Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan.
National Institute of Health (NIH), Health Research Institute, Research Centre, Fatima Jinnah Medical University, Lahore, Pakistan.
PLoS Negl Trop Dis. 2021 Sep 23;15(9):e0009802. doi: 10.1371/journal.pntd.0009802. eCollection 2021 Sep.
Dengue has become endemic in Pakistan with annual recurrence. A sudden increase in the dengue cases was reported from Rawalpindi in 2016, while an outbreak occurred for the first time in Peshawar in 2017. Therefore, a multi-center study was carried out to determine the circulating dengue virus (DENV) serotypes and Chikungunya virus (CHIKV) co-infection in Lahore, Rawalpindi, and Peshawar cities in 2016-18. A hospital-based cross-sectional study was carried out in Lahore and Rawalpindi in 2016-18, while a community-based study was carried out in Peshawar in 2017. The study participants were tested for dengue NS1 antigen using an immunochromatographic device while anti-dengue IgM/IgG antibodies were detected by indirect ELISA. All NS1 positive samples were used for DENV serotyping using multiplex real-time PCR assay. Additionally, dengue samples were tested for CHIKV co-infection using IgM/IgG ELISA. A total of 6291 samples were collected among which 8.11% were NS1 positive while 2.5% were PCR positive. DENV-2 was the most common serotype (75.5%) detected, followed by DENV-1 in 16.1%, DENV-3 in 3.9% and DENV-4 in 0.7% while DENV-1 and DENV-4 concurrent infections were detected in 3.9% samples. DENV-1 was the predominant serotype (62.5%) detected from Lahore and Rawalpindi, while DENV-2 was the only serotype detected from Peshawar. Comorbidities resulted in a significant increase (p-value<0.001) in the duration of hospital stay of the patients. Type 2 diabetes mellitus substantially (p-value = 0.004) contributed to the severity of the disease. Among a total of 590 dengue positive samples, 11.8% were also positive for CHIKV co-infection. Co-circulation of multiple DENV serotypes and CHIKV infection in Pakistan is a worrisome situation demanding the urgent attention of the public health experts to strengthen vector surveillance.
登革热已在巴基斯坦成为地方性疾病，每年都会复发。2016 年，拉瓦尔品第报告了登革热病例的突然增加，而 2017 年白沙瓦首次爆发了登革热疫情。因此，2016-18 年在拉合尔、拉瓦尔品第和白沙瓦市进行了一项多中心研究，以确定循环登革热病毒（DENV）血清型和基孔肯雅病毒（CHIKV）的合并感染。2016-18 年在拉合尔和拉瓦尔品第进行了基于医院的横断面研究，而 2017 年在白沙瓦进行了基于社区的研究。使用免疫层析设备检测研究参与者的登革热 NS1 抗原，同时通过间接 ELISA 检测抗登革热 IgM/IgG 抗体。所有 NS1 阳性样本均用于使用多重实时 PCR 检测 DENV 血清型。此外，使用 IgM/IgG ELISA 检测登革热样本的基孔肯雅病毒合并感染。共收集了 6291 个样本，其中 8.11%为 NS1 阳性，2.5%为 PCR 阳性。检测到的最常见血清型为 DENV-2（75.5%），其次是 DENV-1（16.1%）、DENV-3（3.9%）和 DENV-4（0.7%），而 3.9%的样本检测到 DENV-1 和 DENV-4 同时感染。从拉合尔和拉瓦尔品第检测到的主要血清型为 DENV-1（62.5%），而从白沙瓦检测到的唯一血清型为 DENV-2。合并症导致患者的住院时间显著延长（p 值<0.001）。2 型糖尿病显著（p 值=0.004）加重了疾病的严重程度。在总共 590 个登革热阳性样本中，有 11.8%也同时感染基孔肯雅病毒。巴基斯坦多种 DENV 血清型和基孔肯雅病毒感染的共同循环是一种令人担忧的情况，需要公共卫生专家的紧急关注，以加强媒介监测。
