1921
Volume 96, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

Swat, a lush green valley of 1.3 million persons, remained under militant insurgency from 2007 to 2009, which damaged the health infrastructure. An outbreak of dengue fever (DF) was declared in the valley in 2013. To investigate this outbreak, we established active surveillance of national hospitals and private clinics, reviewed available clinical and laboratory records, and conducted entomological survey. From August to November 2013, 16,000 suspected patients with acute febrile illness were presented to health facilities. Among those, 9,036 were confirmed positive for DF by clinical manifestation and presence of nonstructural protein 1-soluble antigen. Of 9,036 patients, majority were men and aged 21–40. The epidemic peaked in September 2013 ( = 6,487). The attack rate was 7.18/1,000 populations. Among the confirmed case-patients, 36 deaths were reported, and proportion of mortality was 0.4%. Each year, increase in age was significantly associated with risk of complication due to DF leading to death ( < 0.001).

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References

  1. San Martín JL, Brathwaite O, Zambrano B, Solórzano JO, Bouckenooghe A, Dayan GH, Guzmán MG, , 2010. The epidemiology of dengue in the Americas over the last three decades: a worrisome reality. Am J Trop Med Hyg 82: 128135.[Crossref] [Google Scholar]
  2. Thai KT, Phuong HL, Thanh Nga TT, Giao PT, Hung le Q, Van Nam N, Binh TQ, Simmons C, Farrar J, Hien TT, van Doorn HR, de Jong MD, de Vries PJ, , 2010. Clinical, epidemiological and virological features of Dengue virus infections in Vietnamese patients presenting to primary care facilities with acute undifferentiated fever. J Infect 60: 229237.[Crossref] [Google Scholar]
  3. World Health Organization, 2015. Dengue and Severe Dengue. Available at: http://www.who.int/mediacentre/factsheets/fs117/en/. Accessed May 20, 2016. [Google Scholar]
  4. Fatima SH, Atif S, Rasheed SB, Zaidi F, Hussain E, , 2016. Species distribution modelling of Aedes aegypti in two dengue-endemic regions of Pakistan. Trop Med Int Health 21: 427436.[Crossref] [Google Scholar]
  5. Paul RE, Patel A, Mirza S, Fisher-Hoch SP, Luby SP, , 1998. Expansion of epidemic dengue viral infections to Pakistan. Int J Infect Dis 2: 197201.[Crossref] [Google Scholar]
  6. Rasheed S, Butlin R, Boots M, , 2013. A review of dengue as an emerging disease in Pakistan. Public Health 127: 1117.[Crossref] [Google Scholar]
  7. Ud Din I, Mumtaz Z, Ataullahjan A, , 2012. How the Taliban undermined community healthcare in Swat, Pakistan. BMJ 344: e2093.[Crossref] [Google Scholar]
  8. World Health Organization and Health Department, Government of Khyber Pakhtunkhwa, 2013. Swat: Dengue Fever Snapshot (07 August–20 October 2013). Available at: http://reliefweb.int/sites/reliefweb.int/files/resources/Swat_dengue_fever_snapshot_211013.pdf. Accessed October 20, 2015. [Google Scholar]
  9. Government of Khyber Pakhtunkhwa, 2015. KPK Swat District Demographics. Available at: http://kp.gov.pk/page/swatdistrictdemographics. Accessed December 1, 2014. [Google Scholar]
  10. World Health Organization, 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control, 2nd edition. Geneva, Switzerland: World Health Organization. Available at: http://www.who.int/csr/resources/publications/dengue/Denguepublication/en/. Accessed December 25, 2014. [Google Scholar]
  11. Khan J, Khan I, Amin IA, , 2016. Comprehensive entomological, serological and molecular study of 2013 dengue outbreak of Swat, Khyber Pakhtunkhwa, Pakistan. PLoS One 11: e0147416.[Crossref] [Google Scholar]
  12. Dengue Virus Net, 2016. Dengue Epidemiology. Available at: http://www.denguevirusnet.com/epidemiology.html. Accessed November 25, 2016. [Google Scholar]
  13. Suleman M, Faryal R, Aamir UB, Alam MM, Nisar N, Sharif S, Shaukat S, Khurshid A, Angez M, Umair M, Mujtaba G, Sufian MM, Arshad Y, Rehman L, Zaidi SSZ, , 2016. Dengue outbreak in Swat and Mansehra, Pakistan 2013: an epidemiological and diagnostic perspective. Asian Pac J Trop Med 9: 380384.[Crossref] [Google Scholar]
  14. Khan J, Khan A, , 2015. Incidence of dengue in 2013: dengue outbreak in District Swat, Khyber Pakhtunkhwa, Pakistan. Inter J Fauna and Biolo Stud 2: 17. [Google Scholar]
  15. Gubler DJ, Ooi EE, Vasudevan S, Farrar J, , 2014. Dengue and Dengue Hemorrhagic Fever, 2nd edition. Wallingford, United Kingdom: CABI, 123124. [Google Scholar]
  16. Cummings DA, Iamsirithaworn S, Lessler JT, McDermott A, Prasanthong R, Nisalak A, Jarman RG, Burke DS, Gibbons RV, , 2009. The impact of the demographic transition on dengue in Thailand: insights from a statistical analysis and mathematical modeling. PLoS Med 6: e1000139.[Crossref] [Google Scholar]
  17. Paiman, 2009. District Health Profile. Available at: http://paiman.jsi.com/Resources/Docs/district-health-profile-swat.pdf. Accessed November 25, 2016. [Google Scholar]
  18. Chakravarti A, Kumaria R, , 2005. Eco-epidemiological analysis of dengue infection during an outbreak of dengue fever, India. Virol J 2: 32.[Crossref] [Google Scholar]
  19. World Health Organization, 2009. Dengue Guidelines for Diagnosis, Treatment, Prevention and Control. Available at: http://www.who.int/tdr/publications/documents/dengue-diagnosis.pdf. Accessed December 5, 2014. [Google Scholar]
  20. Pham HV, Doan HT, Phan TT, Minh NN, , 2011. Ecological factors associated with dengue fever in a Central Highlands province, Vietnam. BMC Infect Dis 11: 172.[Crossref] [Google Scholar]
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  • Received : 26 Jul 2016
  • Accepted : 08 Dec 2016

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