellingShingle | Najma Javed Awan Ambreen Chaudhry Zakir Hussain Zeeshan Iqbal Baig Mirza Amir Baig Rana Jawad Asghar Yousef Khader Aamer Ikram Risk Factors of Dengue Fever in Urban Areas of Rawalpindi District in Pakistan During 2017: A Case Control Study JMIR Public Health and Surveillance |
| title | Risk Factors of Dengue Fever in Urban Areas of Rawalpindi District in Pakistan During 2017: A Case Control Study |
| title_full | Risk Factors of Dengue Fever in Urban Areas of Rawalpindi District in Pakistan During 2017: A Case Control Study |
| title_fullStr | Risk Factors of Dengue Fever in Urban Areas of Rawalpindi District in Pakistan During 2017: A Case Control Study |
| title_full_unstemmed | Risk Factors of Dengue Fever in Urban Areas of Rawalpindi District in Pakistan During 2017: A Case Control Study |
| title_short | Risk Factors of Dengue Fever in Urban Areas of Rawalpindi District in Pakistan During 2017: A Case Control Study |
| title_sort | risk factors of dengue fever in urban areas of rawalpindi district in pakistan during 2017 a case control study |
| url | https://publichealth.jmir.org/2022/1/e27270 |
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