Risk Factors Associated with a Dengue Fever Outbreak in Islamabad, Pakistan: Case-Control Study.

Autor:	Mehmood A; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan., Khalid Khan F; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan., Chaudhry A; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan., Hussain Z; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan., Laghari MA; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan., Shah I; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan., Baig ZI; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan., Baig MA; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan., Khader Y; Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan., Ikram A; National Institute of Health Pakistan, Islamabad, Pakistan.
Jazyk:	angličtina
Zdroj:	JMIR public health and surveillance [JMIR Public Health Surveill] 2021 Dec 30; Vol. 7 (12), pp. e27266. Date of Electronic Publication: 2021 Dec 30.
DOI:	10.2196/27266
Abstrakt:	Background: On October 23, 2016, 79 dengue fever cases were reported from the Union Council Tarlai to Federal Disease Surveillance and Response Unit Islamabad. A team was established to investigate the suspected dengue outbreak. Objective: The aim of this study was to determine the extent of the outbreak and identify the possible risk factors. Methods: Active case finding was performed through a house-to-house survey. A case was defined as an acute onset of fever ≥38℃ in a resident of Tarlai from October 2 to November 11, 2016, with a positive dengue virus (nonstructural protein, NS-1) test and any of the two of following signs and symptoms: retroorbital/ocular pain, headache, rash, myalgia, arthralgia, and hemorrhagic manifestations. A structured questionnaire was used to collect data. Age- and sex-matched controls (1:1) were identified from residents in the same area as cases. Blood samples were taken and sent to the National Institute of Health for genotype identification. Results: During the active case search, 145 cases of dengue fever were identified by surveying 928 houses from October 23 to November 11, 2016. The attack rate (AR) was 17.0/10,000. The mean age was 34.4 (SD 14.4) years. More than half of the cases were male (80/145, 55.2%). Among all cases, 29% belonged to the 25-34 years age group and the highest AR was found in the 35-44 years age group (35.6/10,000), followed by the 55-64 years age group (35.5/10,000). All five blood samples tested positive for NS-1 (genotype DENV-2). The most frequent presenting signs/symptoms were fever and headache (both 100%). Stagnant water around houses (odds ratio [OR] 4.86, 95% CI 2.94-8.01; P<.001), presence of flower pots in the home (OR 2.73, 95% CI 1.67-4.45; P<.001), and open water containers (OR 2.24, 95% CI 1.36-3.60; P<.001) showed higher odds among cases. Conversely, use of bed nets (OR 0.44, 95% CI 0.25-0.77; P=.003), insecticidal spray (OR 0.33, 95% CI 0.22-0.55; P<.001), door screens (OR 0.27, 95% CI 0.15-0.46; P<.001), mosquito coil/mat (OR 0.26, 95% CI 0.16-0.44; P<.001), and cleanliness of the house (OR 0.12, 95% CI 0.05-0.26; P<.001) showed significant protective effects. Conclusions: Stagnant water acting as breeding grounds for vectors was identified as the probable cause of spread of the dengue outbreak. Establishment of surveillance and an early reporting system along with use of protective measures against the vector are strongly recommended. (©Amjad Mehmood, Fawad Khalid Khan, Ambreen Chaudhry, Zakir Hussain, Mumtaz Ali Laghari, Ijaz Shah, Zeeshan Iqbal Baig, Mirza Amir Baig, Yousef Khader, Aamer Ikram. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 30.12.2021.)
Databáze:	MEDLINE
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