Journal of Vaccines & Vaccination

Dengue fever in District Swat: A paradigm shift; changing epidemiology and clinical patterns, Khyber Pakhtunkhwa, Pakistan

10^th Euro Global Summit and Expo on Vaccines & Vaccination

June 16-18, 2016 Rome, Italy

Jehangir Khan, Shujaat Ali Khan and Abdul Ghaffar

Abdul Wali Khan University Mardan, Pakistan
Islamic International University Islamabad, Pakistan
COMSATS Institute of Information Technology, Pakistan

Posters & Accepted Abstracts: J Vaccines Vaccin

Abstract:

Objective: To explore the epidemiological, clinical, socioeconomic status (SES) and sociodemographic features of dengue fever in Swat (34° 36�?� 56�?� -36° 02�?� 54�?� N & 71° 42�?� 30�?�-072° 07�?� 05�?� E.), Khyber Pakhtunkhwa, Pakistan during dengue epidemics i.e., 2013- 2015. Methodology: A cross sectional (observational) and molecular (Entomological and Serological) study was conducted from June 2013 to November 2015 in Swat. Epidemiological trends, Molecular (PCR based entomological & serological), Clinical profile, SES and demographic features were determined. Clinical and laboratory features of dengue cases studied could be used for the early identification of patients at risk of severe dengue fever. Results: Among 5513 dengue patients, 3806 (69%) were males while 1707 (31%) females, maximum infection (52.5%) was reported in individuals of 14-30 years followed by 31-60 (34.5%) with 37 deaths only. The highly educated community had minimum (11.5%) infection as compared to low (primary) educated peoples (38.4%). A decreasing epidemiological trend of dengue infection was observed in 2014 (5.4%) and 2015 (0.6%) as compared to 2013 (94%). The peak incidence of dengue infection with no significant differences was observed in September (56% in 2013, 38% in 2014) and October (33% in 2013, 24% in 2014), while in 2015 the maximum incidences were recorded in the months of October (54.5%) and November (30.5%). The 63% patients had low socioeconomic status with monthly income lesser than 10000 PKR/month. Out of 500 Government employees having BPS (1-20); 51.8% dengue infections were observed in the employees with BPS (1-10) and lowest in the BSP (17-20). Among the different categories of employees, the highly educated community had minimum (2%) infection while the health department had maximum (4%) infection. The structure of building also played an important role, the individuals living in double/more stories houses were suffered more (65%) as compared to single story houses (35%). Approximately, 70% of the patients belonged to urban areas, Mingora and Saidusharif remained the highly (above 60%) targeted areas of dengue spread during the study period. High fever (up to 40 °C) was observed in 100% patients followed by retro-orbital pain (80%), headache in 70%, liver enlargement in 70%, while bleeding was observed in 5% patients. The reduced WBCs were recorded in 60% patients while elevated hematocrit (along with low platelet count) in 85% of patients. The dengue outbreaks were dominated by serotype 3 (�?�60%) followed by serotype 2 (�?�40%) as the main causative agent of dengue in Swat area. The ratio of these serotypes remained same in mosquitoes as well as in blood. Conclusion: Once dengue had greater victims while at present almost in state of denial in the area. The current Government of Khyber Pakhtunkhwa has played an indispensable role in eradicating the disease by implementing strict policies against dengue spread. The strong efforts against dengue vector reproduction and growth (spraying on vector�??s habitats and public awareness) with improved health care centers with more facilities are the key factors to control dengue outbreak in this district. Additionally, urbanization, socioeconomic and sociodemographic factors are mainly associated with dengue transmission. Moreover, vector control strategies (biological, physical and chemical control) and public awareness should be prioritized to reduce/stop the impending epidemics elsewhere in Pakistan.

Biography :

Email: abu_amna2013@hotmail.com