Evidence map›Paper›PMID 40354421›Full record

ArticlePLoS neglected tropical diseases2025

Clinical characteristics and serotype association of dengue and dengue like illness in Pakistan.

Najeeha Talat Iqbal, Kumail Ahmed, Aqsa Khalid, Kehkashan Imtiaz, Qamreen Mumtaz Ali, Tania Munir, Syed Faisal Mahmood, Unab Khan, Badar Afzal, Farah Naz Qamar and 6 more

Abstract read
In one paragraph

Article in PLoS neglected tropical diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Najeeha Talat IqbalDepartment of pediatrics and child Health, Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan.ORCID 0000-0003-4026-5655
Kumail AhmedDepartment of pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Aqsa KhalidDepartment of pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Kehkashan ImtiazDepartment of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan.
Qamreen Mumtaz AliDepartment of pediatrics and child Health, Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan.
Tania MunirDepartment of pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Syed Faisal MahmoodDepartment of Medicine, Aga Khan University, Karachi, Pakistan.
Unab KhanDepartment of pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Badar AfzalDepartment of pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Farah Naz QamarDepartment of pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Jesse J WaggonerDepartment of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, United States of America.
Hannah FenelonDepartment of Environmental/Occupational Health Sciences, Family Medicine, Global Health, University of Washington, Seattle, Washington, United States of America.
Helene McOwenCenter for Emerging and Re-emerging Infectious Diseases (CERID), University of Washington, Seattle, Washington, United States of America.
Erum KhanDepartment of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan.
Peter RabinowitzDepartment of Environmental/Occupational Health Sciences, Family Medicine, Global Health, University of Washington, Seattle, Washington, United States of America.
Wesley C Van VoorhisCenter for Emerging and Re-emerging Infectious Diseases (CERID), University of Washington, Seattle, Washington, United States of America.

Funding

University of Washington Arboviral Research Network (UWARN)U01AI151698 · NIAID · UNIVERSITY OF WASHINGTON · PI Michael Gale, PETER MACGARR RABINOWITZ · 2020 to 2026
$13.3M
American Asian Centers for Arbovirus Research and Enhanced Surveillance (A2CARES)U01AI151788 · NIAID · UNIVERSITY OF CALIFORNIA BERKELEY · PI Josefina Coloma, Eva Harris · 2020 to 2026
$9.6M
NIAID NIH HHS U01 AI151698NIAID NIH HHS U01 AI151788
6 · The paper itself

Abstract

backgroundPakistan has been an endemic country for dengue virus since 1994, with a significant increase in cases reported in 2022 largely due to heavy rainfall and flooding. All four serotypes of the dengue virus (DENV) are present in Pakistan, with DENV 1 and DENV 2 being the most prevalent. The current study aims to explore the clinical presentations and features of dengue fever in a tertiary care hospital. METHODOLOGY: We enrolled and studied 349 cases of suspected and confirmed dengue presenting for care at the Aga Khan University Hospital in Karachi between June 2021 and November 2023. Collected data on cases included clinical symptoms and laboratory results including qRT-PCR and serotype characterization.

findingsThe majority of subjects enrolled (75%) had mild disease without warning signs, while 11% exhibited warning signs, 1.4% had severe dengue, and 12.6% had no dengue diagnosis. Patients with severe dengue (SD) had significantly higher levels of liver enzymes (AST and ALT) compared to those with non-severe dengue (NSD) (AST; p = 0.024 and ALT; p = 0.047). Additionally, a higher grade of thrombocytopenia was significantly associated with hospitalization (p = 0.0008), and prolonged illness (p = 0.03). Both Platelet (p < 0.0001) and WBC counts (p = 0.001) were significantly lower in dengue PCR-positive patients in comparison to Dengue PCR-negative. Among those tested for dengue serotypes, DENV 1 (34%) and DENV 2 (45%) emerged as the predominant serotypes, with mixed infections accounting for 17%. The sensitivity of q-RT PCR was found to be 87.25% and the specificity of 68.35%. qRT-PCR detected 43.5% of cases with viral fever initially screened negative by IgM or NS1.

conclusionThe epidemiology of dengue fever during a widespread outbreak in 2022 showed a predominance of DENV 1 and DENV 2 serotypes with milder phenotype of viral illness. Screening with rapid tests requires further confirmation by molecular assay in cases with dengue and dengue-like illness. The sensitivity of q-RT PCR using gold standard.

Indexed as

DengueDengue VirusAdolescentAdultChildChild, PreschoolFemaleHumansMaleMiddle AgedPakistanSerogroupSevere DengueYoung Adult

Identifiers

PMID40354421
PMCPMC12068610

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.