Asymptomatic dengue infection in adults of major cities of Pakistan

OBJECTIVE@#To determine the asymptomatic dengue infection in adults of Pakistani population.@*METHODS@#This study was conducted in five major cities (Islamabad, Karachi, Lahore, Multan, and Peshawar) of Pakistan. A total of 5 230 adults aged 18 years and above without a history of dengue fever at any point in their life were enrolled from participating laboratories. Those who were confirmed for dengue previously were excluded. Of the total, 62.6% (n = 3 276) were male with an average age of 34.6 years. Participants were briefed about the objectives of the study, and written consent was obtained to perform dengue IgG test using enzyme linked immunosorbent assay. The brief information related to age, gender and area was also taken on proforma.@*RESULTS@#Overall 32.3% (n = 1 691) was having asymptomatic dengue infection which was 67.5% (n = 756) in Karachi followed by 39.1% (n = 391) in Islamabad, 29.9% (n = 316) in Lahore and 21% (n = 228) in Peshawar and none from Multan. More males were affected with asymptomatic dengue infection than females. The asymptomatic dengue infection was significantly higher in different cities; however, there was no significant difference with respect to age groups.@*CONCLUSIONS@#The asymptomatic dengue infection is higher in cities i.e. Karachi, Islamabad and Lahore which are at risk of developing secondary dengue infections. There is a need of awareness among the public about secondary dengue infection.

Asymptomatic dengue infection in adults of major cities of Pakistan

Objective To determine the asymptomatic dengue infection in adults of Pakistani population. Methods This study was conducted in five major cities (Islamabad, Karachi, Lahore, Multan, and Peshawar) of Pakistan. A total of 5 230 adults aged 18 years and above without a history of dengue fever at any point in their life were enrolled from participating laboratories. Those who were confirmed for dengue previously were excluded. Of the total, 62.6% (n = 3 276) were male with an average age of 34.6 years. Participants were briefed about the objectives of the study, and written consent was obtained to perform dengue IgG test using enzyme linked immunosorbent assay. The brief information related to age, gender and area was also taken on proforma. Results Overall 32.3% (n = 1 691) was having asymptomatic dengue infection which was 67.5% (n = 756) in Karachi followed by 39.1% (n = 391) in Islamabad, 29.9% (n = 316) in Lahore and 21% (n = 228) in Peshawar and none from Multan. More males were affected with asymptomatic dengue infection than females. The asymptomatic dengue infection was significantly higher in different cities; however, there was no significant difference with respect to age groups. Conclusions The asymptomatic dengue infection is higher in cities i.e. Karachi, Islamabad and Lahore which are at risk of developing secondary dengue infections. There is a need of awareness among the public about secondary dengue infection.

Adulticidal efficacy of azadirachta indica [Neem Tree], sesamum indicum [Til] and pinus sabinaena [Pine Tree] extracts against aedes aegypti under laboratory conditions

Background: Emergence of resistance to insecticides against mosquitoes and other disease vectors has prompted the need for alternate sources of mosquito control which are more target-specific, easily bio-degradable and effective against mosquitoes

Materials and Methods: The adulticidal efficacy of crude Neem oil extract, Pine oil extract and Til oil extract with five different concentrations i.e. 2%, 4%, 6%, and 8% was tested against five to six days old sugar fed female Aedes aegypti using standard WHO Bioassay test kit. The percentage mortality was observed after 24 and 48 hours under laboratory condition

Results: The LC[50] [Lethal Concentration] values of Neem oil extract against adults of Aedes aegypti were 1.17 ml and 0.09 ml after 24 and 48 hours of exposure respectively, while the LC[99] were 4.27 ml and 1.17 ml after 24 and 48 hours of exposure respectively. The LC[50] values of Pine oil extract after 24 and 48 hours were 0.25 and, 0.06 ml respectively, while LC[99] values at 24 and 48 hour were and 0.89 ml and 0.64 ml respectively. The LC[50] values of Til oil extract after 24 and 48 hours of exposure were 1.17 ml and 0.05 ml respectively while LC99 values were 4.18 ml and 1.28 ml after 24 and 48 hours of exposure respectively. The LC[50] and LC[90] values were indicative that the plant extracts were highly toxic after 48 hours of exposure. Among the tested plant oil extracts the maximum adulticidal efficacy was observed in the pine oil extract. No mortality was observed in controls

Conclusion: Crude extract of Pine oil was more effective against Aedes aegypti as compared to Neem and Til oil

Economic burden of dengue in four major cities of Pakistan during 2011

To assess the economic burden of dengue infection by calculating cost per patient and disability adjusted life years lost. The cross-sectional study was conducted in Islamabad, Lahore, Faisalabad and Karachi from July 2012 to March 2013. Residential addresses and telephonic numbers of dengue patients were taken from the records of Pakistan Institute of Medical Sciences, Islamabad, Mayo and Ganga Ram Hospital, Lahore, Civil Hospital, Karachi, and Allied Hospital, Faisalabad. A total of 250 dengue confirmed cases - 50 from each hospital - were randomly selected. Information regarding duration of illness and out-of-pocket expenses were collected to estimate the direct cost, while indirect cost [number of work days missed by the patient] was calculated from disability adjusted life years using Murray's formula. Overall, there were 162[65%] men and 88[35%] with a mean age of 30.4 +/- 13.5years. More than half 138[55%] were below 30 years of age. Socio-economically, 145[58%] belonged to low, 70[28%] middle and 35[14%] to high socioeconomic groups. Of the total, 210[84%] cases had dengue fever followed by 32[12.8%] dengue haemorrhagic fever and 8[3.2%] dengue shock syndrome cases. Average duration of illness was 32 +/- 7.1 days. Overall direct cost per patient was Rs.35, 823 [US$358] and average pre-hospitalisation, hospitalisation and post-hospitalisation was Rs.6154, Rs.21, 242 and Rs.8, 427 respectively. The overall disability adjusted life years per million population was 133.76. Although the government had provided free treatment for dengue in public-sector hospitals, still patients had to pay Rs.21, 242 during hospital stay, resulting in substantial burden which needs to be addressed