Dengue Reinfection and Co-infection: A Study of Incidence and Outcomes in Adults Admitted to a Tertiary Care Hospital, Karachi, Pakistan

Abstract

Aim: To determine the occurrence of re-infection and co-infection with dengue among the adult population in Karachi, Pakistan. In addition, to determine the frequency of various medical complications among dengue patients with or without co-infection and reinfection. And to identify possible risk factors associated with dengue reinfection. Study Design: Retrospective cross-sectional study. Place and Duration of Study: Department of Internal Medicine, Aga Khan University Hospital, Karachi, Pakistan, between January 2022 and August 2022. Methodology: A total of 500 adult patients aged 18 years or above; admitted with a confirmed diagnosis of dengue were included in the study. Information was collected regarding clinical and demographic data using structured questionnaire. Data was analyzed using SPSS version 25. Results: The current study reported an incidence of 3.8% for dengue re-infection and an incidence of 19% for co-infection among adult dengue patients. The most common clinical symptoms were fever, nausea, vomiting, and abdominal pain while bleeding, acute kidney injury, and nosocomial infection were the most common complications with a proportion of 10.6% (n=53), 7.8% (n=39) and 4.2% (n=21). The study could not find any statistical association between the socio-demographic factors and disease-related characteristics. Conclusion: This study determines a low incidence proportion of dengue re-infection and co-infection among adult patients admitted with a confirmed diagnosis of dengue infection at a private tertiary care hospital in Karachi. Bleeding, nosocomial infection, and acute kidney injury were identified as the most frequent medical complications among hospitalized dengue patients. The study did not show any statistically significant risk factors associated with dengue re-infection. Large scale multi-center studies are warranted with sufficient sample size and objective assessment methods to determine the incidence of dengue re-infection and co-infection as well as for the identification of risk factors associated with dengue re-infection among the adult population of Pakistan.